Mayo Clinic Center for Social Media disses physicians

The Mayo Clinic has always been at the forefront of the social media and health care intersection, and is the first institution to have an official Center for Social Media.

When they recently announced the invited first 13 members of their Advisory Board for the Mayo Clinic Center for Health Care Social Media, the first thing I noticed that there were zero physicians, and few with clinical experience.

What a slap in the face.

There’s little question that the qualifications of the selected members are beyond reproach, and all are respected luminaries in the health care social media field.

But this is the Mayo Clinic, one of the leading health care institutions in the country, so it’s odd that clinician-bloggers were blatantly ignored.

Bryan Vartabedian ponders the exclusion of physicians in a thoughtful post, writing,

physician involvement in all levels of social media is scarce. The medical profession has been dangerously slow to accept the ideals that the social health community promotes. Maybe physicians haven’t earned a seat at the table. Or better yet, perhaps past performance suggests that we have nothing constructive to add. Mayo’s exclusion of physicians in their initial stab at an advisory panel profoundly reflects the changing role of the traditional provider in the new social order.

That’s true. And yes, doctors can apply for one of the additional 12 seats, selected via crowdsourcing. But haven’t we done enough to earn at least one of the initial, invitation-only, seats?

Obviously not.

I said earlier in a video blog that the exclusion was a “disappointment.”

But maybe it’s the wake up call that physicians need to get engaged in social media, or else face exclusion in future social media leadership positions.

 is an internal medicine physician and on the Board of Contributors at USA Today.  He is founder and editor of KevinMD.com, also on FacebookTwitterGoogle+, and LinkedIn.

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  • http://bizsavvytherapist.com Susan Giurleo

    Kevin, thanks for bringing this to our attention. I’ve noticed that all conferences plugged as “health care social media” are populated with speakers who are not providers, but administrators, policy wonks or researchers. They all have important things to say, but can’t speak to the day-to-day realities of using social media with patients and in the community. Let’s work to change that!

  • http://www.hemonctoday.com/blogs.aspx Noelle

    Also a shocking lack of non-white advisers and only two women in the whole bunch!

  • http://www.occampm.com/blog Michelle W

    That’s disheartening news, since I don’t think exclusion from such a board will encourge people to get on board: more likely, it will reinfoce the idea that social media is something being thurst upon the medical profession by “outsiders” who can’t understand the challenges clinicians face. The idea of representation is to ensure that everyone with stake in the outcome has a seat at the table. Besides, I can think of plenty of clinicians who blog and tweet regularly in this space. Their voice surely deserves to be heard.

  • pheski

    I think you are being either thin skinned or too quick to take umbrage.

    Look at the opening sentence of the description of the board:

    We’re pleased to announce today the formation of our external advisory board…

    Reading their press releases and the information they have put forward, it seems fairly clear to me that this is intended to be an external and largely non-medical group to provide outside the (Mayo and medical) box thinking about social media. They make it clear that the hope/expect to have physicians apply as part of the crowd sourcing process.

  • Lee Aase

    Hi Kevin – I will have more on this later, but just pulling over at a gas station to let you and others know that we plan to have MDs and, as I said in the post announcing the crowdsourcing, “diversity in all of its forms” – in the 25-member board. No slap intended.

    Best regards,
    Lee Aase
    Mayo Clinic Center for Social Media

    • http://social-media-university-global.org/2010/09/on-beta-versions-diversity-and-perceived-facial-slaps/ Lee Aase

      As promised, I’ve answered this much more fully in a post on my personal blog, which is linked to my name. Thanks for the opportunity to clarify how this all transpired.

  • alex

    It’s just another step in the long growing American tradition of disregarding the people who actually do the work (of any kind) in favor of people who market or consult about the aforementioned work. Who needs people who actually deliver health care when you can have people who are “experts in rolling out Health Care 2.0″ (note: ‘rolling out’ cannot actually involve ‘doing’ as the person has no experience or training with that).

  • http://33charts.com DrV

    Kevin, I respect your speaking up. What I like about your quotes in the MSM and this piece is that it shows that despite our less-than-stellar presence in the social world, we’re far from dead. I do think that we’re marginalized too often. You’re an important voice in this regard.

    Victor Montori did remind me that he is the medical director of the center and it would appear that they will be more inclusive of MDs on the next round.

  • pheski

    @Kevin ~> It seems that there is, indeed, an intent to have clinicians involved in a real and important way.

    @alex ~> It’s not about us (or shouldn’t be) as providers. It’s about patients. Or should be. If I were to have any concern it would be whether the patient community is adequately represented.

