Last week’s #hcsm discussion focused on what doctors and patients would want out of social media (SM). The following discussion was vigorous, and many different ideas were discussed. This led me to think: If physicians could describe what they would want from SM and what they needed to make it happen, what would they ask for? Here are some thoughts:
- Better patient care. At the end of the day, this is why any of us should be in health care careers: to improve patients’ health and quality of life. Whether SM increases patient access with their health care provider, or improves how well chronic disease are controlled, better care should be the first priority for any SM activity. Enhanced doctor/patient communication would strengthen the therapeutic relationship, and would stand to improve patient-centered outcomes over time.
- Payment. At a time when all physicians–but especially primary care physicians–feel pressed, asking them to add on more unreimbursed work is a hard sell. Whether an independent practice or part of a larger health care system, there will need to be some return on the time invested in SM. This could be through (a) increased referrals and a larger patient panel, (b) payment for e-visits conducted via SM (or more likely via a secure patient portal)–either direct reimbursement by insurance companies or through self-pay agreements; (c) as part of new models of care such as the patient-centered medical home (where providers are paid for care management and coordination) or concierge practices (where SM communication may be one of the offered communication options), or (d) being reimbursed by their employer/health system for their SM activities.
- Time. In order to have a realistic and worthwhile presence on SM, one must have time to contribute to the communication. For physicians, this could include having a part of their schedule (maybe 15 or 20 minutes–one patient slot) set aside to manage SM content. I would suggest that 30 minutes or an hour would be better, as this would allow more time for physicians to actively engage with patients, or to write a thoughtful blog post.
- Credit. Other than getting paid for SM work, physicians might be more likely to engage in SM if there were some way to get credit for it. This would be especially true in the case of physicians in academic careers: if a physician manages a blog or contributes content to SM sites, it would be a step forward if this activity was considered in reviewing a faculty member’s promotion and tenure. I would argue that simply tweeting might not be enough to count, but working on a blog (which involves more time and consideration) could be considered.
- More efficient work flow. SM offers physicians numerous ways to communicate with their patients, especially if secure patient portals, SMS, and e-mail communications are included. Standardizing these forms of communication and ensuring that they will provide necessary privacy protections would allow physicians to get work done more efficiently and allow offices to increase their productivity.
- Access. Many health care systems still limit access to SM sites such as Twitter or Facebook, even though they can be used for legitimate communication. Similar to the telephone, these sites can be used to improve patient care or to waste time. Therefore, for physicians to have a useful presence on SM, health systems will need to allow them access to the tools they will need.
- Guidance. Many docs will claim uncertainty or fear as reasons they will not engage in SM–uncertainty about how to use the tools, or fear that they might run afoul of legal or professional obligations. Most of us already using SM have found ways to have a substantial SM presence without crossing those boundaries. Either as individuals (or as part of a health system), experienced users should be willing and able to guide newer users in SM communication.
- Professionalism. Physicians working with SM need to behave professionally, and would expect patients and colleagues to do the same. This includes respecting individuals’ privacy (patients and peers), avoiding inappropriate pictures or comments, and always being aware of how one’s online presence can be perceived. It also means that docs need to help mentor medical students while they are still in training.
Those are some starting points. I have no doubt that I’m forgetting something, and that I will comeback to edit this post as time goes on. Please suggest what physicians want and/or need in order to get involved in SM in the comments below.