The Eye and Voice of the Public Physician

October 14, 2013

bits-1This post from Joyce Lee is worth a peek.  It represents the growing importance of the public physician’s eye and voice.

The short version goes like this: Last week HealthTap began a campaign suggesting that they had saved 10,000 lives.  On the twittersphere the catchy suggestion saw traction.  The most surprising people blindly RT’d.  Even the New York Times sold the wonders of HealthTap by headlining all the precious lives saved.  But few spoke up and no one asked for evidence.  Joyce started things and created a conversational vapor trail questioning the dubious claim.

But HealthTap isn’t the first platform to spawn the things worthy of discussion.

  • ZocDoc last week released a survey with implausible results.
  • Figure1 released an application desperately in need of dialog.
  • Numerous start ups are looking for ways to attach sensors to babies.  The pious pitch is that data is good but the veiled intent is to unlock the purses of anxious millennial moms.

As technology and the individual patient assume a greater role in facilitating health care, we often ask, what will become of the physician?  How will we as a profession shape our role in a radically changing environment?

I have an idea:  Perhaps we should take our hard fought, real-world know-how and apply it in a meaningful way in public.  Maybe we should speak up and talk about why something may not be such a good idea.  The social health bubble is cluttered with mindless sharing that suggests every new app offers a shiny future.  Every stat is taken and retweeted at face-value.  Social presence has taken the dangerous turn of being more about how you look sharing than what you’re sharing.

The health community needs more sparring, debate, and criticism among health professionals.  The medical community is simply too quiet, passive and uninvolved.  And as Joyce has shown, don’t count on the mainstream media to keep an eye on things.  It seems they’re accountable to no one but shareholders, advertisers and fawning publicists.

Health dialog has become a 24/7 spin cycle hijacked by those claiming to have the patient’s interest at heart.  Like pharmaceuticals of old, new technologies will look to draw direct-to-consumer attention, bandwidth and money.  As public dialog grows and as conversation plays a greater role in what we understand and believe, medical professionals are in a unique position to counter those shiny objects promulgated as inevitable.

I’ve done my share of technoevangelizing.  I’m optimistic and generally deterministic in my views about technology and its place in the future.  But that doesn’t mean that I shouldn’t be more balanced in the way I see things.  In fact I was even bullish on HealthTap early on.  But I’m learning as I go.  And as my audience grows I’m recognizing the responsibility of a public physician’s eye and voice.  Especially when the numbers don’t seem to make sense.


Alice Robertson October 15, 2013 at 12:11 am

HealthTap at first glance seems like a great opportunity for a layman. But it may very well be a type of Facebook where doctors cleared of responsibility in the user agreement have the freedom to send patients right along with a pat on the head singing tra la la la la!:) It’s said online they can sell our information without culpability on the doctor or site for their type of authoritative counsel given with lack of accountability? It is currently viewed as a type of patient-board where you have a doctor’s ear….but does he have your back?:)

Angela J October 23, 2013 at 1:06 pm

Sentiment shared. Though the sad thing is that all these Facebook type platforms are what’s clicking and what everyone’s into, and its what works in terms of relaying info. This doesn’t exclude the medical sector. Most are there to sell and present information(not necessarily the best) in a way that people buy them.

Davis Liu, MD October 15, 2013 at 9:12 am

Completely agree. I also feel that technology will help make care more affordable, accessible, and of higher quality. The challenge is not all of the technology will do it and we as doctors must help be part of the conversation. My thoughts about HealthTap as it is currently modeled is that doctors will be left hanging the bag the same way artists are on Spotify.

Unless as a community we as doctors speak up, particularly via social media, with will be pushed aside for the latest shiny tech object / program / platform.

Again, just to be clear, I believe the integration of technology will make care more personalized and better as I reflected on a recent start-up conference – Rock Health –

Susannah Fox October 15, 2013 at 3:06 pm

I have a few thoughts to share.

First, I think we need the equivalent of Godwin’s Law for when the comments on an article or essay are so much more sensible than the original post that it tips over into farce. Someone I work with suggested “The Comment/Post Sensibility-Inversion Ratio” and someone else suggested we just call it “The Switcheroo.”

My favorite examples are Amazon reviews which mock the product, like:

“An App That Saved 10,000 Lives” is of course just today’s specimen. But look at the URL for that post, which reveals the original, more tempered version of the headline: “How to Save 10,000 Lives with an App? Flatter Doctors.”

Another ray of hope? The NYT blog does admit they were wrong and post corrections, such as on this howler:

Maybe a NYT editor is reading the comments, or Joyce’s post, or all the counter-tweets and will ask the reporter the question that she should have asked herself, “Is there proof?”

My disappointment is not with Health Tap or anyone else whose job it is to promote their work and get their name in the press. My disappointment is with any reporter, editor, or RTer who lets stuff get past them.

Sadly, this is nothing new. Jonathan Richman got a similar bee in his bonnet in 2011 when CNN went hook, line & sinker for a study that turned out to be, well, not true:

Maybe there’s a pledge we can take: I promise not to RT anything I haven’t checked out myself. Clinicians, as you point out, have a special burden of responsibility, but I think everyone should share it.

In the meantime, here’s to the Switcheroo! Long may it live.

Gilles Frydman October 15, 2013 at 6:55 pm

Of course, Susannah’s comment about her (shared) disappointment with any reporter or editor who let’s this stuff past them.

We are talking about the confluence of the worlds of medicine and technology. Anything done in medicine has the potential to do good as well as the potential to do bad. Any medically related activity that is powerful enough to save 10,000 lives has a similar potential to take 10,000 lives away.

A rational answer to the remarkable statement that “the App” has saved over 10,000 lives could simply be “and how many lives were lost in the same period?

Then, we can all take a breather and see how equally absurd both statements are. Inflated statements of success and impact, although great for simple marketing purposes, do not serve most of us, who are working to show that the internet is a revolutionary tools, facilitating the growth of a population of engaged patients big enough to change & improve outcomes.

DrV October 15, 2013 at 7:45 pm

Wow, G. Beautifully said. And the balance of risk/opportunity is a novel perspective here. Of course, I think we can be assured that few lives were saved or lost here. Thanks for your input.

jim ryan October 21, 2013 at 7:18 pm

as a young family doc i believe that we primary care providers are hard pressed to address the transformation of health care for many reasons.

1) we are overburdened.
2) scientific findings at large has become suspect in their validity.
3) we are not empowered or shown how to effect change in technology. traditionally clinical technology adopted a subset of the knowledge base that was learned in medical school. new drugs and labs were applications of biochemistry and chemistry. software development is completely outside the understanding of typical physicians. the software we are using in our offices is not open to any meaningful input from either physician or patient.

we need a system that is put in place in our medical schools that allows us physicians an opportunity to effect change in HIT, and not just a passive course on HIT.

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