Periscope as a Medical Medium

periscope (1)Doctors are increasingly sharing procedures on Periscope. For the uninformed, Periscope is an in-line Twitter application that facilitates live, personal broadcasting. Most recently, an achilles tendon repair from Ohio State was ’scoped’. I thought it sounded pretty interesting, but I got there too late. The party was over and the video was gone.

The use of Periscope in the OR is the next iteration of live tweeting. The argument with live tweeting was that it was educational. But the reality is that it was a new way for a hospital to have its 15 minutes of fame. On the Visibility-Value Continuum, many of these events have tilted toward visibility.

And when it comes to Periscope and operative procedures, what’s new may be what’s old again.

Admittedly, broadcasts are more interesting than live tweets. But what’s more educational is the enduring nature of a recording that can be seen, linked to, and commented on months later. This would be a recording on YouTube or Vimeo. Periscope, on the other hand, fits into what might be referred to as an ephemeral media. It’s a piece of viewable information that disappears after a time.

Before choosing Periscope as a medium, I might first ask myself whether this is an event that needs a live, in-line broadcast? Or would it be better served recorded and published.

Live has its draw, for sure. And there are things about Periscope that make it valuable. It’s real value may come from the fact that it’s just easy. Even if I wanted to, the process of finding and uploading to a YouTube Channel can be a small chore that raises the barrier to sharing. And for heavy twitter users like myself, Periscope is part of my workflow. Perhaps more importantly, it’s where my audience is.

When it comes to (free open access) medical education, enduring content that’s searchable and retrievable is where the money is. Live has its place, but I’m concerned that it could be more for visibility than value.

The Public Progression of Physicians

5646822351_d8af810d49_z (1)When it comes to doctors and social media, the past few years have been occupied with how doctors can make the transition to public life. Our dialog has traditionally focused on digital immigrants – established physicians adjusting to life with new tools and a public voice. The discussion begins with the argument for why a physician should be there.

But another population gets little dialog: digital natives who come to medicine already engaged. They are our future colleagues comfortable with tools of public dialog but without a clue as to how to it should be used as a professional.

It’s remarkable. Students with no idea how to use social tools as professionals come to medical education under the supervision of teachers who have never used the tools themselves. Students leave medical school with, at best, token discussion of how to conduct themselves beyond the IRL space.

Yet communication, education, and translation of knowledge are at the core of what physicians do. Increasingly, this happens in the public realm. The failure to prepare physicians for the realities of our new social environment is a failure of medical education to keep up with the realities of physician life in a connected age.

I have found that young physician trainees go through a public progression as they transition from personal to professional use of democratized media. It’s a sequence of thinking about how they fit in to the broader discourse. It’s an early concept that I plan to expand. I would love feedback.

College – In the beginning, public media use is almost exclusively personal and social. More engagement-centered and less focused on content. The risk and impact of conversations is barely a concern. Students have little sense of accountability until the point when they realize they will apply to medical school. Public visibility is seen almost exclusively as a liability. Concern is with what their friends think.

Medical school – Students begin to realize that they are part of something bigger than themselves. Students begin to process the fact that their public presence must be balanced with responsibility to community and patients. They recognize that there are actual professional risks associated with public dialog. Students are too far away from professional practice to understand, grasp or be concerned with the opportunities that a digital footprint can afford. They begin to identify and deal with issues of patient boundaries, privacy and personal and professional identities online.

Residency – Aware of the implications of a screwy public profile, residents are more reserved with their outward presence. Some of this may be time/schedule limited. Public visibility begins to be recognized as an asset that can serve their professional needs.

Professional life – This is the culmination of the transition. Our public presence is more centered on our professional interests and passions. We’ve learned to balance our personal and professional identities and are comfortable with and around patients in conversation. Our concern with social tools is centered on what our peers and patients think. We recognize that tools can be used for education, advocacy, professional promotion and learning. What and how we do what we do in a networked world must also be integrated into continuing medical education (CME).

