How to Speak to Physicians About Social Media

September 23, 2010

Last night Susannah Fox put up the Bat Signal.  It seems she’s been charged with addressing the American College of Surgeons next month and she’s looking for some creative input from the medical social community.  Not surprising, really.  Interest in social media among physician groups is growing fast.

I thought it might be worth sharing a few random thoughts on the care and handling of the physician audience.

Doctors think in 1.0

Remember that the average physician is naïve when it comes to social media and its role in health.  Most physicians see e-patients strictly as consumers.  The concept of true socialization and active involvement by patients and physicians will likely be foreign to your audience.

With that said, you’ll get more mileage with a thorough, basic discussion of what this is all about and why it will change healthcare more than you will with a detailed how-to-do-it dialog.

A doctor is a doctor

Don’t sweat the audience.  While you could probably come up with some tailored, specific examples for surgeons or OBs, the core social issues for physicians are not specialty-specific at the introductory level.  In social terms, a doctor’s a doctor.

Raise your expectations

Based on their anemic adoption we sometimes think that doctors are resistant to the idea of social media.   I remember speaking this summer to one of the local medical societies in West Texas.  The audience was much older than I had expected and as I waited I prepared myself for resistance to what I had to say.  But, in fact, the opposite happened.  This audience of older generation physicians saw social as a way to potentially bring medicine back to its focus on connecting with patients.  Who knew?

Even if slow to adopt, physicians are intrigued and increasingly interested in social media’s potential.  We’re a malleable group.

Manage their expectations

It should be understood that we haven’t figured out where and how doctors should make social work for them.  Let’s face it, it’s time consuming and the applications that measurably impact care are few and far between.  The power lies in the potential that comes once we have the entire physician population in the loop.

And be careful of selling the fantasy:  While it makes great fodder for the media, selling “live tweets from the OR” as the saving grace of the next medical generation won’t win over any physician audience.

What keeps doctors up at night

As you think about your physician audience, consider why none of them have blogs or are found on Twitter:  1) Physicians naturally have issues with transparency 2) they haven’t got time and 3) they have concerns over liability and privacy.

But transparency is generational.  Time you can’t fix.  And issues surrounding patient engagement in the public forum are educational.

This patient contact issue and the theoretical potential for liability is a huge preoccupation.  I’ve found that a lot of physicians believe that their social entree obligates them to discuss patient issues in public.  I always convey my bias (possibly a slowly evolving standard):  discussion of patient-specific issues in public forums is off limits; discussion of patient non-specific issues is encouraged. Any attempt at patient-initiated discussion of specific medical issues immediately goes offline and onto the EMR for issues of record, liability and safety.

Doctor-patient dialog surrounding individual care should be limited to HIPAA compliant networks that integrate with the EMR.  I like to cite HelloHealth as an early example of this model.  The screen grabs always wow the crowd.

And if you can discuss an ethical dilemma or two you’ll have the academic elements of your audience drooling.  Bring towels.

Physicians have an obligation to be in the online space

Maybe I get away with it because I wear a stethoscope, but I always tell doctors that they have an obligation to participate in the dialog.  I always use autism and vaccines as the example.  The search engines in this regard are ruled by a loud, vocal minority linking vaccines and autism.  Consider that the American Academy of Pediatrics has 60,000 pediatricians.  If each of them were involved in the creation of some kind of content with reliable information, we would rule the search enginges.  Powerful stuff.  Always has an impact.

Think mobile

It’s estimated that some 81% of physicians will own a smart phone next year and mobile may be the segue into soft social adoption for many MDs.  Touch mobile and win your physician audience.

Tweet by example

One of the most powerful take home messages I pass to physician audiences is to study other doctors who are in the space.  Spend time watching and listening before taking the leap into the public forum.  I encourage people to look at what other doctors are doing and see how it applies to their setting.

Remind them to cultivate their digital footprint

I look at my role with physician audiences as one where I seek to motivate and empower.  And that’s when I feel rewarded. The idea that they can potentially control their digital footprint has huge value.  Ask the audience to do a vanity search and remind them that their reputation is under the control of sites like Healthgrades.  Remind them that they themselves are actually in control what people see when they are searched.

I encourage them to get started with a LinkedIn profile for one thing.  It’s soft social and a nice entrée into an online identity.

I’m not Joe MD

In a strange way I have to warn you to be careful of my advice.  Docs like myself and Howard Luks and others see the world through a very different lens than the average internist or general surgeon in middle America (who I refer to as Joe MD).  When thinking about our approach to the digitally naive physician we have to be careful about how we apply what we know about those of us who have already arrived.  Keep it basic and remember where they’re at.

