Consumer Lab Testing: Will the Doctor be Out?

6863249648_1820d08dbb_zHealth care’s race to the consumer was met with some chatter last week with the announcement that LabCorp will allow patients to order their own blood tests.

This is good, but consumer lab testing can be a tricky proposition.  Numbers and results devoid of context are only numbers.  Outside of the body from which the number comes and divorced from the patient’s story, these numbers may represent data more than information.  Empowerment in this case is relative

Some tests are remarkably sensitive, specific and precise for over the counter sale.  Some aren’t.

Celiac disease is a good example.  The interpretation of celiac serology can be challenging at best.  Beyond basic serology, HLA typing is conceptually dicey.  And in the absence of clinical context, weighing results with presentation to deliver a plan can be dicey.

But as medicine marches toward the precise, this ambiguity will become less of an issue.  Celiac disease will be diagnosed with solid endpoints.  A nanofleck of blood will deliver answers that will require less clinical overlay.

Yesterday on Twitter I suggested that doctors had officially been marginalized.  Or maybe we can decide how marginalized we’ll be.  Until consumer testing and interpretation is so good that patients will stop looking to clinicians for help, It will be up to physicians to figure out where they fit among a patient and her data.

Image via Tom Hart/Flickr

When Your Boss Mandates Twitter

iStock_000059219506SmallI 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 participate in a conversation. They can try, but it won’t work. We have to come into public dialog because we want something that’s there.

I’ve never met a physician who sustainably used a public network because they were told to. Conversely, I’ve never met a consistently engaged doctor who hadn’t found some kind of value in that public presence. If a superior were interested in his team going public, he might build the case for why Twitter, or any platform, might be good for an institution or one’s career. Better yet, he might build the case as a role model.

We often miss the mark in our presentations and workshops. Presentations from highly spirited evangelist physicians often focus on shiny objects. Yet the reason so few of these presentations convert listeners is that they fail to demonstrate how any of this can make things better. In our excitement, we fail to build the case in a way that our audience can relate to.

What you can do is good; what you can get is better.

So whether you’re a boss, speaker or friend at lunch, make your approach about value.

This hilarious/idiotic ‘stock photo’ is part of a promotional campaign for Unfinished Business.

Why Your Twitter Disclaimer Doesn’t Make Sense

Vault combinationIt seems that I’m the only individual in the free world without a Twitter disclaimer that ‘my tweets are my own.’  You’ve seen them, I’m sure. Vague disclaimers invariably copied from someone else intended to create a fuzzy feeling of security.

Here’s why I believe token disclaimers don’t make sense:

You represent your organization. While you may not deliver carefully crafted corporate speak, there’s no escaping the fact that we’re brand ambassadors for our organizations. While you may want to believe that your tweets are your own, your public thinking is terminally linked to your work, family and other aspects of your life. Despite how hard we may try, no disclaimer language will ever detach us.

(and so…) Acting like a jackass will still get you fired. Despite who owns a tweet or who you claim to not represent, you’re still on the hook when you act like a frat boy in public. Perhaps more importantly, there’s no piece of language that will ever protect an organization from looking bad.

Public engagement wasn’t invented with social media. We served as representatives for our institutions long before public media were available. But we never used disclaimers. Cocktail parties, keynote presentations, and professional meetings all involve connection, engagement, sharing and speaking. But I’ve yet to hear a physician at a national meeting open with a slide disclosing that that their ideas are their own. We know that.

Ultimately this language is about fear. But I suspect that those interested in getting at us won’t be deterred by cut-and-paste disclaimers. Perhaps we should all just agree that none of us are the official, branded idea brokers of our organizations … unless otherwise declared in our bios.

You might also check out: Why 911 blog disclaimers may be the longest running gag in legal history

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]