Doctors: There is tremendous opportunity in the online space

I got a really unexpected honor recently: according to Sharecare, I’m the top online influencer for children’s health.

I truly didn’t see it coming. I didn’t go into the online space to be an influencer. I’ve been writing about health and parenting for more than twenty years; when publishing moved into the online space, I just moved along with it. But having been online, blogging and doing other social media, it has become increasingly clear to me that I need to be there—and that more doctors need to be there with me.

The main reason? Because that’s where the patients are. According to Pew Internet, eight out of ten people with internet access look up health information online. I’m seeing it more and more in my patients; “I looked it up online, and…” is something I hear all the time now. People don’t wait for an appointment, or even for their doctor to call them back—they Google their symptoms, and very often make health decisions based on what they find.  If we really care about the health decisions our patients make, we need to do everything we can to be sure that they find good information.

Which means getting online ourselves.

We need more doctors and other health professionals writing good content, but getting online doesn’t necessarily mean writing. It could mean finding good websites and sharing them. It could mean commenting when we see something that we agree with—or don’t. It could mean engaging in one of the many conversations going on in social media about health.

It seems like most of the conversation about doctors being online involves concern about ethics and professionalism. I admit that I’ve seen some stuff on Facebook and Twitter that has made me cringe, and clearly it’s not a good idea to give specific medical advice online (nothing can replace a good history and physical examination). But this is all manageable.

Dr. Katherine Chretien did a study of Tweets sent by doctors and found that only 3% might be considered unprofessional, and less than one percent had any private patient information. Overall, these are small numbers.  As my doctor-blogger colleague Wendy Sue Swanson says, we are way worse on elevators than we are online.  It’s easy enough to come up with guidelines and education to help doctors navigate the online space ethically, professionally and safely.  Another doctor-blogger friend of mine, Bryan Vartabedian, who writes a great blog called 33 Charts, has some really good ideas about this, including a recent post about how he handles online questions from patients.

The thing is, we can’t let these concerns stop us from getting online—because people like Jenny McCarthy are there and doing a better job of giving bad information than we are of giving good information.

There is also tremendous opportunity in the online space. There is so much that we doctors are supposed to be doing and saying and teaching people in our always-too-brief appointments; what if we sent them to good websites (or content we create ourselves) for generic health information, and spent those precious minutes the way each patient needs us to? Obviously we can’t do this for everyone, but if we could do it for even a few, it could make a real difference.

And even more, the Internet brings tremendous opportunities for connecting with and learning from our patients and their families. The Internet is changing how we think about health; it has empowered people to look for different kinds of answers and to share their experiences with others.  As doctors, we have so much to bring to the conversation—and so much to gain.

So, here’s my message to my profession: let’s not get left behind.  Let’s find ways to support health care professionals in giving patients what they want and need online—and in doing it well. Let’s think of the Internet as an extension of the exam room space—and a tool to help people lead healthier, better lives.

And my message to patients and families: be patient with us doctors. We’ll get online with you sooner or later (maybe you could encourage your doctor to do so!). In the meantime, remember to check in with us about what you find when you go there. We want to make sure that you are making the best health decisions possible–after all, that’s our job.

Claire McCarthy is a primary care physician and the medical director of Boston Children’s Hospital’s Martha Eliot Health Center.  She blogs at Thriving, the Boston Children’s Hospital blog, and Vector, the Boston Children’s Hospital science and clinical innovation blog.

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  • http://briarcroft.wordpress.com/ Emily Gibson

    Really great summary on why we physicians need to be continually writing with our opinions and advice online for patients to find in their searches, and one I’ll share on the new College Health blog at http://collegehealthdoc.wordpress.com

  • http://www.911healthshop.com/ 911 Healthshop

    Great advice Dr. McCarthy. Thank you for the article. We found many interesting new tweeps to follow for a lot of up-to-date useful information.

  • http://www.facebook.com/reedmollins Reed Mollins

    This is an absolutely crucial point for healthcare providers to understand and take to heart— if the mission is to improve the health and wellbeing of patient populations, then it should feel like professional responsibility to create and maintain an online presence where medically accurate information is freely available. We’ve designed a whole branch of Doctor.com to facilitate bringing healthcare providers into the online space to present information to patients and engage with the broader community— Please keep sounding this message, as the only way to combat prevalent misinformation is to have our knowledgeable providers make their voices heard.