Finally, I should say that Susannah Fox’s willingness to reach out to the physician community is a testimony to her understanding of how this social stuff is all supposed to work.  Even when we don’t know exactly how to approach something, there’s always someone who does.

I could go on all day.  What else would you add?

 

{ 32 comments }

Nick Dawson September 24, 2010 at 7:33 am

Great post Bryan! Thanks for sharing – timely for me too as I have a similar discussion coming up.

I am curious about your first point – doc are 1.0. Do you think that is a generational thing and/or could it vary widely? My anecdotal opinion is that as a generalization it is accurate, and I also feel like it is changing rapidly towards a 2.0 mentality. Would you agree?

DrV September 24, 2010 at 9:51 pm

Yes, absolutely generational. As digital natives matriculate med school, 1.0 will be studied in textbooks. Then we’ll face the issue of ‘old folks stuck in 2.0′.

Susannah Fox September 24, 2010 at 8:16 am

Wow. Just… wow. Thank you so much for this field guide/halftime speech/discussion starter. I am going to sit quietly and absorb it for a day, but you (and the ACS) will see a much different set of slides & remarks now that I’ve got this in hand.

Thank you, Batman!!

DrV September 24, 2010 at 9:53 pm

Keep in mind, too, that your prez as a professional observer may (and should be) very different from that of a physician presenting. Remember that you are uniquely qualified to deliver some remarkable stuff that none of us could.

Phil Baumann September 24, 2010 at 8:18 am

Cool.

Physicians have important perspectives which we need included in discourse about emerging technologies.

In spite of knowing how generally resistant many physicians can be with respect to social media, I actually we will see increasing interest – especially as more and more examples emerge for them to benchmark, and will feel more comfortable about being online in ways that don’t expose them to the risks inherent in their roles.

btw – I’ve got a gateway drug for at least a smart part of the problem list here. Fortunately, I won’t need doctor’s orders for this one. But I will nudge. :)

@PhilBaumann

Bill Todd September 24, 2010 at 9:33 am

Oncologists are particularly under fire with patients showing up with reams of printed website information of dubious quality.

One application of social media may be for oncologists to help patients by suggesting quality, evidenced-based sites as opposed to those that are more marketing driven and could even be hucksters. A Facebook page giving the oncologists credentials and his recommendations for reliable sites (cancer.org, cancer.gov, livestrong. org, etc.) might be helpful. Or she could use Twitter to share some exciting new discoveries that are moving into clinical trials, and it might just help with accruals.

Imagine giving a newly diagnosed patient a Facebook page and a Twitter address to gain critical information and updates about progress in the fight against cancer.

Many exciting new opportunities.

DrV September 24, 2010 at 9:58 pm

Critical stuff. This is where the concept of information curation becomes critical. We need to recognize that information is power and good information is more powerful.

Concerning Facebook, Anes Younes has created a nice stream as hematologist at MDACC and had even recruited study subjects from among his fans (I’m told).

Greg Matthews September 24, 2010 at 10:21 am

Bryan:
This is great. I think that those of us who’ve lived in a 2.0 world long enough forget how to talk to people who don’t … and I’m glad that you are able to help us bridge the gap. I’ve shared this post with my entire office, and it’s also inspired me to kick off a new project that has been rattling around in my brain for the last several weeks. I’ll tell you all about it over drinks at BlogWorld!
;-)
Gm

DrV September 24, 2010 at 10:01 pm

I love fueling new projects, especially over a beer at Blog World Expo. I think I’m gonna start packing now.

Ed Bennett September 24, 2010 at 10:23 am

Bryan,

Excellent advice. Anyone who works with doctors on social media issues should listen closely. Re the Web 1.0 veiwpoint, I’m seeing an attitude shift. There’s a regognition that Social Media has a place, and the issue is working out the boundary and time problems.

@EdBennett

Erin Macartney September 24, 2010 at 12:10 pm

Thank you, Bryan. Very timely – and good advice. Appreciate you taking the time to share your thoughts. We have been having similar discussions and this is helpful. Looking forward to sharing (and incorporating) some of your suggestions and furthering the discussion.

@emacartney

Adam Nally September 24, 2010 at 1:43 pm

Bryan,
As always great post and wonderful insight. I think I’ve been operating at 1.2 for quite some time. Your comments are great in regards to upgrading to 2.0.
I appreciate the insight into subject matter and relevance.

DrV September 24, 2010 at 10:02 pm

1.2, hehe. Love it. I like to speak with authority about 4.0 sometimes … freaks people out.

