Creating Community
The HCBE has gotten more press recently. First off, we have had many more blogs sign up and display the logo for the code of ethics. Some notable additions include: Junkfood Science, Diabetes Mine, Emergiblog, and Shrink Rap. If you haven’t done so, please look over the growing list of links. There are some sites that I found out about through their submission, and they are really great. Thank you for all who have joined.
Second, there was a very compelling article in MDNG discussing the ethics of blogging. The discussion centered around the ethics codes that currently exist, including the HCBE.
Thus begins the debate about whether medical blogging should be more carefully policed?having a moral standard and ethical code by which it can be monitored. Cue the Health On the Net?s (HON) Code of Conduct for medical and health websites, and the recently compiled Health Care Blogger Code of Ethics (HCBE), which has been garnering much attention on the Web in the last month or so, popping up in articles and blogs everywhere.
David Harlow, former president and current chairman of the Metropolitan Boston Emergency Medical Services Council, and founder of The Harlow Group, LLC, has recently touched upon the issue of these ethical codes on his health care/law blog appropriately titled HealthBlawg. In regards to the Health Care Blogger Code of Ethics (HCBE), Harlow writes, ?Truth is, I?m not sure there?s a need to reinvent the wheel. HON?s code, for example, includes the HCBE principles and is similarly free and self-enforcing (or, rather, community-enforced). It also clearly requires an up-front assessment, which HCBE hasn?t clearly committed to requiring.?
When asked to elaborate on what he perceived to be the differences between the two sets of codes, Harlow stated, ?The [two codes] are reasonable and consistent with each other. Third-party certification, a la HON, may be overkill for bloggers, but the question of the moment is whether it is reasonable to expect self-policing (or peer-policing, a la the bloggers code) to work in the blogging space, especially among anonymous bloggers.?
I posted a response to this, but it did give me cause to consider if we were actually doing enough. The way that I view this code is that it is a community standard to which we have all agreed. We as bloggers have made this standard and I think it represents well what most bloggers hold to in terms of the ethics of their blogging. I think this is what makes this different from the HON code, which is much more oriented toward doctor bloggers, requiring references, etc. Plus, it is administered by a separate organization, where the HBCE is run by the bloggers themselves.
Yet it does run the risk of getting a little top-heavy. I have been doing my best to represent the best interests of the other bloggers holding to the code as to keeping the blogs desiring to display the code to the standards it contains. To do so, I have done several things:
- I have changed the application process to specifically ask if people adhered to each of the principles of the code. This will cause people to think twice to apply if they do not comply with the code.
- I have had a number of people help me out whenever I had questions about a certain blog, most notably Amanda (from It’s About the Walls), Dean (from Rebuild Your Back), Val (from Dr. Val and the Voice of Reason) and Walter (from Highlight Health). Thanks so much to those people (especially Amanda - whom I have called on the most) for the help.
But I wonder if we should do more to create community. It would be very nice make this code like a co-op. The idea of a co-op is that all who benefit from it help to maintain it. I have called on Amanda and Dean so far to start posting on the blogging gallery (and they have done great), but I think we all should take part in making sure the sites being added are up to the standards that we hold.
Do you think that forming a list-serve or Yahoo Group would be worth doing? I would love to be able to send a note to all those who post the HBCE when a new site has applied. Then if nobody has serious objections, I can send the HTML for the widget. Or, if I need someone to write for the Gallery, I can just send something on the List Serve.
I want this to become a community of bloggers with a means of communication. Are you all in favor of that? I still intend to be the “keeper of the code,” but it would be nice to have a better defined community.
Comments?
22 Responses to “Creating Community”
said on August 25th, 2007 at 4:53 pm
I may be off base here; perhaps I don’t fully understand all the issues. But I have a slightly negative reaction. I’m more than fine with the HBCE that we have, and am happy to have included it on my blog. But at some point I sense the possibility of going overboard. What I mean is that blogging is personal, and, at bottom, singular. I agree there are and ought to be ethical considerations; but if I go too far, it ought to be my problem, and my liability. It’s good to be aware — and I suppose there could be some healthcare bloggers who aren’t. Yet taking it to a level of some sort of communal policing seems too much. And there’s this (probably off-base) question. If there becomes a group of some sort, might it carry with it a group liability? Probably not. But it seems to me it’s more than fine to have the code and to subscribe to it; but maybe more than necessary to go much further. I’m quite open to considering it from other points of view. I really haven’t thought about it more deeply than this comment. Plus, in my case, I think I’m about at the end of the useful life of my blog…
said on August 25th, 2007 at 4:59 pm
Rob, you know you’re welcome to call on me anytime (assuming I’m not at work and expected to, like, do job-related stuff). And thanks for the shout-out!