    @Michelle ~> It took me only 5 minutes to ascertain that clinicians were not being ‘excluded’ but will have a seat at the table.

  • http://www.twitter.com/renee_berry @renee_berry

    Hey Kevin,
    Thanks for this post! I have to say that I really do love many of the people they have chosen for their board! I also love that you say what you think. Props to you being absolutely authentic!
    renée

  • PAUL MD

    Kevin,
    Good post. You touched ever so lightly on the phenomenon of, “physicians, and few with clinical experience”.

    The administration of medical care is increasingly co-opted by “administrators” and insurance industry managers and executives as well as government appointees.

    Does an MD degree, regardless of whether or not you actually currently see patients, make you a doctor? There are some MDs doing mostly administrative work at our local hospital and many other hospitals. Are they doctors or administrators?

    The president of our state medical society is an MD but has not seen patients in 15 years. He makes his living in the health care insurance industry. Is he still a doctor? The president elect of our society holds an MD and is a representative of CMS in Washington. Is he still a doctor or is he an administrator?

    Where “physician input” is expected or offered, beware the “paper doctor”, follow the money and figure out their masters.

    It’s clearly no longer black and white. Many hats to wear.

  • Chuck

    Arent physicians generally too busy being… you know, physicians?

  • Frank Fortin

    This is a big time #fail. Never mind not a single physician – last I heard there are still 700,000 of them out there – but only one of out these 25 initial members actively provides health care. What was Mayo thinking?
    Perhaps the reason clinicians aren’t embracing social media as much as the “experts” would like, is that the “experts” are listening too much to each other, and not listening enough to the clinicians.
    (Disclosure – I work for a state medical society.)

    • http://socialmedia.mayoclinic.org/2010/09/16/crowdsourcing-our-advisory-board/ Lee Aase

      I’ll have more on this later, but I think you may have missed something here, Frank. We have only named 13 of the members. It is the total board (after the crowdsourcing process) that will have 25 members. I can unequivocally guarantee that we will have physicians on the advisory board. In fact, in the post linked to my name you will see that we specifically said we “of course” will have physicians. We’ve had some great applications from physicians in the last 2 days.

      More to come soon…

      • http://onhealthtech.blogspot.com/ Margalit Gur-Arie

        That is not the point. The original appointees represent Mayo’s opinion on who should be on the board. The remaining seats will represent the “crowd” opinion on who should be on that board.
        Arguing that Mayo had a priori knowledge of who the “crowd” will nominate is a bit shaky in my opinion, and the a posteriori argument that the “crowd” indeed selected physicians is equally insufficient.

        • http://socialmedia.mayoclinic.org/2010/09/16/crowdsourcing-our-advisory-board/ Lee Aase

          Crowdsourcing doesn’t mean we put all the nominations up for a vote by the crowd. It means we ask the crowd to be a source of ideas. We said we want to include physicians, and we’re asking the crowd to help us find good candidates, or for candidates to nominate themselves.

  • pheski

    Note that the stated purpose of the Mayo Clinic Center for Social Media is patient-centered, not clinician centered:

    “Mayo Clinic believes individuals have the right and responsibility to advocate for their own health, and that it is our responsibility to help them use social media tools to get the best information, connect with providers and with each other, and inspire healthy choices.”

    I see this as being about and for patients (and their need for information and communication tools), rather than about or for clinicians needs. While I would certainly hope that physicians would want to be involved, I don’t see it as necessary.

    • Kevin

      I’m not asking the board to be clinician centered. But having at least 1 of the original, invited 13 to be a physician or clinician is not unreasonable.

      As for the goal of a patient-focused board, there is only 1 patient advocate — Dave DeBronkart. Do you think that degree of representation achieved the board’s stated purpose?

      Best,
      Kevin

      • pheski

        I’m absolutely ok with using a crowd sourcing approach to include clinician input, rather than entitling clinicians. I think that is because I see the key areas of expertise in the invited group to be related to on-line collaboration and community building, and not particularly related to a physician’s conceptualization of medical practice. I’ve had some experience with community building, both medical and not, and a common mistake is to let the wrong folks drive – as opposed to letting a community evolve.

        I am not impressed with patient representation, but I do not know most of the people named, so I am hesitant to claim that I understand what social and cognitive contexts they will bring to the table. (Note my comment to alex above.)

        Had your post been about Mayo dissing patients, rather than dissing doctors, I would have chimed in with support. As it is, this post and most of the subsequent conversation come across to me as missing the point: the key to success is to have the online community driven by the needs of the community members, i.e., patients.