Chuck Wallace September 24, 2010 at 3:54 pm

Bryan,
What a great perspective. Know your audience…duh

Lee Aase September 24, 2010 at 5:11 pm

Excellent insights. I especially like the “obligation to participate” angle, and you are right that your metallic neckwear gives you credibility to say this that others don’t have. Knowing that patients and their families will go online for answers, it’s important to have quality information available.

DrV September 24, 2010 at 10:05 pm

This autism example is powerful when you consider that among those 60k AAP pediatricians only a big handful regularly blog. This example has a big impact because everyone can relate to the power of numbers. And everyone can relate to the minority voice with a big megaphone.

It’s time we all got together.

Steve Levine September 24, 2010 at 5:46 pm

Thanks, Bryan.

I have another talk coming up next month, teaching social media to the first class in the Texas Medical Association Leadership College. I’ll follow your guidance.

DrV September 24, 2010 at 10:07 pm

Hey, I cut my teeth talkin’ to Texas docs….thanks to you : )

Anne Marie Cunningham September 24, 2010 at 7:26 pm

You have been honest here. We don’t really know how social media will really be useful in working with patients, or colleagues…. Yet. Given that it seems strange to say that doctors are obliged to participate. Did the MMR disaster really happen because doctors weren’t online? I’m not aware of evidence (or theories) which suggest that. If I was in your audience I would challenge you here.
You know I like to be a devil’s advocate! But seriously I think we should be spending time talking to healthcare teams and patients to identify the health communication problems that need addressed. Then we can figure out if social media is partvof the solution. We’ll have different needs in my part of the world I’m sure. But in the meantime I think we should avoid trying to guilt trip colleagues without evidence. It goes without saying that I’ll be delighted if you do have the evidence:)
Good luck, Susannah!

DrV September 24, 2010 at 10:11 pm

Aww, you’re just sore ‘cuz the whole Wakefield kerfuffle started in the UK. Kidding, kidding. Point here is that pediatrician involvement wouldn’t have prevented it but rather 60,000 blogging/writing pediatricians here in the States may have been able to influence the search engines which have been hijacked by zealots. And you’re right, it may not have made a difference.

Think if we had been global with our unity.

I appreciate you’re offering the contra view. I can always count on you.

Steve Krizman September 24, 2010 at 9:57 pm

Bryan et al: I help physicians with communications and this post and comments have been extremely helpful. I have an additional observation/question: When EMRs went into the exam room we learned that many docs were afraid of looking stupid if they fumbled at the computer in the exam room. Many did their charting in their office until they were more comfortable. Do you think something like that might be at play in social media — the fear of looking dumb in front of the patient? After all, the power differential shifts to the geek. If so, I wonder what scaffolding we can erect to help the doc through the learning curve.

DrV September 24, 2010 at 10:16 pm

Steve – Absolutely. I think that doctors really struggle with their demeanor and authority. Showing themselves before patients is difficult and this comes to bear in social. Commenting or tweeting is a fairly intimate act for those not used to it. I remember the feeling of dread when I published my first posts on Parenting Solved, my first blog. What will people think? Will I get in trouble? What if someone gets mad? Now its second nature.

But this issue of image is huge, especially with the public platforms. The physician specific networks like iMedExchange or Sermo might help pave the way.

Mary Pat Whaley September 24, 2010 at 10:55 pm

WRONG WAY: Docs go back to their practices and tell their administrators to put a blog on their website or make a Facebook fan page for the practice.

RIGHT WAY: Docs go back to their practices and sit down with their administrators and say “Let’s explore a strategy for social media for the practice together, get educated together if need be and find out how we can leverage SM for the good of the patients and the practice.”

Mary Pat
@mpwhaley

DrV September 25, 2010 at 8:20 pm

Spoke to a fertility doc about this last week. He winked and said, “I’ll have my girls work on that.” Don’t get it.

Nicholas Weaver September 26, 2010 at 1:54 pm

I am blown away, as I am finding out, physicians are not thinking past their immediate office/work environments. Mary, I know for sure your first depiction is the wrong way to approach social media, and the 2nd is a non-confrontational way to make sure both physician and administrator get what they want.

The reason being, I am almost convinced learning html code, should be taught right after english class in our schools. This is an invaluable ability when blogging and working online. What stinks is Rosetta Stone hasn’t made a CD to learn it yet! darn! I very well could be crazy or more likely have OCD because writing code/designing your blog/targeting an audience all should be intimately pursued by the person it represents. For one its incredibly time consuming and doctors among all people have the least amount of time to spare, but I think for physicians to really feel their online presence is effective at conveying their personality/brand/service/etc they must be intimately involved with it.

