Why Shrinks Don't Blog

Moviedoc writes:
The fact is, though you claim your blog is for psychiatrists, my impression is that few of us participate in any blog. What stops them? Snobbery? Hubris? Ignorance? Apathy? Fear?

I'm going to go out on a limb here and make a guess as to the top reasons why shrinks don't blog. But before I start my countdown, let me say that when I started Shrink Rap, 4 years and 7 months ago, I thought I wanted a blog for psychiatrists--- and suddenly lots of people came along for the ride-- other mental health professionals, other non-mental health professionals, and plenty of patients, as well as some random interested parties. We've Loved having Everyone. The funny thing is, we've learned a ton from our patient readers, and I wouldn't change a thing. A blog by psychiatrists for anyone who wants to listen to us.

So why don't all Shrinks have Blogs???

10. Many shrinks are busy struggling to earn a living and keep up with their family obligations. As the ABPN implements expensive and time-consuming re-certification requirements, this promises to make shrinks more busy. And as more and more agencies expect their psychiatrists to see 20-50 patients a day, shrinks may be even busier. Educational debts in the realm of $200K or higher are not helping.

9. Some shrinks like to spend their free time thinking about something other than work. The three of us don't seem to be in that category of peoples.

8. Psychiatrists have traditionally been taught that part of their work entails some secrecy about their personal lives and that the details of their lives should not be shared with patients. This creates some hesitation about blogs and Facebook and social networking.

7. Psychiatrist may fear being stalked by dangerous patients.

6. During Medical Board investigations, information about the psychiatrist that is easily located on the internet may be used as evidence that a psychiatrist is impaired or inappropriate. Has this happened? I've no idea.

5. Medical blogging is still seen by some as being on the fringe and not as valid a form of communication as peer-reviewed journals.

4. Remember Flea [link to Nov 2010 interview on Science Roll]? The perception is that people who blog set themselves up for bad things. Flea was a pediatrician who blogged about his malpractice case--he ended up settling the case and having his story appear on the front page of the Boston Globe.

3. Psychiatrists worry that patients won't like that they blog.

2. Blogging doesn't pay. While Roy has monetized our blog with Google Ads, we're talking about something along the lines of $100-$200/year.

1. Psychiatry is a profession that centers around intimacy, privacy, and confidentiality and a blog is a very public thing where boundaries might be breached (this from my non-shrink husband).

If you're a shrink and you don't want your own blog, you're always welcome here at Shrink Rap as one of our many anons. We're happy to have you.

The Shrink Next Door

This is our 600th Post!
Lately my neighbors have been apologizing to me, which feels a little bit weird. We'll have brief (OK, sometimes not so brief) conversations and they end them by saying something to the effect of, "I'm sorry to chew your ear off," or "I know you're off duty, so I'm sorry about that," or words to that effect. They know I'm a psychiatrist so I guess they think they're burdening me when they do the normal problem-sharing thing that goes along with being a friendly neighbor. Now, it's possible that I get more than the usual share of mental-health related problem sharing because they know what I do for a living. And it's true I know lots of stuff about who in the neighborhood is on which medication, or who would never in their life take that particular medication, or who is looking for a psych referral (I give them names but they rarely follow through), just because of what I do for a living. But it doesn't feel like they're burdening me. I like my neighbors. I've never had a bad one, and that's pretty unusual considering how long I've lived here.

That being said, I can't say that I've ever gone to my mechanic neighbor for car advice or to my hair stylist neighbor for coloring advice (although Dinah probably thinks I should) but that's not because I don't think they'd help me if I asked for it. It just never occurs to me to ask. It is nice to know though that any one of those folks who apologized to me for "problem dumping" would be just as quick to listen to me if the tables were turned. That's just being a good neighbor.

Persona Who?

When I told a told a friend (ah, Clinkshrink) I was going to start a blog, she said,"Your patients will read it!" Is this a problem? My first thought was: I have a novel out there that opens with a mental health professional stumbling upon her cross-dressed husband, how much worse can it get? True, most of my patients haven't stumbled upon my novel, and so far, none of those who've read it have fired me. It's a funny issue though, being a psychiatrist, trying to maintain some neutrality for the patients-- I'm not a psychoanalyst, but I do keep things fairly neutral both because I think my personal affairs would be a distraction in therapy, and because I want my privacy. There are no pictures of my family displayed, and so far the most self-revealing thing I've done is to put a Red Sox cap on the table in my waiting room the morning after they won the World Series.

On the other hand, being a writer is a somewhat public event, at least in brief spurts. Google has changed everything, and some of it beyond my control. I've googled me (as have some of my patients) and I'm in a bunch of places, including tied to a faith-based site called Psycho-babble run by Dr. Bob--- It's not me, but another EM, there are a few of us out there. I'm trying to figure out how to be the EM's who's listed in Who's Who in London.
So, I guess my patients can unearth what they want, and I will admit to the Red Sox fan stuff, even the novel with a transvestite, and the Op-Ed rant about Malpractice Reform. Still not certain what I'll write about here, I don't plan to talk about my patients in a disrespectful, disparaging, or revealing way.

Finally, I'm left with the question of Is This Wise? for vague reasons...perhaps even Is This Safe? Other doctors seem to vary with how identifiable they are on the Web, and I haven't found another psychiatrist blog that isn't anonymous. Maybe there's a reason, maybe I'm missing something here, and should mask my identity. Tell me what you think...