Intimacy, Mission and a Physician’s Public Role

This weekend at Stanford Medicine XiStock_000018781954XSmall I’m co-teaching with Wendy Swanson a Master Class on physician online identity.  As I was working through some of my thoughts on the plane, I settled into the idea that being public with our thinking is a pretty big deal for providers.

Being out and open in the virtual space carries with it a whole new set of preoccupations.  Physicians traditionally only had to worry about their IRL (in real life) presence.  We walked around, we touched people, we talked to them.  All of our interactions were in person.  Eye-to-eye and hands-on defined everything about us.

We still do that, but now we’re faced with the new challenge of managing a presence in the virtual space.  But…

  1. We don’t know what the rules are.
  2. Many of us don’t know what the tools are.
  3. A lot of us don’t know what we want there.

This last reality become obvious when I talk to physicians about blogs.  A relevant blog, of course, requires some degree of focus or direction.  You need to create and share around something that drives or inspires you.  But when you get down to it with them, many don’t know what turns them on.  They have no idea what they could even create a blog post about.  Many don’t even know why they’d want to make or share anything.  So beyond even having a mission, there’s no understanding of why it would want to be shared.  It’s striking, really.  It’s like they’ve never been forced to declare themselves in any meaningful way.

The capacity to be public really amplifies the fact that we all have passions, missions and roles in the world.  Being front and center with a footprint and identity forces us to think about where we fit in the world.  It was easy to be elusive when the world was private and our existence was restricted to an exam room.  But now we’re part of a wide-open, networked world.  This capacity to share and create exposes us for who we are and what we believe in.  Being here is an act of intimacy.  Participation is something that many of us just aren’t prepared for.

Often times I position the discussion of our ‘obligation to be public and present’ as so easy and obvious.  But it’s a big step for the provider trained to contain his life within a silo.

More on this later.

Outward Thinking Medical Leaders

I had coffee with the director of a local residency program. The topic of blogs came up and he couldn’t see the value of a blog for their residency program.  My most compelling case made his face quietly contort.

Then I realized: There are those who look out and those who look in.  There are the public and private, connected and disconnected.  There are those who see the transformative power of engaging beyond their immediate space.  And there are those who haven’t made the connection.

Most physician leaders see the world from the inward perspective.  They’re silo’d.

A defining feature of a leader in the networked age will be the capacity and will to look beyond what they can see and touch.  The leader of tomorrow will be defined by the ability to create, connect, influence and lead in a new medium.

What are we doing to create leaders?

4 Reasons to Consider a Surrogate Blog

BlogAs online reputation and digital footprint become more important for professionals, blogging has to play into your strategy.  Unlike purely social applications, a blog represents one of the best ways to define and park your ideas for others to see.

Conversation and curation are good, but creating the stuff that everyone talks about is the ultimate footprint move.

I also realize that this isn’t realistic.

So a surrogate platform may represent a good solution.  A surrogate blog is one that belongs to someone else but hosts guest bloggers.  Good examples are KevinMD who provides a great place for general medical commentary.  Wing of Zock offers a solution for academic physicians looking to share ideas that may not fit in a traditional journal.  And if I didn’t spend so much time here, I’d write more for Medicine | Milestones | Miracles or Momentum, the blogs of my own Texas Children’s Hospital and Baylor College of Medicine.  Most institutions these days have blogs and they’re typically thrilled to have a member of the medical staff or faculty willing to pitch in with good thinking.

So when should you consider a surrogate blogging platform?

  • Fear – When you don’t want to go it alone.  When the perceived risk of owning a site is more than you can think about, you might want to write out of harm’s way.
  • Money – When you don’t want to spend the cash.  When done right, keeping a blog costs money.  Writing in someone else’s space saves you the cost of web development, maintenance and other hidden costs.
  • Time – When you haven’t got the time.  Looking after a busy blog can eat your bandwidth.  And if you’re only in it for a couple of posts a month, maintaining a site may be more trouble than it’s worth.  The surrogate site does the heavy lifting by taking care of issues such as setup and server issues.
  • Reach – When you need more reach.  When you blog on someone else’s site, you ride on their Google juice.  An established blog will offer instant reach and visibility that takes years to develop on your own.

Of course there are more reasons.  Why else would you consider a surrogate platform for blogging?

