Month: November 2016

This thought was presented first at #MayoInOz Social Media in Healthcare Summit, Melbourne.

Many social media non-users don’t understand Social Media the way many non-Aussies don’t understand our national preoccupation with The Vegemite.

Social Media is like the Vegemite. It does not come with any How-To Guides. Most clinicians end up just jumping into it and experimenting with it, while others are inherently repulsed by it because of the horrible stories they have heard about it. It’s like Vegemite in Australia, Marmite in the UK, Haggis in Scotland, or any other delicacy that is culturally contextualised, you need to see how it is enjoyed to get the full experience.

The problem is, many critics slam Social Media in healthcare without ever exploring it and understanding it in the first place. Like criticising Vegemite without having even tried it properly. Vegemite is not Nutella. You can’t do Vegemite the way you do jam, Nutella or cheese spreads. If you use it poorly, you’d go “ugh” that’s horrible. You need to be shown how to enjoy it. You need to be shown how to use it. Then you’ll get that Eureka moment and realise, “Oh wow. This is what it’s all about. This is what everyone’s been talking about.”

Social Media isn’t just about marketing, self-promotion, Doctor-rating, cat photos, outfit of the day, or food photos. It is personal learning network. It is social support. It is professional engagement. Don’t criticise social media unless you’ve been properly shown how to enjoy it. Once you realise how good it is, like Vegemite, it becomes a delicacy that unites a nation. Grab someone you know and ask them to show you how to Social Media. And if you’re not an Aussie, grab an Aussie and ask them to show you how to Vegemite. 

 

I believe Clinicians (Doctors, Nurses, Physiotherapists, Speech Pathologists, Dietitians, Audiologists, Social Workers, etc.) need to be on Social Media. I believe that it is our ethical obligation to be where our patients are when they’re discussing health matters. I believe that we need to listen to our patients, fill the online space with accurate health information and therefore influence the health conversations occurring already on social media.

 

I encounter many clinicians who do not think much of Social Media, primarily because they’re not certain of the role of social media in public and personal health. The following are common fears and criticisms around Social Media and what you can say in response:

 

Social Media is a waste of time.

Of course it can be. Just like reading magazines and newspapers can be. The good thing is that social media is my personalized learning channel. I curate who and what I follow on social media and hence I get the latest educational information on things that matter to me. I have ready access to a wealth of information whenever I have some time between activities.

 

Social Media is for selfies and food photos.

If that is so, then you’re following the wrong people. Social media helps me see what patients are concerned about. Social media shows me the social effects of diseases. Social media allows me a peek into some operating theatres and helps me attend conferences virtually. I have been exposed to more relevant evidence-based medicine articles through social media than I ever did through stopping by at the library. I read lots of abstracts and other papers discussed on social media.

 

Social Media is a passing fad.

That’s what they said about the internet. I have been on social media for 5 years now and it’s only getting better, more sophisticated and smarter. People are finding health information, health forums, other patients and health professionals much quicker than ever. Patients are sharing information about illnesses in a way that is disrupting the traditional way of doing medicine. It’s like going from the fax machine to having emails and smartphones. It is the natural evolution of social communication. Having a social media account is much like having an email or a phone number.

 

Social Media is risky.

So you think being on social media places you at risk of being slammed and rated by patients? Which do you think would be a higher risk, being on social media or not being on? Without a basic social media presence, you have no control of your reputation, your content or your supposed expertise. Someone else could potentially grab hold of your profile and turn it bad, as has previously happened before. You can stay in an enclosed ivory tower in medicine, but that’s not the way that health communication is going. Patients seek and respect professional opinions of physicians on the online space.

 

Social Media exposes my personal life.

The proper use of social media still allows you the opportunity to delineate public and private life. There are good privacy settings on all platforms, and you don’t have to share any of your personal life information. Mind you, in today’s world, anyone can take a picture of you and plaster it all over the internet. Having a private/public divide does not entitle you to behave unprofessionally in private. Be it public or private, health professionals are fortunately or unfortunately expected to behave at a certain standard.