  • http://www.thehappymd.com/ Dike Drummond MD

    Love your enthusiasm Dr. McCarthy and IMHO for most doctors, social media makes no sense at all because there is no Return On Investment (ROI).

    The average over stressed doctor in a practice that only makes money when they see patients in the office and are paid by insurance – that is the majority of them – cannot show an ROI on anything either of us would call “social media”. Not twitter, facebook, linked in, pinterest or any of the others that social media consultants try to convince them are essential to their future in medicine.

    Confidentiality precludes these as meaningful ways to communicate. Most of them don’t need more patients – what they need is more time.

    If we are talking about the larger industry of medicine – general marketing to attract patients to larger groups, hospitals, healthplans and such … YES .. social media works, it has an ROI and I recommend it highly.

    And for the typical doctor, with a closed practice, when it is 6PM after they saw 32 patients and their option is to head home for dinner with their family or bust off a tweet and a couple Facebook Updates … it makes no sense to do anything but get in the car and drive home.

    Here is my full blog post on the subject:
    http://www.thehappymd.com/healthcare-social-media-a-waste-of-time-for-most-doctors/

    Dike
    Dike Drummond MD
    http://www.thehappymd.com

    • carolynthomas

      I agree Dr. D – I often wonder how docs who blog/Tweet/write/respond to online forum discussions have the time or energy to do things like, oh, let’s say, enjoy a good book, read bedtime stories to the kidlets, spend a lovely evening out for dinner, take a yoga class or just hang out with their friends – and still manage to practice medicine at the same time?! I know patients who have their doctors’ personal cell phone numbers and email addresses – and fully expect timely responses to every call/message. That’s like eternally being on call. And doctors also feel compelled to launch into social media at the same time?

      I think you missed the mark, however, when you wrote “Healthcare Social Media is a Fad, it’s a Bubble” – which sounds like some kind of magical wishful thinking to me. Can’t stuff that genie back into the bottle, alas. Patients are online. Period. But docs don’t have to re-invent the wheel by creating their own original content (or breathlessly witty Tweets); they should at the very least be producing/distributing lists of credible online resources for their patients – and there are tons out there that are both well-written and trustworthy.

      Find them and share them with patients – and then go put your feet up and finish that good book. More on this at: “A Second Opinion From Dr. Google” – http://myheartsisters.org/2012/04/09/a-second-opinion-from-dr-google/

      • http://www.thehappymd.com/ Dike Drummond MD

        Hey Carolyn — when I say it is a fad … I am talking about the relentless drumbeat of newly minted “social media consultants” telling all doctors they have to all be online RIGHT NOW because basically “everyone is doing it”. Sooner or later they will see that the vast majority of overworked docs are not following that advice – because it makes no sense – and they will begin to concentrate on areas in healthcare where social media works. That is the fad and it will come to a well deserved end. Patients will always be online … and docs too in different ways.

        Your doctor google article is an absolute classic case of “hindsight is always 20/20″. Doctors miss diagnoses. They are not perfect. Google only serves to widen the differential diagnosis of a given symptom complex. Creating a comprehensive differential diagnosis is NOT being a doctor. It is step two (first the history, then the DD) of at least five steps to a successful treatment course.

        Google is not a doctor … neither are medical apps or other computer programs that ask algorithmic questions. Sorry you had a heart attack … really I am … and no one can be sure if google would have changed anything that night as it was actually happening.

        My two cents,

        Dike
        Dike Drummond MD
        http://www.thehappymd.com

  • http://twitter.com/KateLandMD Kate Land MD

    At first reading, your post here provided me a nice motivational kick in the pants. Time to get back to the online world! I’ve missed it and perhaps on some level, my voice is needed there. Time to write.

    However, it is not so simple perhaps. The two comments before mine make valid points. As a practicing Pediatrician with the usual demanding mix of clinic and administrative duties I often end the day with the choices Dr.s Drummond and Carolyn Thomas mention: my personal life or another tweet, post or blog… The incredibly talented physicians credited by your post, Dr.s Vartebedian and Swanson face the same choice as I do. However, they (and you) share a common support that allows your success. You have support from you institution and from the groups you practice with. Until all of our medical groups support and encourage our time spent online it will continue to be difficult time to carve out. So, while communicating with and crusading for our patients here in the online arena, we must also continue to convince our colleagues that this is time well spent. Until then, many of us will continue to be glad that you and others like you are able to speak so well and be so well promoted!