Medical Apocalypse

businessman with gas mask watching TVWe’ve become preoccupied with health care to the point that we’ve lost sight of who delivers it.  To understand the depth of the crisis look no further than the words of Dr. Jordan Grumet.  This week he announced his pending departure from clinical care.  To think that we have evolved a system so dysfunctional that it can’t support a dedicated doctor of this caliber is unconscionable.

If you have a moment, thumb through his blog.  It’s like a window to his heart.  Be sure to read between the lines.  And as you read, think about what we’re giving up.

We’re about to learn that our healthcare system is only as good as those who deliver the care.

Is There a Physician Mandate to Connect?

The more popular Twitter becomes, the more we hear about the mandate to participate.  Those of us who’ve made the step feel like we’ve discovered something that everyone should do.  We want our friends and coworkers to jump in with us.  In the corporate communications world there’s a shortsighted trend to ‘make CEO’s use Twitter.’  The same pressure can be seen among medical professionals.

The decision to tweet, blog or record should be made on value.  Those of us trained to think in the analog era have a hard time seeing the value of networked knowledge and communication.  The physician’s comfort zone is the silo of the clinic.  Our understanding of professional connection is limited to the doctor’s lounge, hospital hallway or, at best a listserve.  Our understanding of health teaching is limited to the 7 minute face-to-face encounter delivered under the harsh glare of UV lights.

But there are 50 ways to use something like Twitter to make your world, or the world of those around you, a better place.  YouTube’s potential application in health care is limited only by the imagination.  While no one has to use any of these tools, believing that Twitter is only a place to share what you’re eating for breakfast is to live with your head in the sand.

We can’t value what we don’t understand.  And we’ll only understand what something can offer by poking at it and trying it in different ways. The world is increasingly networked.  And when you find the right place to connect, share and create, you’re likely to find value.

How Often Should a Physician Blog?

Recently someone asked how often a medical blogger should post.  True-to-form there was the suggestion that you post daily.

This is a timeless question.  But I’d be careful believing that there’s a firm answer.

What you do with your blog and how often you do it depends upon what you seek to gain from your presence.  If you are dependent upon advertising you must continually feed the beast.  If, on the other hand, you are a general surgeon interested in showcasing some of your thinking before potential patients, you might get the job done posting a couple of times a month.  If you are a serious writer I suspect that you’re better off honoring quality over quantity.

But the point here is that your mileage may vary.

My problem with all these rules is that it often keeps good doctors quiet.  And for better or worse, our best examples of physician bloggers are those most focused on blogging.  Most examples are unsustainable.  But most physicians do not want to be focused on blogging.  There’s lots to be gained from voices of the everyday physician – even if just once every week or two.

Then there’s the tendency are to get wrapped up in metrics.  We want more but typically we don’t know why.  We all learn pretty quickly that more we post the more traffic we see.  Ultimately it’s important to think about why you’re here and what you want to get out of your presence.

And that’s what should determine how often you post.

Try New and Improved Scope

Check out the facelift on Scope, Stanford School of Medicine’s blog.  Their new look is clean, easy on the eyes and custom built for the efficient consumption of content.  And I love the big, soft social sharing buttons at the end of each post.  I just wanna push ’em.

Under the direction of John Stafford, Scope is one of my leading destinations for the serendipitous discovery of new medical information.  While there’s lots of Stanford related material (and there’s nothing wrong with that), they manage to capture the best of the rest.  If you are a medical school looking start a killer blog, study Scope.

I think I’ll put my feet up and try out those buttons.

5 Fresh Medical Voices

I love finding new physician voices.  Here are a few that I’ve been peeking at over the past couple months.  They’re worth checking out.

Linda Pourmassina.  Linda is an internist in Seattle and one of the finest writers in the medical blogosphere.   You can find her over at Pulsus where she offers commentary on an eclectic mix of medical goodness ranging from social media to the subtleties of patient interaction.  Really good stuff.  Check out The Internet and Delusional Thinking.  Beyond her blog, Linda’s Twitter output is the perfect balance of valuable links and dialog.  Put her in your feed and she’ll bring you good things.