        Peace.
        Peter (aka pheski)

        • Kevin

          IMO the entire panel should have been crowd sourced, rather than starting with an initial, invited few.

          Kevin

          • pheski

            +1

            Peter

      • http://socialmedia.mayoclinic.org/2010/09/16/crowdsourcing-our-advisory-board/ Lee Aase

        One explicit patient advocate so far, in @ePatientDave. He’s a non-Mayo patient. Tom Vanderwell is a Mayo patient, which was the basis for his selection. He also happens to be involved in supporting a Haitian orphanage through social media. As I said in the post, other patients and patient advocates are welcome.

  • Mike

    You said: “But haven’t we done enough to earn at least one of the initial, invitation-only, seats?”

    I say: Done enough what? Do you mean “done enough” by your shear existence as physicians? Because if that’s what you mean, then the answer in this particular situation is “no.”

  • http://Www.healthecommunications.wordpress.com Steve Wilkins

    I can’t help but notice that certain social media mavens have a decided bias against physicians. These individuals would have you believe that chronic care patients would be better served by using social media outlets to talk with other like patients than consulting their physician. The lack of evidence to support this position does not seem to deter these individuals.

    Social media outlets like Twitter seem to be less about the actual exchange of ideas and more about who says what most people agree with. You know “who is following who.” Because physician are an easy target, and because few physicians have the time for participating in discussions on Twitter, etc. It does not surprise me that they are overlooked.

  • http://www.pacificpsych.com/ pacificpsych

    >>Mike September 18, 2010 at 9:08 pm

    I say: Done enough what? Do you mean “done enough” by your shear existence as physicians? Because if that’s what you mean, then the answer in this particular situation is “no.”<<

    Kinda says it all…

    Personally, I think physicians should quit the 'healthcare' system. Since we shoulder all the responsibility and have no say in any of it, let's just leave. Leave it to the paper pushers. Opt out of everything. Don't work in any hospital. Don't participate in any plan. Don't fill out any "credentialling packet". Sit in your office, see patients, write a little 4 line note to yourself, that's it. And if that becomes impossible, quit that.

    How long will "healthcare" survive? Will those CEOs continue to sit in their plush chairs harassing doctors? Will the insurance company parasites still rake in the big bucks? Will all the specialty boards continue to profit? What about the AMA with its CPT?

    This Mayo thing is just another instance of disdain towards physicians. So just say no. Don't want us? Think we're inconsequential? Like to lord over us with myriad nonsensical dictates? Fair enough, we'll just walk away…

  • Meredith Gould

    Wow, just read through this effluvia and so many thoughts come to mind. Here are my top two:
    1) We — the community that includes providers, patients and caregivers — cannot have it both ways. IF we agree, which as many docs who participate via social media do, that we are ALL patients (at some point), then everyone should rest assured that patients are well represented on this Advisory Board. Please contact me directly if you really want my sick-person-dealing-with-healthcare credentials.

    2) There IS a doctor on this first round of named participants, but I just so happen to have a Ph.D. rather than an M.D. — talk about what “counts” and what doesn’t!

    • pheski

      Re #1: While I agree that we are all either patients now or patients-in-waiting, without our stressful medical journey still ahead. However, we are not typical or representative of the patient population in many ways. Physicians, for example, have 11+ years of education after high school. We are all fluent in medicalese. We are likely to have contacts and be adept at finding medical information or accessing services. We are treated differently by our colleagues. I don’t think we are likely to be the mosts perceptive or useful advocates for the other 98% of the patient population.

      Re #2: Great point. I make an effort to talk and write about clinicians rather than physicians or doctors, in order to include NPs, PAs, nurses and other professionally trained clinical staff whose job entails assessment and decision making.

      The bottom line for me is that this is a perfect example of where diversity will trump expertise.

  • http://www.pacificpsych.com/ pacificpsych

    Talk about offensive…

    I really think no one will get it unless doctors simply quit, en masse. Walk out. Walk away. No one appreciates you anymore. Everyone is happy to jump on the bandwagon, to explain how you’re not the captan of the ship, how you’re nothing special, and not really needed.

    You have only one life to live. Don’t waste it.

    The Mayo thing is just the tip of the iceberg. Save your souls, physicians. It’s either go to Africa, develop a very specialized cash only niche practice, or find a different career. Nobody cares about your education and dedication. Get out before you’re in the grave. It’s not worth it.

  • http://philbaumann.com Phil Baumann

    Hi Kevin

    Thank you, Kevin.

    I wholeheartedly agree that physicians need representation (it’s one of the things I’ve been advocating for years).

