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I’ve been doing this for nearly three years.  I obviously enjoy having a blog and have found it a chance to use some of my previously-hidden talents to some good.  I suspect there are some readers who are wondering quietly to themselves if they should start a blog and others who are doing so but aren’t sure they will continue.  So here is some advice I have from my own experience.

Here are some reasons to blog:

1. You like to write.  This is a must, as that is the medium for blogging.  That writing doesn’t have to be perfect.  My writing three years ago when I started wasn’t nearly as refined as it is now.  Some of your learning has to happen by putting things out there and seeing if they fly.
2. You have something you think others want to hear.  Some people claim that they don’t blog with their readers in mind.  I think this is ridiculous.  If you don’t care about readers, then keep a journal.  Blogging is about communication, which involves two people (or more).
3. You have passions about things.  The long-haul of blogging is only maintained by those who have more than just “I want to” as a motivation.  I need to communicate things.  I feel nobody gets to hear what “Joe Doctor” has to say – the primary care doc in private practice.  That passion gives me much of my staying power.
4. You have thick skin.  Since you are putting what you write out there, it will be judged.  That judgment is not always friendly.  I have had some people who are outright hostile, but most of my criticism comes in the form of yawns.  Putting a post up that nobody comments on (especially one you thought was good) is a hard thing.  Yet that happens a good amount to even the best of bloggers (so I have heard).
5. You have something to add.  Don’t try and copy anyone.  You may borrow (which all writers do), but you must forge out your own style and your own niche.  When I started there were far fewer medical bloggers, so the place for a somewhat deranged primary care physician who likes llamas was still available.
6. You are committed.  I write 2-3 posts per week, each usually taking 1-3 hours to write.  Sometimes I can zip something off with inspiration, but usually there is a lot of self-editing.

Don’t think that there is much money in blogging.  I have made a little bit, but my hourly wage from this would be equivalent to the wages earned by a Hungarian peasant in 1930.  You don’t do it for the bucks, you do it for the love of doing it.

If you are wanting to give it a go, here are some tips:

1. Put good stuff out there first.  Don’t first try to get readers or links, first write good stuff.  If you write well, you will eventually get noticed.
2. Read and comment on other medical blogs.  Part of the joy of medical blogging is the community we have among the bloggers.  They need to get to know you and the only way to do that is to make that happen.
3. Link to other people’s blog posts in your posts.  I see when other people mention my blog, and usually go over and read it.  Most other medical bloggers do the same.
4. Don’t hide booby-traps in the posts that will cause your readers’ spleens to enlarge.  That’s just bad style.
5. A Blogroll or list of other med blogs is most important early on.  I have a hard time keeping up with it now, but since I have a steady readership I do OK.
6. Submit quality content to grand rounds or other med blog carnivals.
7. Be very, very, very nice to Kevin, MD.
8. Consider hosting a carnival as well – but I don’t recommend doing it until you have submitted several times and have established yourself.
9. Twitter.  Lots of people read my posts now as they are fed to Twitter.  Other people like my goofiness on Twitter and go read my blog.  That is not my intent while on Twitter, but it is a nice side-effect.
10. Wear deodorant.

My personal process is different from other bloggers.  I write most of mine in one long sitting and generally do so when inspired by something.  I do roll ideas around in my head (there is a lot of room for things to roll), and have a number of half-written posts, but my best stuff comes out of passion.

I also have several types of writing I do within the blog (which I think is important), including:

• Issue-oriented posts – mainly on issues that affect me directly in the office.  I want people to see how specific issues impact physicians like me.
• Healthcare issues – Medical issues/controversies come up and they are good fodder for posts (as long as they fall within my realm of expertise).
• Posts about people from Idaho named Jim – I have yet to do one of these, but plan to do a series of about sixty.
• Rants – I try not to do too many of these, as they make me tired to read too often.  I think the rest of the medical blog world does far too much of this.  But you can’t work in healthcare and not rant at times.
• Education – I probably enjoy this area the most (at least it is the easiest to write).  The series on the physical exam is an example of this.  There is much more latitude with teaching, and so I weave much more humor into these posts than other types.
• Posts that smell like baking brownies.  People like that sort of thing.  It really attracts readers.  Popcorn works OK, but the people over at Boing Boing complain about it a lot.
• Personal – Life sometimes hits the emotions hard – often in the exam room.  It is dangerous to get too personal, but I think people want to get to know you if they are going to commit regular time to read.
• Fun – Some stuff is just goofy fun for your readers.  I think this builds your community.  Having inside-jokes (like llamas) or other things that make coming to the blog a change of pace is something I have always emphasized.  I think it takes me off of the pedestal (or soap box) and makes it more like I am just having a good time with my readers (which I am).
• Lists with great big dots in front of each point.

This hasn’t really been a conscious plan on my part; it just kind of happened.  I am still figuring out new types of things to write.  The bottom-line is, however, that I am myself and am writing because I like to write and like my readers.  I do write for myself, but I am most gratified when I write something I like and others like it as well.

Blogging has really changed my life.  I know that sounds a bit corny, but I have whole new set of friends, a time-consuming hobby, and have actually gotten some fame out of blogging.  It’s a great medium in which a writer has direct interaction with the readers – no other media type has that.

Do I recommend it?  Yeah, but only if you are up to it.