 

Social Media is Advertising.

You can if you want to, but most of us clinicians don’t use social media for marketing purposes. Social Media is where we learn from others who are both in and those who are not traditionally in our social circles, where we listen in on our patients’ conversations about the issues they have with their diseases. Social media is more of a listening and learning tool rather than a marketing tool.

 

Patients can find you on social media.

Of course they can find you, just like they used to find you on the White Pages. The same privacy rules apply, you can totally set your settings as private so no one can find you, or you can be found and then you can direct enquiries to the office. There’s no obligation for you to engage patients directly on the social media platform. If you are contacted by patients, you can direct them to have a formal consultation in the office. Your patients can “like” your Facebook Page or “follow” your Twitter timeline, but you need not and must not be their “Friend” on your Facebook Profile.

 

Patients may not like what you put up on Social Media

It depends on what you put up. Patients will ultimately gravitate towards clinicians they like. Some patients may be drawn to the more human side of you, others may prefer to choose a straight up formal clinician. Either way, that’s a good selection process in itself. I want to build rapport with my patients and if they see my page and still like what they see, that’s rapport building even before they meet me in real life.

 

Social Media is like an echo chamber

That’s what a non-engaged user would say. The epidemiology data is clear. More and more patients are using social media to direct their health behavior, through consuming information, engaging clinicians, and collaborating with other health consumers. I applaud the patients who spend time researching on social media because that’s a marker for initiative, which is a great health behavior. Social Media is not an echo chamber. It is more like a doctor’s waiting room turned into a classroom where patients share information that they have found through their personal research.

 

Clinicians should invest their time in something else more important.

Sure, you can lock yourselves up in the library where information is stored within it’s walls, or choose to be present in the community where our patients are already having an open discussion about health. We need to be on social media because our patients are already there. We need nurses, speech pathologists, physiotherapists, dietitians, etc. to be present in the online virtual town square where significant health conversations are occurring. We need clinicians from every specialty to immerse themselves in these conversations, listen in, and if possible, value-add to the discourse.

 

So where do I start?

I recommend starting with Twitter, because it does not need to take up too much of your time. Open an anonymous account, if you’re really that worried. Follow the people of your ‘tribe’, then follow the ones they follow. Listen to the conversations. Then listen in on specific hashtag conversations such as #HCSM (Health Care & Social Media) or #MCSMN (Mayo Clinic Social Media Network). Get a feel of the discussion and add to it. Give yourself a few weeks, and graduate to more extensive engagements. I’ll give you some tips on how to use Twitter next.

This is a recurring question I get asked by patients, communication officers and other doctors. Why are clinicians not on social media? What are the barriers to getting clinicians on to Social media?

Many of the reasons and excuses can be summed up to these 3 F’s:

1. False understanding of the purpose of Social Media

Many clinicians think that it’s a frivolous waste of time with selfies and food photos. Others think that it’s about marketing and self-promotion. Some others think that it’s a place where patients slam you and rate you.

Those things are not the primary use of social media in health care. Social Media is my medium of education, my personal network of learning. As a surgeon, I engage with other surgeons, and clinicians who are not within my specialty. I learn lots from anaesthetists, Family Practitioners, paramedics, nurses, Speech Pathologists and other craft groups. We talk about treatments, managements, equipments, etc. I learn from specialists from rural areas and other countries. I learn from students. And most importantly, I learn from patients and health consumers. I listen in on their conversations that may not occur in traditional consultation settings. I am better because of the personal learning network and communication that I engage in through social media.

Clinicians need to understand that Social Media is about connected learning, with clinicians and patients from all over the world.

2. Fear of regulators

Clinicians fear the regulators, lawyers, AHPRA, Boards, Hospital Execs, etc. We worry that we are crossing some legal boundaries.

Let me tackle the Australian National Law Section 133 that is referenced by AHPRA directly with regards to social media and advertising.