Chris Porter.  Chris is a surgeon who has been writing at On Surgery, Etc. since April.  This guy has an incredible voice and offers rare insight into the experience of the surgeon.  He has a remarkable way of seeing medicine at its most granular level.  When he corrals his narrative in just the right way I expect we may see him on the new release table at Barnes & Noble.  Check out his experience as a surgeon in Guatemala.  And from the narrow column Blogger template to the liberal use of crazy images, his site offers the raw feel of some of the vintage medical bloggers.  His bio reflects the mindset of a next-gen physician: I’m Phoenix-based and world oriented.  How can you resist that?

Aaron Stupple.  If I were a medical student I’d be thinking like Aaron.  He writes at The Adjacent Possible where he drills down on some of the pressing issues at the interface of medicine and technology.  He’ll help you think about the where the next generation sees themselves heading.  And if this makes any sense, he writes in a way that I like to read. Of course, he had me at The Adjacent Possible, a concept popularized in Steven B Johnson’s book, Where Good Ideas Come From.  Apparently Aaron and I think alike. While he’s only been at it since late 2010 I’m interested to see where he takes this.

Jin Packard.  Jin Packard at Fresh White Coat is another real voice representing the future of our profession.  He’s been at it since late 2010 and brings together a collection of material reflective of someone thinking ahead of the curve.  He’s even been courageous enough to try to bring his medical school to task on its social media presence. If you ever find yourself discouraged with the future of the medical profession, read Jin.  And I love his site design. On Twitter he’s @JinPack.

Franz Weisbauer/Lukas Zinnagl.  These guys write at Medcrunch. They kicked in late last year with the goal of  ‘creating a new kind of online magazine, that deals with topics that you won’t find in the NEJM or The Lancet – topics that will change the way you view the practice of medicine.’ I have to admit that every post I read makes me say, ‘why didn’t I think of that?’  Check out Signal vs Noise in Patient Care.  Follow them on Twitter @MedCrunch.

I’m always looking for fresh, new voices.  Who else should I read?

Unprofessional Physician Behavior on Twitter

I woke up this morning to a couple of DMs from physicians alerting me to the Twitter thread seen below (tweets read bottom to top).  Is it unprofessional?  Decide for yourself.

Whether you change details or not, the use of the social space at the comical expense of those we’re called to treat is irresponsible.  While the detailed depiction of the patient’s problem is bad enough, the suggestion that you would have somehow ‘fixed’ the situation long before 36 hours is reprehensible.  This is something I’d expect from a frat house, not a treating physician.  Of course this level of dialog could only be sustained by someone hiding conveniently behind the cloak of anonymity.  Case in point for putting your name and maskless face behind everything you say.

Concerning doctors and public dialog, if the crowd doesn’t look after things, someone else will.  But I shouldn’t complain.  This sort of stuff gives me fodder for my next presentation.

What say you?

Comments to this post without a proper name and link to a digital property (Blog, Facebook, Twitter, etc) that identifies you as a palpable human being will be deleted.

Comments are now closed.  There are an amazing variety of views below as well as a number of ongoing conversations throughout the infosphere.

Physicians on Twitter – 48% Link to Their Blog

It seems for many doctors Twitter activity is an outpost connected to some other online place.  48% of physicians on Twitter link to their blog according to Katherine Chretien’s recent study published in JAMA.  Doctors apparently understand that different types of information flow better in different channels.

If you had asked me I would have estimated that this Twitter-blog association was much lower.  Of course I like to believe that I understand the social doctor better than I actually do.  And this is why we need original research like Katherine Chretien’s.

Image via Art Designer

33 charts to Host Grand Rounds

33 charts is proud to serve as the host of Grand Rounds next Tuesday, January 25th, 2011.  For the uninitiated, Grand Rounds is the weekly collection of the best in medical blogging, featuring writing from physicians, nurses, researchers, students and healthcare professionals.

Okay, grab a chair.  We’re gonna mix it up a little here:  This week submissions must be made on behalf of a blog other than your own.  What have you read that we shouldn’t miss?  Help with the curation of social health’s best of the past couple of weeks.  No theme except we’re turning the spotlight away from ourselves.  Who nominated who and why will not be disclosed.

You could say I live dangerously.

I need the name of the post, link and one simple sentence describing why we all need to check it out.  The deadline is Sunday night when I go to bed.  Send submissions to Fox42   At with a subject line that makes it clear you’re not spamming me.

Spread the word.