Last night's Letterman or 60 Minutes used to be a staple of dinner party patter. These days, it's just as likely to be: “Hey, did you see that thing on Boing Boing today?”

Blogs have entered the nation's media diet in a big way. They're written and read by millions. The big ones are closely tracked by reporters (the dreaded “MSM”—mainstream media—in blogger argot) and have thus become an often vital link in the media food chain. Directly or indirectly, many Americans are now getting news and views on health topics from these unmoderated and often anarchic fronts, where passion frequently stands in for expertise and misinformation can abound unchecked. But as a gauge of popular sentiment, they can't be beat.

“They can act as an early-warning mechanism,” says former FDA PR head Peter Pitts, now an SVP at MS&L and author of Drugwonks.com. “They give you a sign as to what people are thinking out there. Ignoring the ‘blogosphere' is ignoring reality.”

Sneezers and leaders

According to search engine Technorati.com, which was, at this writing, tracking 36 million blogs, there are more than 75,000 new blogs created every day. The vast majority of these will be seldom, if ever, updated and will never draw a regular audience you can't count on one hand. But an elite few boast a higher average daily readership than some mid-market newspapers. Right-libertarian blog Instapundit  gets an average 115,459 daily visits, while a left-wing counterpart, blog/community hybrid Daily Kos, gets 465,525 visits. Gizmodo, a popular gadget blog, gets 335,777, and Manhattan media gossip Gawker pulls in 234,538. (Blogs are also a model of transparency when it comes to basic readership data, as most use publicly viewable trackers like Sitemeter.)

While most blogs are highly personal—essentially online journals—the mega-blogs, for the most part, are highly specialized, focusing on politics or consumer technology or industry gossip. Forget the stereotype of the pajama-clad geek pecking furtively at a Commodore 64 in his mother's basement, says Steve Rubel, an SVP at Edelman specializing in blogs and a prominent blogger in his own right (micropersuasion.com). “These are the people [author] Seth Godin calls ‘Sneezers,'” says Rubel. “They tell people what to buy. They influence those around them, and they go out and influence others.”

Their readers, too, are highly motivated and opinionated information seekers; by nature they're influencers and often bloggers themselves, linking to other sites and driving traffic up and down the pyramid. As a result, even blogs with relatively small readership can have a big cumulative impact. “You can build a deep level of engagement with 20 people through a blog that you never could through TV advertising,” says Edelman's Rubel. “The blogosphere makes people with thoughts thought leaders,” says Pitts. “Is a blog more powerful if it reaches 500 people, or if it reaches 50 people who together reach 500? It would be nice to know that the pope read my blog, but I'd be just as happy to know that 500 priests read it.” 

Moreover, insider policy blogs like Pitts' are closely followed by reporters and FDA officials. Pharma Marketing News editor John Mack, whose Pharma Marketing Blog (pharmamkting.blogspot.com) draws around 133 visitors a day, has gotten calls from The Wall Street Journal, The Seattle Times and The Delaware Sentinel about his posts on ED drugs and other topics. “It's typically beat reporters from local papers,” says Mack. But the national titles are reading, too.

That makes monitoring essential, though with so many blogs out there, which are worth watching? That's a question vexing many pharmaceutical communicators.

Weighing blogging

“There's an awful lot of discussion going on online,” says GlaxoSmithKline's Mike Pucci. “How do we value that discussion? I spend my life on the road speaking and putting a face on the company. I don't have a lot of time to spend monitoring Web sites.”

Sitemeter can tell you how many visitors a blog is getting, but it can't tell you much about those visitors. (A Sitemeter reading is typically accessible through an icon at the bottom of a subscribing site's home page.) A good measure of the influence a blog has is its relationship to other blogs—how many other bloggers are feeding traffic to it through blogrolls or links to posts? Technorati can tell you how many inbound and outbound links a site has. Better yet, Technorati lets you search the blogosphere by keyword to get an idea of how much play a topic is getting. Search “reimportation” and you'll find several recent posts by Peter Rost, the former Genotropin marketer who emerged as a would-be whistle-blower and industry critic before being dismissed from his job at Pfizer last year. Rost now blogs at HuffingtonPost.com, the celebrity blog of the wealthy politico Arianna Huffington. The site gets 1.5 million unique visitors a month, Rost says, and some of his posts have made the top five. “That surprised me,” says Rost, whose fulminations against Pfizer and greedy doctors have drawn readers. “I thought my focus was a little narrower than most, but people really care about healthcare.”

Which leads to the question: If Peter Rost is out there opining on evil drug companies, why shouldn't drug companies be blogging, too? Answer: Legal says, “ROTFLMAO!” (Google it ...)

There are adverse-events reporting requirements to consider. Should a commenter write that a company's drug gave him high blood pressure, the company would be required to report that to the FDA. You can always turn off comments, but doing so defeats the purpose, says MS&L's Pitts. “It's the interactivity of it that makes it unique,” says Pitts. “Otherwise, it's just another controlled marketing resource.”

Perhaps, but what's to say the scientists featured in GSK's recent corporate campaign couldn't write on a company site—however obliquely and thoroughly vetted by PR—about their work, provided they steer clear of product promotion? Readers are sharply attuned to an author's authenticity, as Pitts, who cautions against “astroturf” efforts, notes. They relish the give-and-take, the parry-and-thrust, of a world of ideas in which there is no middle ground. But as the cliché has it, we are also all patients, with a surprisingly hearty appetite for health information.

“Blogs don't have hard edges,” says Edelman's Rubel. “People blog about what touches them, and healthcare touches us all.”