I think a Yahoo group would be worth doing, but I shall, as usual, bow to those who are ultimately more affected by the primary focus of the group.
said on August 25th, 2007 at 5:24 pm
I think you’ve raised some good ideas here.
1. I like the idea of every member having a vote (or a chance to voice an opinion) on new submissions before they are accepted. We’re a large enough group now that we should be able to get a good cross section of opinions.
2. A community-based means of communication is also an interesting idea. A Yahoo group is one possibility. An onsite forum is another.
Dean
said on August 25th, 2007 at 5:50 pm
Creating a group would make it easier for members to communicate with each other if the need arises.
I would suggest consider using a Google Group http://groups.google.com over a Yahoo one.
An online forum would have it’s own merits, but I think would be the next option.
said on August 25th, 2007 at 6:44 pm
I am still developing my blog, so cannot yet meet HON’s requirements. It’s just a matter of time and diligence.
As a consequence, I see the Blogger’s Code as an additional layer of certification.
However it is difficult to police and probably an indication of intent and goodwill more than a meaningful certification.
Group works fine…
said on August 25th, 2007 at 9:39 pm
I am in agreement with Sid.
said on August 25th, 2007 at 10:14 pm
The idea of getting a chance to vote on each new site up for admission is an idea worth considering. I don’t like the idea of policing sites. There will always be the questions of where and when to start, should we check sites after they are able to display the logo (could be very time consuming as well as invasive) What requirements can we put in place to discourage those who might abuse the privilege? Wouldn’t it be better to have these requirements in place before giving out the code? Maybe we could do a before and after vote. Vote to let them have the code (or not) and then vote yearly on whether or not they(we) are adhering to the code we have all agreed upon. This would be time-consuming and would only probably work if the yearly vote was completely random and the date known only to the keeper of the code….um, er that would be you, Dr. Rob
Anyway, just my two cents.
said on August 25th, 2007 at 10:28 pm
I like the idea of a Yahoo Group, but my concern would be that as more and more bloggers joined, fewer would feel responsible for actually checking out new blogs. As in, someone else will check that blog, I don’t have to do it. Otherwise, I’m happy with the code as it is.
said on August 26th, 2007 at 12:15 am
Interesting issues. As a physician, I am already bound by a certain code of ethics, and I’m not exempt from it online.
said on August 26th, 2007 at 8:59 am
I think a Google Group would be the right choice and you could always ask the other bloggers about new blogs that desire to display the code. As this should be a community of bloggers, then the community should play an even more important role in deciding whether a new blog could get the code or not.
HONcode and this code could both exist as the first one is a third party organization; but we should be a real community who can determine an other blog’s value.
said on August 26th, 2007 at 11:16 am
Well, I have two sets of thoughts on the issue. The first is a thought on group process (my psychiatrist side). The second is on the procedure side of undertaking this task of reviewing sites as a group (my geek side).
I agree with Dean that we should all have a vote, or rather, a “say” or a voice in accepting new blogs. It is not fair to leave it to 1 or 2 or 3 people to do this work, unless it becomes a business enterprise and those few benefit financially. Otherwise, we would all benefit while only a few people take the risk and do the work. Thus, a fundamental assumption is that we are a community, not simply “users”. That entails some shared responsibility. I think we mostly agree that this should not be a heavy-handed, let’s vote Val ::wink:: off the island sort of deal. On the other hand, would good is an approval process and guidelines if there is no method of dis-approving and sanctioning? We also need to be aware of natural group process and limit the tendency for some to “vote” against a “competitor”. (That may sound silly, but I assure you that, over time, if this code becomes more widely adopted, this will become an issue.)
