Googling, blogging and flogging
While the medical community debates the merits of “Googling for a diagnosis” at the British Medical Journal (for real!), another internet-related medical article appeared in the journal Lancet. Dr. Ivan Oransky, deputy editor of The Scientist and editor-in-chief of Health and the Media, wrote a thoughtful piece discussing the often hidden agendas of disease-oriented blogs. Since bloggers are not always experienced journalists or bound by professional journalism ethics, he wrote, they are free to accept funding from special interests, such as pharmaceutical companies, whose products or services they might go on to write about or promote on their sites. Many scientists and researchers would dispute that professional mainstream journalists are wholly objective and uninfluenced by agendas, beliefs, advertisers or special interests. Even the editorial content of professional journals has been riffe with some questionable ethical conduct and conflicts of interest.*
In fact, bloggers may actually be more able to work independently, question and speak out more freely and thoughtfully, and be less encumbered by constraints of parent companies. The very best blogs and bloggers are those with integrity; have reputations as sources for credible and trustworthy information; honor copyrights, give accrediation and refrain from advertiser-driven copy just as other publishing venues; and are working via the internet to help balance the marketing and politics pervasive in today’s mainstream media. And, sure, there are also quite a few blogs that are openly selling things, promoting businesses and advocating various campaigns and beliefs.
But Dr. Oransky makes very valuable points. It’s the blogs that don't disclose their conflicts of interest and appear unbiased, but aren’t, that are especially insidious. And few surfers realize just how prevalent the problem is.
The blog world, like the entire internet, is being actively used by companies and special interests for covert marketing. The varieties of techniques and the terminology seem to be evolving as fast as internet viruses. What were once crude “splogs,” or spam blogs, have evolved to “flogs,” or fake blogs with legitimate-seeming content. And then there are varieties of “flogging blogs,” people being paid to post about a product, service or agenda on blogs. While pseudo-identities are common on the internet and the internet is like the Wild West when it comes to snake-oil salesmen, not owning up to the fact you’ve been paid to make a blog post seems especially unthinkable. But it’s become so rampant, that Michael Bloch at Taming the Beast has uncovered several online marketing companies devoted to finding bloggers for advertisers. Apparently, there are a lot of bloggers happy to say anything for a price.
Special interests hire marketing professionals who are expert at using the internet, creating internet identities, steering online discussions, moderating and filtering out negative or critical information, and manipulating emotions in order to sell for their clients. But floggers aren’t always paid directly and may also be organized groups simply with shared agendas, special interests or beliefs. When they do their work well, they can completely take over a group and shape opinions.
“Direct to consumer” marketing in healthcare is increasingly done through patient and advocacy groups which can often be more influential than regular advertising. Blogs and internet groups have proven perfect venues for this tactic. By creating online communities; empowering consumers, patients and believers to help one another; and appearing homegrown and grassroots, blogs and internet groups have become especially powerful sale vehicles. And the source of the sponsorship is rarely recognized by most participants. Nor do most ever realize just how cleverly they’ve been manipulated.
While Dr. Oransky didn’t know of any “Astroturfed” medical sites, examples can probably be found in virtually every health, nutrition, and treatment modality out there. Among Yahoo Groups are 7,648 devoted to alternative medicine; and just among the 35,717 Yahoo Support Groups are 4,242 for weight loss, 891 for weight loss surgery and 590 for obesity. Clearly, there’s a wide open field of opportunity for companies.
With obesity and weight loss concerns ubiquitous today, conflicts already appear widespread in weight loss surgery and diet support groups, message boards, forums and chat rooms, which are often supported, hosted and/or moderated by weight loss, pharmaceutical and bariatric industry interests. The members-only groups are more vulnerable to manipulation, as these intimate groups are less publicly visible or accountable. In some instances, the hosts and moderators may be true converts who believe in what they are promoting and may or may not be even aware of their own biases; other times the moderators are marketing professionals. Not surprisingly, the focus for many of the bariatric sites are to keep prospective patients motivated and help them get insurance approval for bariatric surgeries. They sell false hope, and the exclusion of nonbelievers and contrary information leads to cult-like devotion among the members. The information at many of these online portals is largely provided by the bariatric and weight loss companies and paint overly optimistic pictures of successes of whatever they’re selling and downplay risks. And, just like the disease blogs that Dr. Oransky mentioned, their educational missions are often to sell the “diseases” and exaggerate the magnitude of the “problems” of “obesity.”
It really behooves us to be skeptical. Before we make any health decision, it has never been more important to take a step back, read opposing viewpoints and evidence, and think critically.
Let's be careful out there. If something sounds scary or too good to be true, our emotions are being played, not our brains.
* For example, the blog Clinical Psychology and Psychiatry: A Closer Look recently called attention to “sponsored editorials” in professional journals.
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