On Hosting Grand Rounds

This has been an exciting week in the blogosphere for me, far more so than I anticipated. Hosting Grand Rounds was a very positive experience, one that I enjoyed immensely. I strongly encourage you wavering medbloggers out there to step up to the plate and do it!

Before I hosted, I read with interest the post-Rounds posts created by some hosts (is that iambic tetrameter?) with their recommendations for future hosts. I wish to offer the same for those who may be curious.

My two most important recommendations are to give yourself adequate time, and be organized. Try to be realistic about yourself on those two items.

The adequate time question will be different for each host, and probably for each week. If it is at all possible for you, arrange not to be working on Saturday, Sunday, and Monday before your GR date. Put up your call for submissions post seven to ten days in advance, state your submission deadline, and request early submissions.

Put some serious thought and energy into the pre-Rounds interview questions Dr. Nick Genes will send you. He does his homework by reading your entire blog before the interview and asking well-considered and open-ended questions; do your part by giving him substantive answers. Once he posts your interview on Medscape, put a post on your blog announcing and linking it, and again encourage early submissions for your GR edition. As you will see, many bloggers will comply; as a future submitter to other hosts, I will make more of an effort now to do the same.

For GR 2:52, I received 47 submissions. They came in as follows: Tuesday 1; Wednesday 4; Thursday 6; Friday 7; Saturday 12; Sunday 11; Monday 6. So most (41 of 47) came in before the last day. I put the deadline for submissions as Monday at noon Eastern time (8 am Alaska time), which gave me 16 hours to work with. I planned to put the Grand Rounds post up at one minute after midnight Monday night, Alaska time. If I had had to work on Monday, I'd have never made it.

One thing that was interesting to me was the variety in submission emails. As requested, all had "Grand Rounds" in the title, which helped in my first step. When I submit, I generally just say "here's my submission: url-of-the-post". Many people do just that, but some were more elaborate. They included blog name, blog URL, post URL, and post summary. I found these to be really helpful, and it will guide my behavior as a future submitter.

So, how to be organized? This is what worked for me. I created a folder in my email just for GR. As each submission arrived, it went into the folder unread, so the title (containing GR) remained in bold. As the folder grew in size, it was easy to see where I was in the post-reading process. When I opened the email, I clicked on the link, went to the submitter's blog, read the submitted post (and sometimes a few others), decided which category it should be in, and gave it a rating on a 1 to 5 scale, with 1 being awful and 5 being fabulous. Most ended up being 3s or 4s.

I decided ahead of time on seven categories I would use to sort the posts. This came about originally because I intended to organize the whole GR edition like an issue of The New England Journal of Medicine. I was going to call it The Blogosphere Journal of Medicine. So I used the categories that NEJM uses, slightly adapted for the blogosphere, in essentially the same order they use. I subsequently decided that would be waaaay too boring, and decided to treat you to Postcards From The Edge of The Planet instead; but the categories worked pretty well, so I kept them.

Once I started reading posts (pretty much as they came in; don't get behind) I kept a notebook next to the computer (yeah, real paper and a real pen--I'm an old fart) and made an ongoing list that contained six items: blog name, blogger name, URL of submitted post, quality rating (1 to 5), category, and one-sentence phrase describing the essence of the post.

This list is what made the job the easiest. By Monday morning it was five pages long, with three lines for each submission. I should have organized the list by category to start with, giving each category its own page and listing the posts after I read them under their appropriate catagories. I didn't think of this until I was looking at five pages of posts listed in the order of their receipt. Those of you with more computer skills than I have will not have a problem with this, as you will do it all on computer and let the editor do the sorting for you; I found it too cumbersome to switch back and forth between a Word document and my email, so went to the paper system. Out came the scissors and tape. I cut the pages into 3-line strips, one for each post; sorted them by category; ordered the posts in each category by rating and/or my own preference; and taped them down to new pages.

Once that was done, it was a simple matter to go through the new ordered list and write the Grand Rounds post. As many of you know from my earlier writing, loading photos on Blogger has been a thorn in my side from the very beginning, and the GR post was no exception. It took me nearly five hours to find, scan, load and arrange the dozen photos I used. For some reason, Blogger would not load any photos on the left, and some it simply would not load at all. They were all less than 200 KB, so it was not a size issue. I wanted to close with a beautiful shot of the Northern Lights, but Blogger said NO.

The amount of time I gave myself worked out perfectly. I spent the entire day on Monday working on it, and finished the edition with one hour to spare. The post went up at 12:01 Alaska time on Tuesday morning. It took an hour to then go through the post on my blog and click on every link to be sure it worked. I highly recommend this. Four of them did not work, mostly due to single-character errors in the URL. As a Grand Rounds reader, I hate dead links, so wanted to be sure I didn't have any. With all corrections done, I went to bed at 1:30 am, too wired to sleep for at least an hour.

By 7:00 I was up again, interested to see what readers would think of the post, what comments I would get, and what my sitemeter would do. I expected the sitemeter to show a good-sized bump, but I had NO IDEA what was going to happen that day. It practically exploded.

The comments were wonderful, very positive and encouraging, and thanking me for hosting. But one thing I did not anticipate was comment carry-over. Dr. Genes needs to have the URL of your GR post to include in the pre-Rounds interview, so he recommends putting up the GR post to establish the URL and then taking it down, saving it as a draft, changing the date to reflect your edition's actual date and reposting it on Tuesday morning. I figured out how to do this, but decided I would let the early GR address be my call-for-submissions, which I would leave up till the deadline, then take down and replace the content with the actual GR edition. It worked fine, except that I had comments on the call-for-submission which carried over to the GR edition, which I didn't want. But I didn't want to delete them, either. Do it Nick's way. He's really smart about this stuff.

Now about the sitemeter. Holy cow. For the last month or so, I have been averaging 70 to 90 readers per day. After less than five months blogging, I felt pretty good about that, since the first month was less than 30 per day. Of course I had blogenvy of Fat Doctor's 300 per day, and Life in Alaska's 7,000 per month. But still. Seventy to 90 is a good steady core (thanks, TMD regular readers!); on good days it was over a hundred, and my all-time high was 210 on a GR day back in May when I had submitted a popular post.

At 7:15 am the sitemeter registered 117 readers. I kept checking every hour or two throughout the day, and my eyes got bigger and bigger as the sitemeter just kept going up. By midnight Tuesday night, it registered 676 readers. Let me say that again: six hundred and seventy-six! I was totally floored.

The surge not only continued on Wednesday morning; up until 4 pm, each sitemeter check showed even more readers than the same time Tuesday. It dropped off after 4 pm, and by midnight the total was 557. Thursday continued the decline and ended up with 346 (about the ballpark I expected for Tuesday).

I attribute the huge surge to two things: more people read Grand Rounds in the fall than in the summer (this is Borneo Breeze's idea, and I agree); and more bloggers this week put up a "Grand Rounds is up" post than usually do. I am aware of 26 blogs with such a post, and I may have missed some. Thanks to all of you who linked!


I have had the luxury of hosting Grand Rounds in the midst of nine days off work, which I am sure was significant in decreasing the stress factor and increasing the fun factor. It was simply fortunate for me that Nick was able to let me have the date I wanted, since I had to request time off months ago. I have a lot of vacation time and have scheduled a week off every two or three months, primarily to have time for writing. My favorite vacation is to just stay home and write; I live in one of the most beautiful places in the world--why should I go anywhere?

Let me close by encouraging those of you who may be thinking of hosting Grand Rounds to go for it. It was a wonderful and exciting experience, and I am really glad I did it.

Blogger is SO tempermental!