So, here’s my techie comment/suggestion. I don’t like the idea of yet another listserv to clog up my email, but an online forum, like Google, Yahoo, etc, seems much preferable. You might also think about putting it onsite, using something like the free, open-source, phpBB (eg, medbloggercode.com/forum), which is pretty easy to implement (not sure if Wordpress has a plug-in that can do the following, but there are plug-in modules that link to phpBb (here, here). The advantage to that is that you have more control over how it is set up. Why is that important? Here’s my idea… set up a forum that has three areas:
(1) General discussion
(2) New applications
(3) Current members
In #2 and #3, each blogsite gets a single line (”topic”), so that all discussion about, say, Shrink Rap, would be contained in a single topic, not spread all over the forum. #2 & #3 would be set up so that only Rob or a handful of “administrators” would be responsible for *starting* the topic when a new applicant comes in, but then any of the current members (all bloggers who currently display the code).
Then, in #2 (New Apps), all of us would get a mass email sent out by the forum software, alerting us that there is a New App. We would have some period of time established (1 or 2 weeks?) to review and comment on the site. Unless it clearly doesn’t fit in (as defined by the group, and guided by the …umm… guidelines), an administrator would then *move* the topic from the #2 area to the #3 area (Current Members). I guess if there were ambiguity, we could take a vote, which the software makes very easy to do.
In #3 (Current Members), there remains a single topic for each member. The list can be sorted alphabetically or by most recent posting. Here’s where the co-op part comes in. The idea would be to periodically make a comment on someone’s blog topic. Over time, each blog’s topic will get a few comments, confirming continued meeting of the guidelines or raising questions, when appropriate. Since these can be sorted by last comment (which is the default), then those who have not be commented on for a long time can easily be identified, so that there is continuous review of sites. That would allow us to say that this is a self-governing group (”policing” sounds too authoritarian for me). Since all the comments are in the open and not anonymous, it limits some of the games played when folks can comment anonymously.
The General Discussion area would be for less structured discussion about guidelines, or whatever, and (perhaps) could be open to anyone, even “non-members”, so that ideas remain fresh and challenged and that the groupthink does not become too inbred.
I know I’m getting real specific here, but if this is gonna work well and be self-sustaining, without Rob and others getting burnt out, I think we need to have a plan.
What do y’all think?
said on August 26th, 2007 at 11:29 am
Alright, let me throw back my thoughts.
First, I have no desire to police any more than you guys do. I have too much other things to do. Yet I feel awkward being the main one to give thumbs up or down to websites without getting some feedback from the users. This would certainly be voluntary, but I just want to feel I represent people well, since they are putting the code up on the site and some of the meaning of a code of ethics is reflected in who is allowed to display it.
Second, I would like to say that Berci stated my feelings exactly on the difference between this code and the HON code. This is our code and I would really like it to be something that we don’t just put up on the site, but actually believe has value.
Finally, I would like to thank Roy for his suggestions. I have actually looked into exactly that, because my web hosting company does allow me to add a forum, and phpBb is one of the ones I looked at. My main hesitation of doing that is that it is “just one more thing” for people, and that is why I e-mailed to get the general idea of what is going on. I can send a newsletter out regularly, but that is a lot of work and (as Roy stated) I will probably eventually burn out on it. So I think a forum is probably best, and I will work on it a little (maybe get Roy involved, since he seems to have the propensity for that kind of thing).
The nice thing about the application forms is that I can forward the results to whomever I want. So eventually this thing could be self-sustaining and not take a huge amount of effort on any one person’s part. That is why I entitled this post “Creating Community.” I think we do have a community already, but we need to have a forum on which to discuss these issues.
Well done, people. I am greatly encouraged by your comments.
said on August 26th, 2007 at 12:21 pm
Okay, to make it more concrete, I set up an example forum HERE. It took me 5 minutes to set it up, 5 minutes to set up the 3 areas, and 15 minutes to populate the areas.
said on August 26th, 2007 at 1:22 pm
I agree with the member who accurately points out that professional members of this HBCE already ascribe to their profession’s code of ethics. I think that adherence to one’ respective code of ethics should remain sufficient. If a more structured community were to form I would be interested in participating. This would allow us to share resources and information. I like MyBlog Log and Google groups as potential venues.
said on August 26th, 2007 at 3:57 pm
[…] Creating Community (Healthcare Blogger Code of Ethics): it should be a real community that can determine an other blog’s value. […]
said on August 26th, 2007 at 5:23 pm
I agree with Sid (hope he really isn’t on the way out of his blog, as I really enjoy it. Found it too late, if that is the case). I also agree with Roy (I have enough in my inbox now). I agree with PalMD–my physician ethics/standards don’t stay in the office. I have found that I enjoy reading and writing in the blog world, but I have only so much time and don’t always manage to stay up. So as more blogs get added to the HBCE, I know that I will not be able to visit them routinely. I am willing to visit a certain number (maybe assigned randomly as we grow so it’s not like the playground and some weren’t picked), but please don’t expect me to visit all on a daily basis. Thanks for allowing me to be part of the community.
said on August 27th, 2007 at 11:03 am
I like that the net of the HBCE includes patients/patient’s moms. What I like about the code/idea of community is that it can encourage shared perspective and mutual accountability (at least a little bit).