So def. sit down with your administration, and when you have been given the ok, chart out your brand, goals, design, pick which platforms you like using, and create something you enjoy updating and working with and especially make sure it is useful for your patients/target audience!

DrV September 26, 2010 at 2:11 pm

Nicholas, the assertion that understanding code as a key requisite to social is absurd and one of the ‘intimidation’ factors that keeps good voices down. I don’t even know what ‘code’ means and, well, here I am.

Nicholas Weaver September 26, 2010 at 3:15 pm

I am not saying you “have” to know code by any means, but I think having a basic concept gives you a distinct advantage in being able to shape your online presence. Code is indeed very intimidating to say the least! I often run away from my computer screen when I see it. I’m trying convey that knowing just a little code can help you create greater ease with how you share/communicate and interact with your online environment.

Have you ever wanted your blog to function/look/feel just a bit different? I know I have! My comment was focused on becoming more intimate with what you do and are involved with online. As I have said before, consistency on and offline is important in my opinion and having someone just throw your contact information and picture online isn’t creating an online presence or digital footprint I would be satisfied with. I think you see a large difference when drifting from sites like twitter/Facebook/linked in to a doctor’s personal site. You often find those with just a tiny bit knowledge of code are able to do some really great things with there sites that make interacting with them more enjoyable. Maybe its just me but I tend to gravitate to those sites more often. Thats all I am really saying.

I know I am part of a niche crowd who likes to do it myself. I want things to wholly represent me. I want to customize my phone/computer/home to best fit me purely for convince and efficiency. Doing this with our blogs/twitter/Facebook accounts can help you to leverage and harness these mediums like Mary mentioned.

As you stated, you are “here” and that is the beauty of social mediums. That at its core, it is social and anyone can join in if they choose. Social platforms are great at making it easy to connect and share information, but I would argue they don’t allow free range for personal manipulation, they have boundaries which you must function within. With blogs/websites the gates to freedom are opened a bit wider and that is exciting to me. With or without code physicians can and should be involved more online with the social spheres.

Sue Woods September 25, 2010 at 8:41 pm

Fabulous post and discussion, thanks. Decided to join the fray, add some perspective with a post focusing on how online patients can alter the interaction – in a good way.
Susan Woods, MD, MPH
Shared Health Data
http://www.sharedhealthdata.com/2010/09/25/engaging-clinicians-on-patients-using-social-media-embrace-the-patient-for-a-richer-encounter/

Salvador Casado September 26, 2010 at 4:18 am

Thank you Bryan for your post.
It makes me think about social media. I’m a spanish GP trying to offer a new aproach to patients. I provided email, blog for patients and a public twitter account for patients.
In my team there is a great percenteage of digital illiteratism. We need time, changes in health systems are slow but epatients are coming and we can’t make them wait.

DrV September 26, 2010 at 2:13 pm

Keep in mind that it isn’t just about e-patients….the e-doctors are coming as well!!

Mark Harmel September 27, 2010 at 10:46 am

Social media is not about reinventing the wheel, just putting it on a new surface. One approach in talking with physicians is to show them some social proof of what is being done already.

I did this back in May when I was advising the American Diabetes Association on social media outreach to their professional community. After sharing Dr. Len’s blog http://www.cancer.org/AboutUs/DrLensBlog/ with David Kendall, MD, the Chief Scientific & Medical Officer of the ADA, he asked to see other examples.

There were fewer examples then, and I discovered that a blog is a very personal statement. Some are focused on medical issues; others are more geared to advocacy. There were many varieties of doing it right.

I took the approach of showing him options so that he could find his comfort level. The original list with some additions is available here: http://www.harmelphoto.com/blog/healthwiki/

Feel free to suggest your favorites as well.

Louise Kinross October 14, 2010 at 9:24 am

Dr. V — I’m late in responding, but I wanted to know how you think social media can improve communication between professionals and patients/families, and how this could improve care.

I work in communications at Holland Bloorview Kids Rehab Hospital in Toronto — Canada’s largest children’s rehab hospital. We have a magazine on parenting kids with disabilities that combines parent voices and professional advice. We launched a blog to extend its reach and have found an international audience. But while parents/families participate, I don’t see active participation/dialogue by professionals. I’ve looked at many hospital blogs — including those who are investing heavily in social media — and I don’t see comments from clinicians.

I’d like to know how you believe engaging professionals in social media could improve their understanding of parent/patient issues and how we would measure success. Do you expect tangible changes to service delivery?

I’m very interested to hear your thoughts and those of your readers. Thanks!

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