A handful of the early adopters who remain active *within* the intersection healthcare and social media have written lately (here and here ) about how we seem (at times) to be stuck in an *echo chamber* — or spend too much time focused on the shiny new objects of our attention. Many of us also field repeated questions from interested observers about issues related to privacy, risks, behavior, content, literacy and whether or not physicians and other health care professionals are ready for their prime time debut on the social media scene. Clearly the risks of being on a public stream keep most physicians silent and off the grid. That said, as many of us have noticed, there have been a whole slew of physicians, nurses, medical students, and even pre-med students who have been establishing a presence of Twitter and Facebook. Is this because of a marketers suggestion? … Perhaps. Is it because they are truly interested and see the appeal and promises many of us have regurgitated over and over? Perhaps. Time will tell. Anyway… for physicians and other healthcare professionals, this was a very interesting few weeks in terms of some of the content and blogs that hit the social media scene. Hopefully, this will prove to be useful to the few who read this :-).
For those of us who are fairly active every Sunday on the #hcsm or Tuesday on the #mdchat twitter chats — it often feels that we regurgitate or talk about the same issues — over and over. While this activity is important to support the newcomers and help drive adoption, it also runs the risk of leaving the most savvy behind due to burnout or dis-interest. Some of the topics mentioned below, should maintain the interest of those of us who have been around for a while… and at the same time, provide useful hints to those considering leaving their lurking status and becoming an active contributor.
*We* are starting to have some of the conversations that are sorely needed and necessary to aid in the maturation of the healthcare and social media landscape and to carry on with our desire to have social media play a large (and meaningful) role in leveling the healthcare landscape for all (with computer access)…
For physicians on social media… when is a doctor-patient relationship established — and what risks are you taking by providing advice on a public platform? This was a short piece on the www.imedicalapps.com website by Joseph McMenamin, MD, JD. I found it interesting that he felt he had to conclude an article about disclaimers with a disclaimer :-) — but, all kidding aside, this is a topic that physicians need guidance on. For now, do not engage patients on public platforms, and be very careful about providing anything that can be construed of as advice on a public stream. Although there is no case law on this yet… you do not want to be the guinea pig :-( .
There has been a lot of attention of late paid to who can utilize the content you post on a public stream.
Michael Zimmer asks if it is Ethical to Harvest Public Twitter Accounts Without Consent?
IMHO, of course it’s OK…. as long as the person/persons/platform/network ,etc do not alter the content, or the context, and utilize proper attribution.
How should doctors behave on a public social media stream? If a physician is thought to be unprofessional, how should that be handled? Unfortunately there are no rules as of yet, aside from HIPAA and basic some guidelines from the AMA.
@Doctor_V, on his 33charts blog posted Unprofessional Physician Behavior on Twitter. This stirred quite a flurry of comments and Bryan has closed them… but let’s just say that there were plenty of well thought out opinions on the issues presented. Though there were a number of issues raised by many in terms of who was singled out, how she was singled out and why she was singled out — this post initiated a discussion that I believe we need to have as physicians establish a digital presence in a very public environment.
Two of the blog responses to Bryan’s post were:
ShadowFox who blogs at Movin’ Meat — who followed through with his own guidelines for discussing clinical medicine in a public environment.
and Wendy Sue Swanson, MD (@SeattleMamaDocs) posted this on her blog. I’m a Physician on Twitter: Patient Privacy
Atul Gawande presented a commencement address to the graduates at Harvard Medical School. While it was a very well written and well delivered address… with a useful message— I wonder if medical students are the right audience for this? Yes, they are the future… however, they are about to leave medical school and be taught by physicians who over-treat, over-utilize, own MRI facilities, or surgery centers and practice under the CYA and FFS models which led to many of the cost issues we face in healthcare today. I doubt that an attending is going to listen to an intern when they try to articulate what they learned from Atul at their commencement.
Oprah is gone!!! by Dr.Jen Gunter: The Queen of “medical woo” is off the air.
Social Media vs. Social Circles.
Social Networks are like that pre-schooler’s party(where the whole class is invited). Rather then being made up of “friends.” they are repositories of people whose existence you acknowledge. You connect with everyone you’ve ever met because the tools have not been developed to create more complex social circles that make up mature adult relationships. It makes sense that the evolution of digital social will follow the same developmental path we take as humans.
Squandering Medicare’s Money : An Op-Ed piece in the NYT by Rita Redberg. Obviously a very polarizing piece — but the days of Eminence Based decision making in medicine are nearing an end. Not all decisions can be made on Evidence Based Medicine (because we do not have the evidence), but many decisions can be… and need to be if providing healthcare is going to be affordable or sustainable going forward. It wouldn’t hurt to also address: Malpractice Reform, CYA Medicine, FFS and self referral issues, Fraud, Over-Utilization, etc….
Kudos to @carlosRizo and his colleagues at the Innovation Cell in Toronto… their recent publication proves that the social web is going to disrupt … and hopefully facilitate the pace at which research and patient insights are indexed, catalogued and recognized by investigators and industry — and push the research envelope to adopt these new technologies.
The G8 met this week and the *internet* was up for discussion. This summit was most likely (cynical snicker) directed behind the scenes by many industries that are being disrupted by the social web … and they are seeking to tax, or legislate their way back to a profitable balance sheet.
Let’s hope that these nations recognize the world wide web for what it is… so we can continue to pursue our agenda of improving patients’ access to useful, actionable content, quality providers, and “friends” or networks where they can share their thoughts, fears, knowledge, hopes and desires— all in the quest to improve the outcomes for all.
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Dr. Luks, great meta-post to round up what’s been happening. I do get the sense that we are a small vocal minority (I read somewhere someone called us a suprisingly inbred crowd, LOL) and the topics can be repetitive. It’s easy to get caught in those pitfalls you mention.
But come to think of it, for ages we’ve been building medicine and science upon undeniably human nature-driven rituals of publishing, critiquing, duplicating, and aggregating stuff we have to say. I guess it follows that our behavior in social media roughly follows that MO, though tweets are infinitely less rigorous than a journal publication.
There may be some good in repetitive discussions, especially since in many of the scenarios we’ve discussed, ethical consensus remains elusive.
Thanks for the comment on the current disruption as evidenced by @personalmed1 , @Healthtap , @doximity and so many others. As a fellow disrupter in the field of implementing mobile docs who are clearly “off the hospital grid” I have found myself staring down the barrel of a lawsuit from a multibillion dollar health system seeking to coffer it’s lab and MRI service line strategies on more than one occasion. But Christensen says that the phr will win the battle. Hope you can make it to dc! Natalie