Doctor, do you Tweet?

No, not really. I registered on Twitter some years ago and began but did not keep it up, although I do have a number of Twitter followers. When I first checked Twitter out, the dominant drivel of narcissists pretty much turned me off.

Were you also slow to start using the Internet?

No, I quickly recognized a huge upside to a well-utilized Internet, so we were very early in establishing its medical usefulness, like in 1996.

Do you agree with those who say that poor communication is the cause of most human conflicts and that improving communication is the key to solving them?

Yes and no. For example, perfect communication of ill will is unlikely to produce good will.

Do you favor instant communication, which is a hallmark of modern civilization?

Instant communication can be more a curse than a blessing, because it deprives the receiver of think-time or time to cogitate before replying.

Are you the guy who said information on the Internet was about as trustworthy as conversation you hear at a bar?

I am that guy. Still true. But that caution also applies to what you read on paper, hear on the radio, or see on television. You have to be careful about what you believe.

Are you the guy who called blogging ultimate communication anarchy, in which the blogger can be author, reviewer, editor, copy editor, editorial board, owner, publisher, censor, advertiser, sponsor, and marketing publicist, all at the same time, and fake the whole thing?

Yes. Guilty as charged.

Well then, I can see why you don’t Tweet. You must still be influenced by Alexander Pope’s ancient dictum: “Be not the first by whom the new are tried, nor yet the last to lay the old aside.”

Yeah. Pretty much.

Now, do you know see value in Twitter?

Yes, I do.

Millions of users and the marketplace have shaken it out. Its value includes speed, when that is useful; conciseness, to prevent verbosity; capacity for prospective selectivity of sources; rapid topical search; aggressive multiple re-tweetings with dissemination multiplication, a la “broadcasting”; and amazing linkage capabilities.

But all the downsides of blogging anarchy are magnified many times on Twitter.

Be super careful, not only in evaluating the Tweets that you receive, but especially the nature of what you Tweet.

Spur of the moment thinking that becomes identified as your Tweet could haunt you for a long time.

Retraction, deletion, or “de-Tweeting” may not be as easy as it seems.

George Lundberg is a MedPage Today Editor-at-Large and former editor of the Journal of the American Medical Association.

Originally published in MedPage Today. Visit MedPageToday.com for more health policy news.