I find it somewhat hard to believe, but it has been almost 4 years since this site first launched. Back in 2005 few people had even a basic idea of what kind of impact open Internet publishing will have on the worlds of health and healthcare.

But the world is changing and I believe in changing with it. I have been doing some introspection that led to me to resolution that I must "escape from my Personal Branding Prison". What does it mean in practice? I want to make Trusted.MD less dependent on myself as a regular blogging personality and change my own posting schedule from "weekly" to "once-in-a-while" format.

Why am I doing this and what does it mean for everyone here?

I have to say the healthcare reform debates were fascinating to watch over the last few months. While I doubt the final outcome is by any means certain I think we can draw a few conclusions from the back-and-forth so far.

If one thing is already clear is that Barack Obama is now looking like yet another mortal. Gone are stratospheric approval ratings. Instead the Administration is about to give up on the "public option" (via NYT) which just a few months ago they pushed as a "must-have" for any reform. The left is furious and Howard Dean even said that no bill is better than a bill without a public plan.

How did it come to this? What can we learn? What is coming next?

A bit over a week ago I listened in on John Mack's Pharma Marketing Talk podcast with Kru Researchabout their experiments with engaging the twittering public in pharma marketing projects.

The results, highlighted in John's post, are quite notable and say a lot about the psychology of perception, persuasion and marketing. I think they also highlight the elephant in the room of social media marketing. What constitutes authenticity, how it could be stretched and what does it mean for marketers and audience.

So what was Kru's specific test and what does it mean?

In many of my posts this year I raised many concerns about activist government and their harmful actions towards online marketing. Key controversies I highlighted included FDA's meddling in search ads and social media and FTC's questionable scheme for social media regulation.

I am glad the official advertising industry groups are taking note and preparing to fight back. AdAge published a lengthy editorial (behind a paywall), reproduced on the site of Advertising Education Foundation. The notable thing about this piece is that it puts together the "full picture" of how the newly activist government is preparing to harm the business of marketing.

What are the key highlights and takeways?

The title of this post may seem contrarian. After all, the healthcare reform is dominating the agenda of the US Congress and is saturating media coverage, both online and offline. You might think this is #1 issue of interest to Americans.

No doubt, the level interest is remarkable. Every political group is mobilizing for a fight. Health reform hashtag (#hc09) briefly hit the list of trending topics on Twitter. But the real question is whether the engagement is limited to the most passionate activists or the entire American public is truly tuned in.

Recent piece on POLITICO highlights that it might be the former

Last week the Internet technology community experienced a true bombshell. Twitter, a darling of the media, a star of Silicon Valley, a poster child of cloud computing has been hacked. Company's secrets have become public.

I am not going to rehash details of the story, broken and thoroughly covered by TechCrunch (In Our Inbox: Hundreds Of Confidential Twitter Documents). Nor will I dive into the substance of the documents released, though they are truly worthwhile reading. I would like to highlight how exactly was Twitter hacked and how it could happen to your medical records.

Let us thank Hacker Croll for sharing the details on his break-in!

Last week I highlighted the controversy with Obama's staged healthcare town-halls and wondered if this is a symptom of not just media manipulation, but fundamental roadblocks the proposed reforms are running into.

Now a week later, Politico reports that "Health care deadline unlikely to be met", quoting a lot of sources in or near the Congress. Missing the target August deadline looks like a big blow to President Obama's agenda and may call in question the future, the contents and the very existence of the bill.

What is going on and why is this happening?

In my commentary this year I have been trying to stay away from the general topic of healthcare reform. The debate is shifting very fast, there is a lot of noise and we hear familiar positions reiterated by every stakeholder.

But last weekbroke some new ground in the debate, at least as far as process and format is concerned. I am talking about Obama's scripted town-hall events that prompted Obama-Bush and even Obama-Nixon comparisons. The shocking part is, the Administration is being attacked by its former cheerleaders!

How do you go from being a darling of media to the target of attacks?

As I highlighted a few months ago, FTC is hard at work updating 30-year old rules on testimonials for the age when anyone is a publisher: "FTC Guidelines for Endorsements Could Shake Up Social Media Marketing".

They made headlines again last week touting the need for regulation: "FTC plans to monitor blogs for claims, payments". Now with the agency's direction being less of a surpirse we are starting to see more coverage and real discussion of if and how such regulations may or may not work.

A government agency regulating an industry? What could go wrong?

This year I have written several pieces calling out FDA for their lack of enlightenment about Internet and social media marketing. My conclusion has been that literal application of last century regulations, without understanding the changes in media are counter-productive to FDA's stated mission.

I spared no scorn criticising the agency in posts titled like "FDA Bureaucrats Gone Wild, Launch a Witch Hunt on Internet Marketing", "Will DDMAC Ever Get a Clue About Internet Marketing?" and "Dumb Regulation Watch: Traditional Healthcare Marketing Rules Can Be Meaningless Online". I have been ahead of my colleagues in calling out FDA's flaws, but now looks like the frustration with the agency is growing louder and louder.

In the last weeks pharma blogs hosted some pointed exchanges