It’s good to encourage everyone to think a little before they post something — I believe that a patient, like a doctor, should post carefully and believe that the HBCE stands for not carelessly trashing someone’s reputation. I’d like to think that opting to post the HBCE will mean some thoughtful and quality material will be available for looking over, at least intermittently — that could be me being a little dreamy and naive though (flaw/gift of the Pisces).
said on August 29th, 2007 at 8:39 am
When you look at the long list of blogs on this site now, it is clear what we have created has value! Blogging is different that web development which makes a blogging code of ethics by definitition different than the HON code. There are many similarities between blogs and websites but the differences are not sublte nor at all small. The fact that blogs are very opinionated and often represent ideas and concepts bring to light very different ethical issues than websites. And, the community aspects are much more real in the blog world.
So, as others have stated, I feel strongly that our code is important and needed and serves a very different role than the HON.
I’m all for a google or yahoo community and like everyone else feel a community/group vote for new submissions makes the most sense, and is in the best spirit of what blogging is all about. I’ve never been comfortable with the idea of policing but do like the idea of inclusion and acceptance.
Criticism always comes with treading into new waters which is what we have done. Sticking together and letting others know what this code is about is the only way to improve the blogsphere in the healthcare niche and keeping it clean and with the highest integrity possible, which is what we are all after.
Finally, I also like the idea that we are including all aspects of healthcare because that broadens our sense of community.
said on September 3rd, 2007 at 11:19 am
My comments are similar to those above: not too keen on “policing” but big on being a community to help vote for new submissions.
Question: what if some members say yes and some disagree? Who will be the deciding panel?
said on September 3rd, 2007 at 5:34 pm
Kim has raised a valid question here:
The following are my personal opinions and do not reflect the opinions of the HBCE:
Currently, Dr Rob makes the final decision on inclusion. This seems to be working pretty well, so far. He is being extremely fair and impartial and his efforts have been to include as many bloggers as possible.
Perhaps we will eventually need to form a panel for arbitration, but I think that’s something we can address as a community if a dispute ever arises.
My personal opinion is that the vote should be almost unanimous for a blog to be included. Most of the quality medblogs that we’re all familiar with will have no trouble achieving a unanimous vote.
For a blog to receive a large number of negative votes would mean there was a very real problem with that application.
Since the voting is done in the private members-only portion of the forum — dissenting votes can (and should) be accompanied with a forum post explaining why the blog should not be included. Additional discussion can then take place as an integral part of the voting process.
BTW, Roy (of Shrink Rap) has gone above and beyond the call and set up the forum and members can register and start voting now. Sign up and cast your votes for the applications currently under consideration. Only by trying it out and seeing how it works, can we determine what changes are needed.
This is a great question and one of many that will probably come up as we move forward with this community-building project. I’m sure Dr. Rob would agree, we’re sort of “learning as we go” with this thing. Any and all ideas are welcome as to how we should address these growing pains.
Let us know what you think concerning Kim’s (and all of the above) questions.
Dean
said on September 3rd, 2007 at 5:46 pm
Thanks both Kim and Dean. I would say that 90% of the blogs are obvious one way or the other. It is those blogs that are in the gray area that are trouble to figure out. I would say that I am planning on putting every blog on the forum for a bit just to get comments. Obviously I did not run Emergiblog by anybody because I know it quite well and it obviously conforms to the standards. On the other side, there were a few blogs that I thought were off, but wanted other opinions. From here on, blogs will run by at least those who care to go to the forum. If there is significant disagreement at that point, we can put it out the the entire community. Sounds good?
said on September 4th, 2007 at 11:34 pm
health care blogger code of ethics is an interesting idea.. i am considering using it/displaying it on my website. ethics is a very important topic in health and medicine so i think it is entirely appropriate to take this issue seriously
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