Comments on: Doctors who are not on Facebook, Twitter and blogs risk becoming irrelevant; my USA Today op-ed

By: joe

joe — Sat, 30 Jan 2010 02:43:42 +0000

Mike:
“Stop the assembly line of medicine and actually do your job. Modern physicians need to spend more time with their patients and with their journals; that’s what being a good physician is about.”

Sure I would love to. My question to you (and your insurer), is why won’t YOU pay a rate that will allow these longer visits? You are once again showing the typical american attitude of expecting surf and turf for the price a happy meal. Do you genuises really wonder why american med school grads run away screaming from primary care?

By: Kevin

Kevin — Fri, 29 Jan 2010 12:23:00 +0000

Cited by Bodenheimer here:
http://content.nejm.org/cgi/content/full/359/20/2086-a

By: drhowell

drhowell — Fri, 29 Jan 2010 09:56:07 +0000

“According to The New England Journal of Medicine, half of patients admit to not understanding what their doctor told them during an office visit.” Would you mind sharing the NEJM article you that states this fact.

By: Michael Laccheo

Michael Laccheo — Fri, 29 Jan 2010 07:42:53 +0000

Wrong.

As you say in your own article, you are among the minority of doctors on Facebook and twitter. There are significant waiting times to see physicians and a significant shortage is expected. Irrelevant? Hardly. Any good physician is worth his weight in gold even if he doesn’t have a clue how to email. Give me a doc who knows his medicine and listens to my chief complaint and I don’t care if he can even turn a computer on.

What’s irrelevant are physicians who think they should see a patient in 15 minutes and then spend time on twitter or facebook to make up for their lack of patient care. “The typical, 15-minute office visit often is not sufficient for a thorough discussion. A better way to connect with patients is needed,” writes Kevin.

No, not a better way, just more time. True medicine, education and relationships are forged in a 8 by 10 exam room while holding your patients hand and looking them in the eye, not with your hands on a keyboard and occasional glances up from a screen while thinking you need to get on to the next patient.

It’s the difference between a large lecture hall class and a small seminar class. Are we providing McDonald’s or Ruth’s Chris? Stop the assembly line of medicine and actually do your job. Modern physicians need to spend more time with their patients and with their journals; that’s what being a good physician is about.

I’m sorry Kevin. I just can’t take this nonsense anymore. I’m removing your feed from my rss reader.

By: ninguem

ninguem — Thu, 28 Jan 2010 19:06:41 +0000

Internet presence for research and pulling up documents.

E-mail, argued, but certainly could be useful.

A web page with a lot of links for subjects relevant to your practice.

But be on Facebook and Twitter or you’re marginalized?

Overstating the case if you ask me. I’ve never……ever…..referred to a doctor because of a blog or Facebook or Twitter. Never had a patient bring it up.

By: docguy

docguy — Thu, 28 Jan 2010 15:38:40 +0000

by the way, no i don’t have a policy in place for email and facebook, i’m in solo practice, i’m really supposed to sit down and give myself a policy?

what would you do, say usually i say that’s to complex for email come in for a visit, and they say what about this and that… these are the same patients that want to do everything on the phone and never come in for an appt.

By: jsmith

jsmith — Thu, 28 Jan 2010 01:00:36 +0000

This family doc doesn’t fool around with social media. And yet the waiting room is always over-full and several job solicitations arrive weekly, from all areas of the country. I guess I’m not irrelevant yet.

