Op-ed: Social media can enhance the doctor-patient relationship

A version of this op-ed was published on January 27th, 2010 in the USA Today.

Raise your hand if you’ve ever left a physician’s office without fully understanding what the doctor just told you.

Studies show that half of patients admit to not understanding what their doctor told them during an office visit; and more than 75% of emergency room patients acknowledge not fully grasping instructions given to them.

As a primary care physician, being unable to clearly communicate with patients is frustrating. The typical, 15-minute office visit often is not sufficient for a thorough discussion of health issues, let alone to clarify any patient confusion. A better way to connect with patients is needed.

Perhaps that is why more patients are turning to the Internet. A recent survey from the Pew Internet & American Life Project estimates that 61% of American adults surf the web for health information, with the majority looking for user-generated content written by others with similar medical conditions.

Social media websites that encourage reader interaction and conversation are playing an increasingly large role in providing information tailored to online patients. There are thousands of blogs and Facebook groups, for instance, where patients discuss their experiences living with cancer, HIV or depression. And patients use Twitter to share tips on battling diabetes, or give advice on finding the right doctor or hospital.

But like a lot of the information on the Internet, not all medical content is credible. In fact, acting on inaccurate web information can be dangerous. That’s where medical professionals can help patients interpret and decipher what is accurate on the web. And with 57 million Americans reading blogs, combined with 120 million monthly U.S. visitors to Facebook and Twitter, social media presents a compelling opportunity for doctors to better interact with patients.

I regularly blog and use other forms of social media; both to provide patients with a physician’s perspective on breaking medical news and to guide readers to reputable sources of medical content. But when you consider that more than two-thirds of doctors don’t even e-mail their patients, it’s probably safe to say I’m in the minority of physicians who use Facebook or Twitter.

One reason deterring more physicians from using the Internet is because professional standards of care are unclear on these platforms. Should physicians diagnose patients who “friend” them on Facebook? Or would a doctor be held liable if he missed a patient who Twittered that he had chest pain? Because few have looked at social media’s impact on patient care, there is little guidance on how physicians can incorporate it into their medical practice.

Dr. Daniel Sands of Harvard Medical School co-wrote a seminal set of guidelines on doctor-patient electronic communication. Sands says that “the only commodity physicians have is time. Doctors don’t want to introduce new technologies of unknown value, which is why something like Twitter is going to take longer to accept.”

Another drawback is that most insurers only pay doctors who talk to patients in the examination room, giving physicians little financial incentive to reach out to patients over the web.

But doctors who are not active online risk being increasingly marginalized. Facebook and Twitter users, half of whom are under of age of 34, rely on the web for most of their information. As this demographic ages, it’s conceivable that they will consult social media first to answer their health questions, rather than schedule an appointment with a doctor.

Already, 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.

The Centers for Disease Control and Prevention use their prominent Facebook following to keep the public abreast of dynamically changing events, like the status of the H1N1 influenza pandemic. And doctors can blog and disseminate analysis on breaking medical studies, instantly informing patients of their impact.

Quality health care requires a doctor-patient dialogue that doesn’t simply end once the physician leaves the examining room. While ultimately standards of care online need to be established by professional medical societies, in the meantime doctors should embrace social media as a way to continue the conversation, and to provide patients with the trusted health information they’ll need.