The problem,, IMHO, with a blog is if you actually open up for real, you're going to have several comments that are not walking on the high-ground. That's what I think is going on with Carlat and his blog.
If I had my own blog, during fellowship, you'd see a lot of complaints written on it. I've worked this year with one of the top guys in the field. The guy expected me to do my best and had very high standards. If I had a blog where I vented all of my frustrations, I'm sure I would've mentioned here or there how I didn't like my butt being kicked. It might've given others a bad impression.
But overall, the program was great. It's probably been the best curriculum I've been through. My butt getting kicked was often due to my mind going through the ego-dystonic process of seeing mistakes I was making and seeing better ways to do things. People tend to vent frustrations on blogs.
But a problem here, is that like any psychiatrist (or any doctor for that matter) putting up their opinions in a public forum will alter people's perceptions of that doctor, for better or worse.
If a doctor for example were to go on some roman orgy website (and I'm only using that example because it was used on the TV show ER, this has nothing to do with Carlat), and mention his name and how he wants to hook up with others for the local orgy, sure it'd negatively affect people's perceptions of that doctor, even if that doctor was the best in the area. Just like we don't want to hear about our local pastor's sex tape that might've leaked onto the internet and gone viral.
This is probably one of the reasons why thelastpsychiatrist.com keeps his name anonymous. Carlat's report is an excellent source of information. I'm still a big fan of it and him.
But getting to your Nader analogy, I very much disagreed with the Oregon bill, mainly becuase it left ambiguity as to WTF was supposed to happen if the "physical" health professional and the psychologist disagreed. This can and would lead to several legal problems concerning responsibility and the operation of care if the bill was passed. Having someone being specifically pinned having the final say on a medication certainly points to who is responsible IMHO would be needed. How do I know this? I see several psychiatric patients where their PCP is ignoring some medical issues, and I, as another medical doctor, but not the doctor in charge of that specific medical condition, am very very frustrated. At least in this situation, there are some guidelines pointing to who is responsible for what, and I can do what I can up to where those guidelines tell me what to do. Supporting that bill IMHO did seem a bit Naderesque.