By: Kelly

Kelly — Thu, 28 Jan 2010 00:01:01 +0000

Funny, I just wrote a quick blog on the same subject. So here’s my humble opinion.. of course, I agree with Dr. Pho. If more doctors would follow his lead, we might move a little faster in accepting what is here and now. Medical social networking is not a new concept, it’s happening now and it’s going to continue. We need to be constructive and acknowledge that people have valid fears, doctors and patients alike. But we can’t and shouldn’t stop progressing towards what can only improve what is now the big hot mess of healthcare. To argue about privacy issues, or wonder whether ‘friending’ patients on Facebook is appropriate is getting old. In fact, to make Twitter and Facebook the ‘face’ of social networking is a mistake too.. they may be the most popular platforms, but there’s a whole universe of social media devoted solely to healthcare. Perhaps it’s time we focus on overcoming these stumbling blocks rather than continuing to bicker about them.
Let’s start with the privacy issues. And then let’s stop, because it’s a waste of time. No doctor, no insurer, no one that is privy to protected health information should disclose the PHI of any patient. If they do, they should be fined for HIPPA violation. I think everyone would be shocked and dismayed if they knew how insurance companies (ok, not all of them, so don’t bother with the backlash) treat data and paper claims in a ‘traditional’ setting. There are HIPPA violations every single day- why aren’t people worried about that? Do you know where your claims are? Do you know who has access to them? Compared to that, the internet is a finely oiled machine. Yes, the internet is more ‘dangerous’, because it allows for lightning fast communication and exchanges of information to such a broad audience.
Social networking and social media are two different things. Everyone who participates has the choice of who they want to communicate with (forums, chatrooms, etc.), how and what they want to communicate (blogs, podcasts etc.). Most of us are participating in some kind of social networking or have incorporated some form of social media into our personal and/or professional lives. We make decisions about what is now referred to as ‘netiquette’ every day, Most of us have also utilized the internet for banking or shopping. In fact, almost everyone I know banks online. This is ‘financial social networking’ isn’t it? Doctors submit claims to insurance companies online every day. So why the sudden fire storm over doctors using Twitter and Facebook?
A doctor can and should embrace these tools to reinforce his patient care. And he or she may do so without exchanging ANY individual patient information. Doctors don’t need to accept friend invitations from patients, nor do they need to answer random questions from patients that are clearly misusing a service. However, Doctors should be guiding their patients to resources on the internet that they endorse and trust- there is no risk in that is there? And for the more tech-social savvy, maybe they moderate health-based online communities or provide their patients with podcasts. There are no privacy issues here are there? Well, that’s social media/networking. How about making your own appointment on the internet rather than having to call? Well, that’s social networking too. What about e-mailing lab results? Now there is a legitimate privacy concern. And we have the technology to deal with it. How people use or misuse the technology is the issue. Are we going to stay in the dark ages? I hope not.

We can’t control what everyone does- if Docguy found himself fielding questions from patients that were inappropriate or complex, I would bet there wasn’t a strategy in place before he started. Let’s use some common sense. In other words, e- mailing ,tweeting and friending is one thing, it’s not everything. Do it or don’t do it. Do it, be careful and make sure it’s secure.
Let’s move beyond the mundane, the fear and leave those behind who refuse to do so. We need to concentrate on real challenges and make some progress.

By: R Watkins

R Watkins — Wed, 27 Jan 2010 19:22:33 +0000

“patients are seeing how social media can improve their care. Hospitals are posting emergency department wait times, as well as updating family members on the status of their loved ones during surgery, on Twitter.”

These sound more like PR gimmicks than better care. Please explain how anyone’s health is improved by either of these innovations.

If you’re basing your ER visit based on Tweets about waiting times, you don’t need to go there to begin with. And I really don’t want the crew cutting on me to be thinking about when they have to send the next Tweet to my family members.

Skeptical.

By: EJH

EJH — Wed, 27 Jan 2010 17:54:37 +0000

I think you glossed over some very real privacy issues that I perceive as an obstacle for the use of mainstream social media by physicians & patients… not to mention the cost to the physician alluded to by docguy. Once these issues are overcome and the majority of docs are emailing their patients (which I’m sure will occur before I retire, as I’m a medical student now), the new hurdles will be to ensure that patients have appropriate access and technical literacy. Online communication skills on both ends will need to improve.