Recently I received a friend request from a woman in the community where I practice. I didn’t recognize her so politely sent a message apologizing for not remembering where we had met. She promptly responded and informed me that we had never met but she had read my book. Her baby it seemed was miserable and the wait for an appointment in my clinic was too long for her to bear. Politely pleading for her baby to be seen, I arranged a phone call and subsequently saw the baby in my office.
Now I’ve always helped out those I’m connected to. As a doc I offer friendly advice to friends and neighbors when they need help with medical stuff. Frequently I speak on the phone to the relatives of close friends needing direction with their child. Sometimes I even go the extra mile to help facilitate a consult with a colleague. And why not? I have a connection with these people given our common acquaintance. All physicians and health professionals do it and we think nothing of it.
So should it be different with my social network? Probably not. But just as in life, the depth of the relationships I build on social media platforms is variable. And those I share a strong bond with are more apt to earn my time, mental energy, and concern. Strangers and transients are nothing other than that despite our sometimes-flirtatious Twitter repartee. While I am developing some great relationships, most remain superficial.
Okay, so regarding my screaming baby from Facebook. I didn’t know this mother so why did I offer to help? Social media empathy you might call it. Or perhaps I’m just a big softie. You could even argue that once I chose to reply on that friend request I had some obligation to see to it that the baby was checked out by someone. But that’s the subject of another post.
The relationships we share with those who we choose to connect with on social media platforms will give rise to new social, ethical and legal challenges for physicians. And while I think that raw connectedness and transparency are Parkinsonian traits that we want to achieve in this new medical order, we’re still working to define the doctor-follower relationship.
{ 7 comments… read them below or add one }
Physicians I know are increasingly perplexed by people who assume a personal Facebook, Twitter or other casual social network relationship entitles the person to medical advice or consults. (Guess this is the internet evolution of the often parodied cocktail party request for free medical advice.)
Will be interesting to see where the boundaries of "social media empathy" are defined by physicians and patients.
Another great post. Thanks.
Thanks for your comment, Tom. I think this issue of defining doctors in the SM space is going to evolve and generate more debate. I think the legal issues may even make for some interesting press.
Dr V. Thanks for sharing your perspective. I appreciate the front-line clinical report and potentially problematic decision tree you face relative to the allocation of your time.
As an early adopter your experience and insights will no doubt be of high value in this unfolding space.
Not sure if this applies, but I have been told more than once, that "how you show up in one area of your life, is how you show up everywhere".
In other words, there can be no justifiable separation; authenticity, and integrity are constants not situational variables.
Docs have a unique challenge in the social media space due to the supply/demand imbalance, not to mention the cost, access and navigational challenges of the delivery system.
Open is open though, and the trend appears to be more of it, in real time, and authentically proffered. We'll see…
Very interesting post and one that resonates in the small rural community I live in. The old-fashioned Berlin Wall between patient and doctor has been blasted away by health informatics and the world-wide web over the last 10 years and social media is allowing that stones to crumble over into our personal lives. In consultations I often use small parts of 'personal' information that help me illustrate points or express empathy – a technique not shared by many in London, but much more so here. And as the Twitterverse expands, we are likely to gain more insight into what patients generally want and we may just get asked a few more favours too….
I look forward to developments and the ramifications of open communication.
I love the post, Doctor V – Incredibly thought-provoking. I guess I want to know the same thing that a lot of others do . . . how can you make a living practicing medicine through social media? Or maybe a better question would be, "what kind of system would allow you to make money IRL if you are spending time and giving *free* advice online?" Is there a way that your IRL time could be filled with *more* and *more valuable* patient time and less time with credentialing, billing and paperwork?
Thanks for the great thinking . . .
Reimbursement for SM engagement is an interesting question. In a sense it's no different than the issue of telephone care – should be reimbursed but with great potential for overuse. Concierge and cash practices account for telephone encounters in many cases. Jay Parkinson at Hello Health runs a practice in Brooklyn where patients freely interact with him via SM. In its current primitive state its hard to see physicians using SM for billable patient care.
Great discussion topic. I think as a profession we need to define the doctor's role in social media. I like to use my FB and twitter (@docnicole)to coach and nag my "friends"….the interesting thing I have found is that our words define us much more than anything else…so I understand your social media empathy. It is easy to grow attached to new friends. I try my best not to give out advice beyond the basics and just pointing people in the right resources. Sometimes people just need reassurance or a second opinion.