    Now because the list appears alphabetically, I’m at the top and I’m a registered nurse who’s been actively involved in promoting clinician involvement online for years.

    So the interesting thing is: a clinician is actually on the list – a Registered Nurse in fact.

    I started RNchat totally on my own, and I’m getting ready to launch a chat for physicians – in part because one doesn’t exist and I strongly believe in their input.

    What I’ve learned about the Web is this: you can’t wait for things to happen – it’s a new frontier and you have to go forth and make things happens yourself.

    I hope we don’t lose sight of this – it’s actually a pretty remarkable moment to have a nurse on the board.

    I also hope that rather than seeing this as a slap on physicians that it’s actually a reinforcement of the need for more physicians to get actively involved.

    I’m sure the nursing community appreciates that one of its own is on the board.

    That’s no small thing – Nurses matter too!!! So don’t forget us! :)

    @PhilBaumann

    • Kevin

      Phil, of course I noticed you were on the list, and hence, intentionally worded my post as such: “[there] were zero physicians, and few with clinical experience.”

      I continue to maintain that the entire board should have been announced at once, rather than the tiered approach which, as someone privately e-mailed me said, smacks of cronyism.

      That said, I applaud what the Mayo is doing in taking the lead in advancing social media in academic health care circles.

      Best,
      Kevin

      • http://philbaumann.com Phil Baumann

        Oh I understand – I just want nurses to get recognized :)

        I simply wanted to emphasize the point because there’s been a lot of discussion about this matter and it’s easy for things to get lost in the discussion, that’s all.

        I think we’ll see more physicians enter the discussions and I really want that.

        At this point, I guess all we can hope for is that time will show how important it is to get physicians involved.

        Cheers
        Phil

  • http://www.pacificpsych.com/ pacificpsych

    How about this – the only people on the panel should be one of two categories:

    1) Internent savvy patients.

    2) People who when they hear ‘code blue’ run *towards* the code, not away from it…even if they don’t really feel like it…for example if they’re a psychiatrist… ;) The pitter patter of feet is what counts here, you see, not what you call yourself when the going is easy.

    • http://philbaumann.com Philip Baumann

      LOL. (When I was in ICU, I never ran away from a code) :)

      Kidding aside, I do think we need a diverse group. No one perspective has it all. Just like there is no one ‘clinical’ perspective, there’s no one ‘patient’ perspective. Rather, there’s a spectrum of views.

      Anyway, besides: this is a first step – it isn’t the last for sure.

    • pheski

      Would you consider the addition of some internet-naive (sounds better than internet-phobic or internet-illiterate) patients? This would give a voice to those who – for whatever reason – have found the barriers to internet use too great.

      When starting a work-group, I always make an effort to include outsiders. For example, EHR committees tend to be populated with IT and administrative folks and clinical superusers and leave out the entry level users. The result is a product that all too often caters to those already best able to use it, and ignores those most in need of help. If one wants to narrow the gaps, one has to broaden the range of participants.

      ;-)

  • http://www.pacificpsych.com/ pacificpsych

    Here’s the problem:

    Physician, far from being the all powerful ogres that some imagine them to be, not only have had medicine taken away from them by paper pushers, they have NO SAY in anything.

    Examples:

    Psychiatrists are told they will do ‘medchecks’. !!! What_the???
    Psychiatrists are told how much time they are “allowed”.
    Psychiatrists are told what paperwork to fill – and it’s 99.9% junk. Jacho decided, admin decided, UR decided, IT decided – doctors had NO SAY.
    Psychiatrists are told by Managed care and UR when to d/c the pt.!!

    NOTHING in the healthcare system operates in the way I think it should, and many many physicians feel the same way.

    The above are just a few miniscule examples of how physicians have been marginalised.

    The only way out is to exit the system.

    So back to our topic – this is, I repeat, just the tip of the iceberg. If you want to get physicians participating in online interactions – I sure do, it’s part of what I do, after all – the first limiting step is respecting them. Respecting physicians does not detract from respect towards nurses and certainly does not put patients in second place – that idea is preposterous.

    Respect towards physicians is respect for patient’s well being above profits, respect for caring, knowledge, logic, reason and the advancement of medicine as an art and a science. Respect for physicians is respect of the physician patient relationship – a sacred relationship that has been beaten almost out of existence by outside forces.

    Disrespect towards physicians equals buying into the Administrative/Bureacratic/Paper pushing/Bean Counter view of the universe.

    That’s why those of us who do participate actively in this newfangled invention here called the inter-web feel dismay. It’s not so much about being left out (and only temporarily perhaps) of one little corner of the health media scene. It’s the whole shebang.

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