How do you deal with medical blog comments?

No Comments?

In No Comments Pushback, Russell Beattie writes why he stopped allowing readers to comment on on his blog:

The bottom line: "I’ve repeated from the very beginning in response to all sorts of criticism over the years, I will publish this weblog how I want, about what I want and you read if you want. That’s it, very simple."

Two years later, Russel turned on (and then turned off) comments once again: "The comments lately have been especially bad, so I just got rid of them all together... I mean, one moron recently suggested that I *delete* the post he was commenting on."

GruntDoc had a similar moment but then he switched the comments back on.

My Opinion

I regularly delete comments if I find them offensive to other readers or commercial rather informative in nature.

Most bloggers think of their blog as a personal space but at the same time, this space is available to the public and you want other people to visit it, right? Very few people write a blog only for themselves, admit it...

Two Schools of Thought

You have to strike the right balance between letting other people using your blog space and maintaining its original purpose.

Some bloggers, like Jacob of DocNotes, let comments stay in moderation for a while before they appear. This takes away the instant gratification of seeing your comment under the blog post and it reminds me of the journal peer review process. This is one approach and it's not bad.

Others, like Kevin, M.D., let pretty much any comments appear instantly which, I think, adds to the unique experience of reading Kevin's blog. He has short posts with a line or two of his personal opinion and 20-40 comments from different points of view (Note: Kevin has modified his blogging style since this post was originally published in 2006). The comments often dwarf the post but you get a fair idea of what the blogosphere thinks of a particular issue. See what Kevin has to say about the comments on his blog: A word on comments.

A NYTimes blogger writes about his virtual friendship (?) with a commenter on his blog:
There is a serial commenter on my blog and others at The New York Times, “Mark Klein, M.D.,” an older, accomplished gentleman with a lot of opinions and time on his hands. He can be a bit of a crank, politically incorrect to the point of provocation, and yet he always writes as though we are friends.

And maybe we are. A week ago, he posted a note saying that he was traveling to Israel and that I wasn’t to interpret his sudden silence as a sign that he’d lost interest in me. As if I cared.

Except that I did. I sort of missed him.


Feel free to comment. Comments are part of what makes blogs living organisms and we don't want to kill that, do we?

Consider adding a commenting policy to your blog and you can use mine as a draft:

Commenting policy

This web site has an open comment policy. All reader comments that are offensive to other readers will be deleted. Spam comments and those that are commercial rather informative in nature will be deleted.

Comments from Twitter

@SeattleMamaDoc: Rarely censor. Delete only if they are mean/off-topic/commercial


Comment Spam Discussed at Northern Voice. Scobleizer.
Guidelines for comments. Matt Cutts: Gadgets, Google, and SEO.
Dealing With Haters. YouTube Blog.
24-Hour Newspaper People. David Carr.
Bored with my blog. Russell Beattie’s Weblog, 04/2008.
The Day I Was Flamed At My Blog (And 7 Steps To Handle Flames With Grace). ProBlogger, 2010.
"Turning Off the Comment Demon" - Newspaper site requires credit card number to post a comment, no comments since then.


  1. I do not think any blog that does not allow comments can be taken seriously. This clearly signifies someone who pushes an agenda (of whatever kind) and cannot be trusted.

    Comment moderation is even worse, as it implies an ideological filter. It is not needed since spam can be deleted with automated tools.

    If you are afraid to be challenged, become a preacher, not a blogger.

    But some still do not get it.

  2. I guess that one reason for stopping the comments it's the abuse for the sole purpose of "getting a link".
    It's not about "i have this oppinion regarding the subject you're talking about". It's more like getting a lead to improve your search-engine results.
    Btw: Russell's option to stop comments might be a good one for him (due the massive amount of comment-spam that he receives).
    Still: if you have the time and you're really interested in starting a dialogue with your readers, having comments enable it's a must.


  3. Actually, all comments have a "no-follow" in the HTML code which makes leaving a comment almost useless in improving the search engine ranking of the commenter's website. That was the reason why the search engines agreed to implement the "no-follow" link protocol in the first place.

  4. my bad
    Thanks for the lesson :)
    (agree, it's better to know it later then never, but that doesn't excuse my mistake).
    Anyhow, i'm still persistent in my ideea that comments are good as long as they're not taking all your time to moderate them.


  5. I do love reading the comments and for the most part I think all comments should stand.However, when you have a BLOG you also have some sense of responsibility to atleast put forth some effort at monitoring your own site.

    For some it becomes an issue of "Quanity vs. Quality". If someone is getting 40-60 comments on one post then that must mean he has a REALLY good BLOG. But, if the quality of those comments deteriorates to the point of verbal attacks, use of obsence language, excessive name calling then the dedicated people who have frequented that BLOG since it's beginning will soon find other places where Quality still matters. Eventually, when a BLOG deteriorates to that point it is only a matter of time, (without an over hauling) until that BLOG becomes one of TROLLS only visiting.

    Most people like differing opinions, and a good back and forth but abuse is an entirely different matter.

  6. Jan:

    I think you're right.

    A blog is like a house that you own -- you have a responsibility of what is going on in there.

  7. I disagree with Jan.

    A sore throat can be "cured" by beheading, but it is not the best option. There are plenty of tools for comment moderation (required registration, troll IP banning, spam filters, etc.etc.etc) that can solve the problem without requiring too much time commitment.

    Unfortunately some of the so-called "A-list" bloggers like Beattie start thinking they are above criticism, they are right and everyone else is wrong.

    Turning off comments is a sure sign of a blog that peaked and is heading downhill.

  8. A select portion of the blogger population is outspoken and enjoys and sharing their thoughts regularly... and I can see how they might be upset about the limiting of their "blogger rights."

    I'm guessing that most people are ambivalent to the whole thing though, since most people read to be informed by others, rather than to inform others.

    It is nice though, that the nature of a blog suits the connectors and the lurkers alike.

  9. I do moderate comments. I think I have only ever not published a comment on one occasion- when it was obvious spam for a pornography site. My blog is geared to parents of young children- I don't want the risk of something inappropriate being seen by my readers before I have a chance to delete it. In my opinion, it would would compromise the quality of the blog.

  10. I allow snarky comments on the blog and negative ones, but not if someone has a clear agenda to be personal or vindictive, neither do I allow comments that a clearly just there to sell something.

    in other words, comments are there to add to the debate on the blog.

  11. I don't have an issue with comments because my blog is still low in readership, but Akismet helps with spam.

    For spam that gets through and/or offensive comments or intentional misinformation, I have a comment policy similar to yours - it's a good idea to share it in writing, though, so thanks for that.

    @Medical Blog Network: completely agree, however the worst is a blog author who deletes all that dissent.