Thinking about the sequence and stages of public professional transition is important as we must deliver content in the context of where the trainee is at. Students must learn to mitigate risk early in their training. Students beginning their clinical training must understand the specific issues that they’ll face when in contact with patients. Residents must understand how social tools can be used for professional growth. Trained professionals must recognize how to specifically leverage these tools for their specialty and work situation.

We have approached this issue at Baylor College of Medicine with our Digital Smarts curriculum. It is an undergraduate program that takes students from orientation through to graduation with the delivery of material specific to the student’s context and stage of development. Exclusively case-based, the program is entering its third year and it represents the first and only curriculum of its kind.

I would love feedback on this concept of the physician public progression. I may be reached at bsv at bcm dot edu.

If you are interested in the evolving role of the physician in public, please download a free copy of my book, The Public Physician.  

[Image via phlubdr on Flickr]

The Public Physician Free Download

book-coverGreat news: The Public Physician is now available for free in a new, updated version. Released as a PDF in the fall of 2014, it’s been exciting to see TPP evolve as a valued resource for medical professionals. And based on reader input, it’s been reorganized, reformatted and made easier to use. If you own an iPad, go over to iBooks and grab a copy.

What is The Public Physician?

The Public Physician is a practical, hands-on guide to help doctors survive and thrive in a new age of connectivity and transparency. Built from the content and community of 33 charts, The Public Physician builds a case for the physician voice then empowers medical professionals to jump in to converse, curate and create.

Why iBooks?

While I understand that this is a limiting factor in distribution, the decision was based on ease of publication and revision. I’m experimenting with the multimedia/multitouch capabilities of the platform that I hope to leverage further in the future with videos, etc. I’d like to maintain The Public Physician as a living, breathing product that’s never quite finished. Look for frequent updates.

Will The Public Physician be available in other formats?

I’m hoping to make a PDF available soon for those without iPads. Stay tuned.

Why is it free?

I’m passionate about the mission and messaging of this book. It’s this mission that has driven 33 charts over the past few years. I also want as many people as possible to learn from what I’ve seen. I need more feedback. Availability drives visibility and conversation.

Will The Public Physician be free forever?

I hope so. I was fortunate to have been able to cover my up front costs on Tinypass over the past 6 months. We’ll see how the project evolves.

Is The Public Physician just for doctors?

Absolutely not. If you are in health care and you want to understand what providers can and should do in the public space, it’s a great resource. All of the advice here applies to advanced practitioners, dentists, etc. Medical communication professionals, for example, can use TPP as a resource in understanding how to work with their medical staff.

How can you help?

  • Download a copy. Downloads drive attention and spread the message. And did I mention that it’s free?
  • Tell someone else. Tell everyone who might benefit from the advice in TPP.  Please share this with doctors you know who need to be more public facing. They would really benefit from this as a resource.
  • Tell me what you think. I need input from readers about what you would change, delete or add to make this really useful. While I can’t apply every suggestion, the book is only as good as the needs of my readers. I’m already working on the next revision for the fall.
  • Rate The Public Physician on iBooks. Tell others what you think and what works, good or bad.

Thank you to everyone who has supported The Public Physician and reads this blog. I’m only here because of you.

When Your Boss Mandates Twitter


I had lunch with a surgeon recently. Salad, hummus and small talk. Then he announces, “My boss wants me to be on Twitter. He wants me to Tweet.  You know, become a Twitterer.” The sarcasm was palpable. Here’s the problem: Nobody can make someone … [Continue reading]

The Man Machine Dichotomy

businessman with gas mask watching TV

Check out Where does the Doctor Stop and the Computer Begin? by Jim Salwitz over on KevinMD. I adore Dr. Jim Salwitz. He represents one of the infosphere’s most insightful minds in oncology. But I have a problem with the title. It assumes a … [Continue reading]