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Healthcare Social Media (#HCSM) Series: Listen Up Medical Providers

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Austin Chiang, MD, Finalist of the Google Glass Challenge!

This article originally appeared on the blog of Austin Chiang, MD, internal medicine resident at New York-Presbyterian Hospital/Columbia University Medical Center in New York City. We’re so excited he’ll be moving to Boston this summer to start his Gastroenterology training at Brigham and Women’s Hospital, a Harvard Medical School-affiliated teaching hospital.

Connect with Dr. Chiang on Medstro, Twitter (@AustinChiangMD), Instagram (@AustinChiangMD), Facebook (AustinChiangMD), or his website!

This is the first of several #HCSM (Healthcare Social Media) Social Media Series blog posts (I’ll be posting this index with links as more posts come out so you can easily navigate from section to section).

  1. #HCSM Series: Listen Up Medical Providers!
  2. #HCSM Series: Keeping It Professional
  3. #HCSM Series: For The Patients
  4. #HCSM Series: Impacting Public Health
  5. #HCSM Series: Industry and the FDA
  6. #HCSM Series: Shaping Medical Education

Maybe you think engaging in social media is a waste of time. Maybe it hadn’t occurred to you that it could be a networking and academic resource. Providers shy away from popular social media platforms such as Twitter and Facebook for a variety of reasons, but failure to recognize how social media impacts them, their patients, and public health may be risky. Between witnessing the ignition of revolutions in The Arab Spring and how social media use continues to grow among younger generations, it may be prudent to think about incorporating social media into your practice. Perhaps acknowledging this growing trend is the first step.

Let’s focus on social media and the provider, keeping in mind how the impact of social media on other parties such as patients and “industry” can have indirect effects on the provider (to be discussed in upcoming entries).

1. Like it or not, chances are you are already using a social media platform.

Kaplan and Haenlein, authors of the landmark article Users of the world, unite! The challenges and opportunities of Social Media (2010), have described the widely-accepted definition of social media as “a group of internet-based applications…that allow the creation and exchange of user-generated content.” Social Media assumes many shapes and sizes. Social networking websites include Facebook and LinkedIn. Blogs and microblogs such as Tumblr and Twitter are popular as well. But other common social media platforms overlooked as such are Wikipedia (crowdsourced referencing), YouTube (video sharing), and Skype (video conferencing).

2. Some doctors have embraced the medium.

A number of high profile physicians are on Twitter. Here’s a list of popular MD accounts (and the # of followers as of 2/2014):

  1. Dr. Mehmet Oz – 3.28M
  2. Dr. Drew Pinsky – 3.07M
  3. Dr. Sanjay Gupta – 1.77M
  4. Dr. Ben Carson  – 153K
  5. Dr. Travis Stork – 108K
  6. Dr. Atul Gawande – 82.7K
  7. Dr. Andy Baldwin – 41.2K
  8. Dr. Eric Topol – 34.8
  9. Dr. Tom Frieden – 34.6K
  10. Dr. Richard Besser – 34.2K
  11. Dr. Francis Collins – 25.5K
  12. Dr. Boris Lushniak – 15.9K

These docs are not alone. One study of physicians and social media revealed a total of 314 doctors with >500 followers, 70% which were MDs, 0.8% which were DOs, and the rest unspecified. Surgeons comprised 15%, internists + IM subspecialities 11%, and family practitioners 9.6%. A survey of 485 physicians, revealed 24% used social media at least daily.

3. What are these docs doing on Twitter?

Disseminating public health information? Informing themselves of the latest medical news? Advertising their shows and merchandise? Connecting with the their patients? Is that even a good idea? (More on this subject in the next in my #HCSM Series: Keeping it Professional)

The aforementioned survey of 485 physicians showed that 59% tweeted about health professional education, 19% tweeted about consumer education, 11% were marketing tweets, 6% was social communication, 5% were fundraising tweets. Interestingly, 3% of tweets were considered “unprofessional.”

Providers have used social media in a variety of ways to reach out to their patients and improve care, some of which have proven helpful. Twitter allows providers to share helpful links and articles with patients and colleagues.  I, myself, have followed various medical journals and thought-leaders within the medical community. (See Section 4 #HCSM Series: Impacting Public Health)

More directed methods such as appointment and medication reminders through certain applications have improved clinic attendance and adherence to certain medications. Reminders have also been shown to improve flu vaccination rates and smoking cessation.

Efforts are under way to utilize social media to connect elders at home to reduce social isolation. Applications such as CareAtHand (Careathand.com) have been created to help home health providers monitor medication adherence and screen for potentially hazardous situations, with the hope of preventing hospital readmissions.  Future integration of the mobile device features (accelerometers, microphones, cameras, GPS location services) into social media will undoubtedly create more ways to affect patient care.

My concept “Procedure Bank” for Google Glass incorporates social media using a YouTube model whereby physicians can comment, critique, and improve upon procedures. Read more about “Procedure Bank” here.

4. How do doctors feel about this so far?

A survey of physicians reportedly revealed high buy-in for certain low risk applications such as appointment and medication reminders (86% and 77% respectively) but less so for adolescent health updates (63%) and providing test results (55%). This makes sense, considering there are privacy concerns with test results distributed via social media. Adolescents were reportedly comfortable with some reminders, but were understandably uncomfortable with others such as STD testing reminders. While adolescents may be the demographic most entrenched in social media, but the age at which teenagers should start interacting with doctors via social media is another question. The survey revealed: 14.6 years old. Would you agree?

Some are afraid that social media with further reduce face-to-face interaction. Others seem to counter this effect by encouraging engagement on social media platforms and blogs. However, some are concerned about how to deal with specific interactions. What is a patient blogs about suicidal ideation, for instance?

5. How can doctors get started with social media?

OK, so you might not be comfortable putting yourself out there in the Twitterverse just yet, but are not opposed to connecting with other physicians or using social media as a tool to stay informed. What to do?

Webicina.com organizes social media resources that can help physicians stay informed by recommending blogs, videos, podcasts, and even experts in a certain field on Twitter.

Social networking among physicians is also becoming increasingly popular with websites such as Sermo and Doximity. Medstro is the latest of these networks, where physicians can seek out collaborative opportunities and exchange ideas. Identifying mentors and collaboration partners is often difficult, and sites like Medstro are a big step in helping facilitate the necessary interaction that could borne the next revolutionary idea in medicine.

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Finalist Piyush Gupta, MD; Finalist Florence Doo; Expert Alia Rashid, MD; and Finalist Austin Chiang, MD

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Austin Chiang, MD

Austin Chiang, MD

    Dr. Chiang completed his medical education in 2011 at the Columbia University College of Physicians and Surgeons in New York, NY. He continued his training at New York-Presbyterian Hospital, Columbia University Medical Center in New York City where he is currently finishing a residency in Internal Medicine. Under the mentorship of Chief Health and Medical Editor Dr. Richard Besser and managing editor Dan Childs, he contributed briefly to medical stories as a resident member of the ABC News Medical Unit at the ABC News national headquarters in NYC. In the summer of 2014, he will begin his fellowship training in Gastroenterology at Brigham & Women's Hospital, a Harvard Medical School-affiliated teaching hospital in Boston, MA. He hopes to explore his role as a physician not only in the clinical and research settings but also in social media, mass media, and medical innovation.

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