Hey Doc, 10 Things You Said to Me

We’ve been meeting together here for a few years. I’ve shared a few thoughts with you and though most of you don't want to talk about it here, you do tell me through phone calls, in-person, email and direct messages on social media. So, want to know what your peers are talking about? I thought you might. So, here are the Top 10 Things Your Peers Say to Me About Social Media (whew, that title):

1      1.     I’m not sure how to say what needs to be said.

      Sure you are. You say it every day. Start there: the blinking cursor is simply a patient who has asked you an important question about her care. Patients like doctors with good bedside manner.

2      2.     It’s too hard to keep up but I need to appear timely.

       Well then, use social media to follow sources that you trust. Simply share or retweet their posts. You’ll  appear helpful and connected. Patients like connected health care providers.

3      3.     Just sharing data makes me sound robotic but I can’t share patient information.

       Ah, the HIPAA excuse. You’re right. But you can provide insight on common problems through your  personal story. Patients like other humans.

4      4.     There’s so much misinformation. I don’t want to be part of that crowd.

      Good for you but by not being there you’re part of the problem. Use social media to dispel common myths patients may have about treatment options by sharing truths. Patients like a trusted source. And to them, that’s always been you.

5       5.     I just want to practice medicine.

       You can and your impact can be far reaching. Use social media to help patients cope with their conditions by providing tips for managing common problems. There you go, practicing medicine. No paperwork to complete.

6      6.     I want to be part of the community.

      Then create one. You have built in neighbors. Use the “groups” feature in Facebook to build a wall around your neighborhood. Or, run it open allowing your patients to invite their friends and family to participate.  Patients like to connect their friends to someone who knows and cares about them and people like them.

7      7.     I’m focused patient retention. I don’t have time for social media.

      That Doc, is a direct contradiction to the power of social media. Not being present demonstrates indifference. Here’s a poem I wrote for a physician friend of mine:

Act like you give a damn.

Show that you care.

Lose the indifference.

And you’re half-the-way-there.  (thanks for indulging my inner-poet)

        8.     I need to prove exponential return on investment for any investment we make in social media.

      Me, too. Let’s make building a community, also known as developing followers, the first factor in return on investment. And no, that’s not some sales guy talking. We both know we need to be in the market before we can do business development.  People, yeah even patients, like to know that you’re investing in them and getting to know them before we start asking of them.

        9.     I want to make a viral video.

      Did you see the one featuring window-washers in super hero costumes? Look for moments that resonate with your inner child. Most viral videos work because they make us smile. Hey Doc, you don’t have to be funny but you can laugh.

  10.  I don’t have time.

I know. But we meet here once a month and to me, I’d give up our time together if you’d spend it with your patients via social media. Patients, okay doctors too, like people who make time for them.

Hey Doc, We Live in the Future

We live in the future. And you know it's true. This past weekend I was watching some reruns of shows from my childhood. I saw the Jetsons. I saw Star Trek. And that's when it occurred to me, we live in the future.

I watched as Mr. Spacely called George Jetson on his television. Well that's what we thought it was at the time. Little did we know that there would be Skype, Google Hangouts and FaceTime that would allow us to talk to someone face-to-face miles away or just around the corner. We can now see and converse with others without leaving our homes. Without leaving our offices. At the convenience of the caller and at the convenience of the one we called.

I saw Star Trek. And I'm sure it's occurred to you before now, that the “communicator” in the hand of Mr. Spock or Captain Kirk was actually a lot like a smartphone. Spock’s ability to turn that handheld device into something that would read the environment or Dr. McCoy’s ability to use it or something like it to scan a body was beyond belief. Now we have apps that power our iPhones and Android devices to do similarly futuristic things.

Look, it's easy to get bogged down in the rules and regulations of an industry. They're there to protect us all. Comply. But what if we allow our imaginations to lead for a minute as relates to the part of doctoring that really matters to us most, patient engagement.

We'd find ways to connect with those who can't get from their homes and to our offices.

What if we find ways to empower patients to tend to themselves, to know more about the environment that they're in and how it affects their health?

We'd have smarter patients and better health outcomes.

Okay enough of the hyperbole it's time to get real. We live in the future. But we practice too much in the past.

So here's what a savvy doctors going to do this year: tap into that Jetsons television thing and enable patients or colleagues to communicate via Skype or Apple’s FaceTime to explore what needs to be explored. 

