Last few weeks have been very busy and exciting for TMBN and now is the time to have a deep breath and take stock.

Having hosted two major blog carnivals in a row (Health Wonk Review #8 and Grand Rounds 2.37) I had a chance to witness the full spectrum of blogger and reader reactions over TMBN new services.

Now the question is: Where do we go from here?

First of all I want to thank everyone who took time to provide feedback about The Good, The Bad and The Ugly. I greatly appreciate everyone who has been supportive. Yet I also want to thank everyone who helped point out things that need work or explanation.

To jump ahead: TMBN will continue developing and improving services for health & medical bloggers, all driven off the member accounts and blog listings. Now let's look at issues that matter:

1) Healthcare Blog Ecosystem

Why do anything at all? Because medical blogosphere is nowhere near living up to its potential. If we look by groups:

The Audience: Most of the regular medblog readers and commenters are other medbloggers. Few people outside of this circle are active or even know where to go. Aside from Google and a web of links there are few reliable ways to navigate medblogs.

The Bloggers: To be sure, the top few get some notice. But what about the rest? What about medblogs' aggregate impact? How can a new or highly specialized blogger find their audience in the ever-rising clutter? That is why we see new carnivals emerging.

The Industry: Not everyone realizes yet how the impact of open medical media will tranform the way healthcare organizations communicate. But more work is needed to quantify the impact of bloggers and make "blogger relations" work for everyone.

So what will happen on the balance? Look at Technorati 100 for clues. Over the last 2 years the list changed dramatically, while traffic has grown. The number of blogs exploded. New stars have risen. Some of the early ones are shining brighter, but some have not kept up.

What has emerged though in the mainstream blogsphere is a whole ecosystem: blogs and networks, pathfinding & advertising tools, analyst reports, conferences, corporate blogging etiquette, blogger relations and so on. Medblogoshere needs all this too.

2) Blogger Registry as a Cornerstone

The idea of TMBN's recent and future services is to contribute to developing this new ecosystem, help grow medblogosphere and further interconnect the audience, the bloggers and the industry.

In this sense, the most important thing we launched is NOT the carnival submission tool per se, but the blog directory of, by and for the bloggers. We have 75+ and counting and this already made TMBN the World's Largest Community of Healthcare Bloggers.

What would come next? Expect most things mentioned in the section on ecosystem and then some. Delivered as part of TMBN technology platform in conjunction with partners wherever appropriate.

As for the future of the carnival submission tool it will continue to be developed as one of those services for registered bloggers. The extent of its adoption will depend on how many bloggers sign up and start using it, but one thing is clear: expect continuous updates for usability and convenience features.

Only give us some time to get all these things done.

While I do not yet want to announce the projects that are too early in the planning, let me reiterate a few that will be launched and/or completed in the very near term:

• Reminders to submit to carnivals
• Feed syndication and AdSense tools
• Various carnival tool improvements

If you have further suggestions, leave comments or drop a note.

3) Independence, Commercialism and Competition

A few people who did not want to sign up and register blogs to submit to a carnival made an argument of this sort: "Well, I am not sure if I want to be affiliated with this service".

Sure, this could be a legitimate question for some but as I found many people have other considerations in play.

One of the lines that Nick Genes wrote introducing TMBN in his Medscape Pre-Rounds seems to echo a mis-conception:

This week, the independent medical blogosphere and The Medical Blog Network intersect when Dmitriy Kruglyak hosts Grand Rounds

Nothing about registering for an account or listing a blog makes a blogger "less independent". Tell me how is this different from signing up for Blogger, Yahoo Mail or claiming your blog in Technorati.

Let's get this clear: TMBN is serving independent bloggers

Next to more weighty issues. As medical blogosphere is growing, so does its commercialization. This will affect its nature somewhat, think of the Internet circa 1994 and how it changed ever since. This is a sign of growing up and TMBN wants to help this trend, keeping a watchful eye on ethics. Bloggers deserve to make some money too!

But you, as a member never have to go beyond your comfort zone

So in other words, while TMBN is going to do a lot to promote commercial applications of blogs and social media in healthcare, you do not have to take any part, unless you choose so. Simply registering and listing your blog does not obligate you to anything commercial.

Finally, let's look at competitive issues

I understand there will always be people opposing any kind of centralized services and seeing them as competition for either audience, mindshare or money. To everyone who may view TMBN as competition to individual blogs or other online community projects I say this:

Let's all work together to make the pie bigger

There is plenty of growth to come in medical blogosphere: numbers, audience, influence, commerce and services. None of us can do it on their own and no one can ever become a real gatekeeper. But there is lots of room for all of us to team up to facilitate community building.

So here I shall end on this hopeful note. If these ideas make sense you can register for an account and set up your blog.