A person must not advertise a regulated health service, or a business that provides a regulated health service, in a way that-

(a) is false, misleading or deceptive or is likely to be misleading or deceptive; or

(b) offers a gift, discount or other inducement to attract a person to use the service or the business, unless the advertisement also states the terms and conditions of the offer; or

(c) uses testimonials or purported testimonials about the service or business; or

(d) creates an unreasonable expectation of beneficial treatment; or

(e) directly or indirectly encourages the indiscriminate or unnecessary use of regulated health services.

To me, statements a, b, d & e are common sense statements. As a clinician, you are allowed to talk about what you do, as long as you don’t claim that you are the best or offer misleading statements. Statement c is interesting in that you are basically not allowed to use testimonials, which mean that if someone talks about how good you are, you cannot retweet, repost or reblog. That’s an oddity in the Law, but that’s the Law of the land that we have to obey.

Above and beyond all this, as long as we abide by the rule of respect and the Privacy Act, there is no reason why a clinician cannot be on social media.

Here’s my simple suggestion: you cannot advertise freely, but you can educate passionately. Truthful evidence based education is not self-promotion. You cannot talk about patients, but you can talk about conditions, diseases or treatments.

Clinicians need to understand that it is ok to be on social media as long as you abide to core principles of professionalism.

3. Finite Resources (Time or money)

Clinicians tell me that they don’t have time for social media. I’m a busy surgeon. I get that.

You do not need huge amounts of time on social media. It would be a misunderstanding to consider Social Media as a waste of time. It is an investment. Small investments at various times during the day that potentially reap huge benefits. You invest time in learning. Social Media is an educational tool. Just as we read news on our smartphones between cases, during commuting and while waiting meetings, I flick through my Twitter timeline and read medical news, contribute to medical discussions and read journal abstracts. I follow Journals, Associations and many clinicians that add to my knowledge base. I summarise my papers and presentations into blog articles for my blog and Facebook page. I leverage the things that I already do on a day-to-day basis whenever I place them on social media. Tweeting my knowledge on the things that I do on a regular basis create public education. Having a video uploaded on a consent discussion that I repeat several times daily allow patients and other clinicians a snapshot into my medical thoughts. I read more journal abstracts through social media than I ever did through visiting the library. I pick up more great tips from other clinicians through engaging on social media than through meetings.

Social media is mostly free (at the moment). Time is a worthwhile investment. Clinicians need to be aware that as information transfer through the media evolve, social media is now the new norm for acceptable communication.

Clinicians need to understand that Social Media is a learning tool that does not require huge amounts of time.

My next blog will be on practical tips on getting clinicians on to social media. Do you have any thoughts on what we can do to get clinicians on social media?

Last year I attended the Mayo Clinic Social Media Residency at Jacksonville, Florida. This was what I wrote. Many of the lessons I learned last year still hold true today.

Today, I attended the Residency again, this time in my hometown of Melbourne Australia as part of the #MayoInOz Social Media Summit. I was one of the Chief Residents, and there were about 35 attendees. There were, I think, only 2 doctors in the group. The rest are hospital executives, organisational policy makers and communications officers.

I learned 3 important things:

1. There are a lot of gifted, passionate and influential people in Australia & New Zealand willing to work hard, learn hard and network well for the benefit of their patients. And they’re not necessarily clinicians!
2. Australia and New Zealand are soon going to have their tipping point when it comes to social media adoption. There are enough champions at each state, organisation and leadership level to effect real change in the next couple of years. The ripple effect of meetings like this is going to be significant.
3. The future of Australian and New Zealand Health Care is bright. We spent the day talking about Social Media, but we all knew that it was just a tool. The primary goal and objective is always going to be patient well being. All these administrators and hospital executives spoke little about marketing, but a lot about patient engagement and education. That makes me real proud.

Social Media is nothing more than a medium. It is a new medium. It is another tool in our armament. Just like any new tool, we need to learn to use it well. When used expertly, we have one of the most accessible and powerful tools to effect social change and improve health outcomes.

Photo credit to @Lisa_Ramshaw, one of the champions of Social Media in Health Care in Australia.