It was a "Law & Order" moment last year when Massachusetts pediatrician Robert P. Linderman admitted during cross-examination that he was the blogger known as "Flea."Â While defending a malpractice suit involving the death of a 12-year-old patient, Dr. Linderman had apparently been writing a blog that criticized the plaintiff's attorney and revealed the defense strategy in a case remarkably similar to Dr. Linderman's. Â The case settled shortly after Dr. Linderman's admission in court that he was the blog's author.

It is estimated that hundreds of physicians currently blog on issues ranging from medical practice and technology issues to the state of the health care industry. The content ranges from scholarly discussion to vituperative rants. Dr. Linderman's case demonstrates one danger of physician blogging, but there are others, most notably HIPAA and medical privacy concerns.

When a physician discusses a case in a blog entry, it may constitute a disclosure of protected health information ("PHI") in violation of HIPAA. Blog postings containing patient-identifiable information generally will not meet HIPAA's exceptions for permitted uses and disclosures of PHI.  Even a seemingly "anonymous" discussion of a patient's case may violate the HIPAA Privacy Rule if it includes details such as (i) the city in which the patient lives; (ii) admission date; (iii) discharge date; (iv) a full-face photo; or (v) "any other unique identifying number, characteristic or code."

Blogs tend to foster unfettered and spontaneous discussion, but for physicians that is just the sort of thing can lead to irate patients ... and HIPAA violations.Â