I can’t get Wes Fisher’s post from yesterday out of my mind.  When the Doctor’s Always In talks about the creeping expectation of physician availability.  Newer, more efficient forms of media and communication have created the belief that doctors should be available nearly instantly and all the time.

It started with the pager and it’s evolved to real-time social media.

I’ve seen it too many times:  Physicians excited to please open the door to unlimited patient email only to see themselves shutting their families out at night as they answer questions – all for free.  And those physicians who suggest that emails should carry a fee are indicted for greed.

One problem is that health care is increasingly seen as a commodity without real costs.  Look at the recent attempt by legislators to cut Medicare 21% from providers who have already shaved their margins to practically nothing.

(Of course, the medical community’s lack of commitment to political action doesn’t help.)

When I speak I’m often asked why we don’t see more physicians in the social space.  Here’s why:  Outreach and engagement using new forms of social communication requires passion and energy.  Most physicians I know are too busy trying to keep their doors open to worry about messaging via social media.  The operation of a business in survival mode doesn’t make for cheery engagement.

Physician time is becoming increasingly devalued.  Once this issue is addressed, don’t be surprised if you see your primary care doctor launching a show on Ustream … after hours, of course.