My twitter-friend Dr. Howard Luks (@HJLuks on Twitter) says that he finds this approach to telemedicine useful in consulting with his patients and would invite conversation, by FaceTime no doubt, with doctors who might be trying to find their way toward the future.

Speaking of exploration, savvy doctors will learn how to use mobile devices and apps that run on them to help patients communicate with their doctor and to help the patient and doctor know more about the environment that they are in and how such circumstances affect their well-being.

Last March I met Dr. Daniel Kraft, MD (@daniel_kraft on Twitter) at SXSWi (South by Southwest Innovation conference). He was there to speak on health care innovation powered by smartphones. It was cool. And it would have seemed like “future talk” were it not for the number of people in the room already using one or more of the diet, exercise, sleep monitoring, cardio, diabetes and anxiety management apps he spoke of there.

Look, George Jetson would get out on the now ever so commonplace treadmill to exercise his dog. Maybe this is the year to exercise your medical practice. Maybe this is the time to rethink patient engagement so that we can get off this crazy thing called the status quo and into the future. Some of us are already there.

Hey Doc, Do You Play Ball?

Sharing information has to start with this – know to whom the information belongs. Hint: it’s not you, Doc, even if you’re the one holding it.

It’s like it was yesterday. It was the first day of school in the second grade. I’d carried my baseball glove and ball for a game of catch during recess. Ricky had done the same. We chose to use his ball. He’d painted it green and yellow to honor his beloved Oakland Athletics. Mine just had a big “T” on it. I left it on my desk.

On the way to recess the new kid asked if he could use my ball. He didn’t have one but he looked like he knew how to play. And since Mom had taught me to share, using mine was fine.

When recess ended I went to retrieve my ball. The new kid threw the ball back to me. But it got by me and the teacher politely picked it up. She and I talked baseball on the way back to class. We were settling back in our seats before I realized that she still had the ball. I watched her put it in her desk drawer. Cool. It would be safe there until I needed it.

After class I went to her desk to ask for the ball. I waited as she talked to another kid. Meanwhile, Mom was waiting in the carpool line. Knowing that, I reached for the handle on her desk drawer to retrieve my ball.

The teacher slapped my hand with a ruler and said, “You can’t look in there.” “Yes, ma’am. But I’m just getting my ball while you’re busy with another patient (oops, I mean student).”

My ball. Someone else used it with my permission. She now stored it. I wanted to use it. She suddenly acted like it was her ball. Okay, maybe I needed some sort of permission to access it. Maybe she had stuff in there from other kids. But at some level it should have been reasonable to let me get my ball – even a second grader knew that.

So is the way it goes with patient data. The ball Ricky and I used was green and yellow. Maybe you’ve heard of the “blue button”.  The Department of Veteran Affairs initially implemented it. Other public and commercial health plans have since adopted it. More than a million patients currently have access to their health data with the tool as found on health plan websites.  And here’s what we learned about its use and patient views on personal health information at last summer’s Consumer Health IT Summit:

Who owns it – “It’s my right to have it,” said one veteran who suffers from a heart condition and Type 2 diabetes. “They’re my medical records and, with the Blue Button, I’ve got control of them.” Not only does he own it, he knows that it can be easy to access.

Who stores it  – “There’s a wide perception out there that HIPAA is a barrier,” said Department of Health and Human Services Director of the Office for Civil Rights Leon Rodriguez, JD. “HIPAA is a valve, not a blockage. HIPAA is meant to regulate health information so that it is used to benefit the patient and for no other purpose.”  So maybe the IT guy should stop offering, “We can’t do that. It’s a security issue,” in response to how it’s stored and accessed and admit that it’s really just an attitude issue. Most of your patients are accessing confidential information from other sources (i.e. the bank). They don’t see their health record as any more valuable than their banking information or any more difficult to access or secure.

Who uses it – allowing access “moves us from personal health records tethered to particular providers to the concept of a personally controlled health record,” National Coordinator for Health IT Farzad Mostashari, MD, ScM, said. Rather than just viewing the record, users are encouraged to take ownership of their data. Patients can add information, point out errors in their records and share their health information with whomever they like.  Heck, they could even put a big “T” on it if it’s theirs.

Individually owned health information is expected to produce better health outcomes in the patient-centered future of healthcare. So let’s agree that the patient owns the data. Let’s let them share it as they like. And let’s accept the notion that whether on the clinic’s system or in the teacher’s desk drawer – we’re going to have to allow the owner to access it when they like even if it’s just for another game of catch.