SEATTLE – Social media are making inroads into medicine; doctors are blogging, engaging patients on Facebook, and using Twitter to keep up to date, panelists said during a discussion of the phenomenon at the 2010 Swedish Medical Center health care symposium.
A few panelists, like Dr. Jennifer Dyer, a pediatric endocrinologist at Nationwide Children’s Hospital in Columbus, Ohio, are texting patients, too.
In a preliminary study, Dr. Dyer texted three of her teenage diabetes patients weekly reminders about glucose testing and mealtime boluses, and asked them about the frequency of their blood sugar highs and lows.
The approach had previously been shown to help Scottish teens with diabetes (Diabet. Med. 2006;23:1332-8).
At the end of 3 months, Dr. Dyer’s teenage patients were missing only about three boluses a week, instead of nine or more, and their hemoglobin A1c levels averaged 9%, instead of 11%, according to a hospital press release and a post by Dr. Dyer on the Diabetes Mine blog.
She plans to expand the study to include 50 patients. "The use of social media to help outcomes is powerful," Dr. Dyer said during the panel discussion.
Social media help in other ways, too, panelists said.
"For me, [Twitter has] extended my colleagues and created an ability for me to keep up to date," said Dr. Kent Bottles, a health care consultant based in Philadelphia and recent past president of the Institute for Clinical Systems Improvement.
Dr. Bottles, who blogs at Kent Bottles Private Views, said he tweeted recently about attending a health care meeting in Colorado. A nurse he had never met before but who followed his Twitter stream offered to pick him up at the airport and took him to a vineyard, because she also knew from his tweets that he’s a wine aficionado.
In response to another tweet, a physician sent him a paper that helped at the meeting. Neither "would have happened without Twitter," Dr. Bottles said.
Another panelist, Dr. Bryan Vartabedian, an assistant pediatrics professor at Baylor College of Medicine, Houston, said his blog, 33Charts, has given him "a powerful voice" regarding the convergence of social media and medicine, the blog’s topic, as well as other matters.
More than influence is at stake. Eventually, "being in the [social media] space will confer market advantage," he said.
Dr. Dyer and the fourth panelist, Dr. Mike Sevilla, a family physician in Salem, Ohio, who blogs at Doctor Anonymous, both said they share some personal information on their Facebook pages, but are careful not to post anything they could later regret.
Dr. Dyer has friended four patients on Facebook; she said it helps them see she’s a regular person, making her more approachable. Also, her teen patients don’t like e-mail, preferring Facebook’s messaging service, another reason she engages some of them on Facebook.
E-mail is also an increasingly important tool, panelists said.
Because of her hospital’s policy, Dr. Dyer can’t initiate patient e-mails, so she tells patients to e-mail her first for test results and other matters. She cuts-and-pastes exchanges into the electronic health record so colleagues know what transpired.
Although e-mail takes less time than trying to reach patients by phone, Dr. Dyer has office staff help with the messages so she’s not overwhelmed.
That was a concern among all the panelists – dealing with the extra work social media bring.
Dr. Vartabedian said he knows colleagues who are "spending their evenings opening e-mails" from patients, and not getting paid for it. Social media also raise concerns about patient privacy and legal liability.
A robust digital presence has its benefits, Dr. Vartabedian said, including countering negative online reviews. But it also opens the possibility that offhand remarks could show up later in legal proceedings. "A lot of this stuff hasn’t been tested in courts," he said.
An audience member even noted that lawyers at her hospital banned physicians from engaging in social media.
Dr. Bottles acknowledged the concerns, but said that "you can never [completely] protect yourself against malpractice suits."
"You have to do what’s best for your patients, give it your best shot, and get over it. We have patients to take care of, lives to live, and pinot noir to drink," he said.