Hey Doc, Wake Up Better


It’s easier than ever for someone to give his or her two-cents-worth. In 140 characters you can say whatever you want about almost anything to just about everyone. But hey, times have changed and the cost of an idea is a little higher than it use to be. So if you’re going to say it, make it count. And so we will.

Sleep. That’s it. Sleep. Okay if you want your 99-cents-worth, the Sleep Cycle Alarm Clock App for your iPhone or Android phone.

What does an alarm clock have to do with what we write about here? Well, this particular idea involves you, your patient community, your use of social media and mobile. We talk about those things here every month. But this time, instead of talking about it we’re going to do something together.

The wellness benefits to a good night’s sleep are well document and so no matter your specialty, there’s an application for your use of this app and a health benefit to be realized by you and your patient.

Practice Family Medicine?  When you’re sleep deprived, you often feel “worn down” -- and that’s a clue that your body is vulnerable to infection. “Not getting enough sleep makes you more vulnerable to picking up illnesses and not being able to fight them off,” says Donna Arand, PhD, DABSM, clinical director of the Kettering Sleep Disorders Center in Dayton, Ohio.  Can’t convince yourself or your patient that one or the other isn’t getting enough sleep? Let the app help.
Cardiology your area of expertise? Then you know the story. But does your patient? Former President Bill Clinton confessed that he thinks lack of sleep had a lot to do with his hospitalization to unblock a clogged artery (okay, maybe the Big Macs were part of it too but he’s on to something) "I didn't sleep much for a month, that probably accelerated what was already going on," Clinton said. 
He’s probably right. “When you don’t get enough sleep, you have an inflammatory response in your cardiovascular system -- in the blood vessels and arteries -- and that’s not a good thing!” says Arand. “We see the same thing in hypertension. If that sleep deprivation continues long term, chronic inflammation has been linked to things like heart attack, stroke, and diabetes.”
In the Mid-South and Delta Region we’re all aware of the diabetes, okay I’ll say it, epidemic. The key underlying problem in Type 2 Diabetes is insulin resistance, where the body does not make proper use of this sugar-processing hormone. Guess what? When you’re sleep deprived, your body almost immediately develops conditions that resemble the insulin resistance of diabetes.
And it’s not just in those we can spot walking down the street. “In one study of young, healthy adult males, they decreased their sleep time to about four hours per night for six nights,” says Arand. “At the end of those six nights, every one of those healthy young men was showing impaired glucose tolerance, a precursor to developing diabetes.”
Another study found that people in their late 20s and early 30s who slept less than 6.5 hours per night had the insulin sensitivity of someone more than 60 years old.
So, what’s this got to do with the app? Many of us lack the discipline to do even the simplest things to improve our health. But a recent survey found that 9 out of 10 smartphone owners wake up with their smartphone. Maybe we can use that information do something powerful.
You, your patients, our friends, and me are invited to participate in our Wake Up Better Y’all experiment. It's not necessarily scientific but certainly a fun and well-intentioned effort to see if what we do here together can be good for us.
Besides, one of the main features of the app is to wake you up at the right time. Not just the time you set the alarm for but in your lightest sleep phase. When that happens you’re more likely to awake renewed and on the ‘right side of the bed’. And everyone us around will appreciate that.
For more information on the Wake Up Better Y’all experiment and the Sleep Cycle App visit www.wakeupbetteryall.com or hit me up on twitter.
Hat tip to the good people at webMD and Donna Arand, PhD, DABSM, clinical director of the Kettering Sleep Disorders Center in Dayton, Ohio.

Hey Doc, Oh Yes They Are


For the better part of the Social Era physicians have decried the use of social media among their target demographic: grownups and the elderly. But guess what? Dads, Moms and even Grandma are all up in social media tools like Facebook and it’s time you connected with her there.

In fact, a recent Pew Internet Research study found that 71% of adults online are on Facebook and that’s up from this time last year. Really, parents and grandparents are the only real growth areas for Facebook with 45% of people 65 years and older using Facebook. However, it’s not the only site to see growth.

Twitter saw growth among adults. But it’s Pinterest that has the most momentum as over 1/3 of all women surveyed about online use report using the image and idea sharing platform to curate inspiration, health tips, recipes, fashion and other topics – often from people like you.

Okay, let’s admit it. Most of the people offering these bits of hope and information are not nearly as well qualified as you to share ideas in a way that might lead to improved health.

I’m going to guilt you into this. You should be using social media if for no other reason than to make sure that at least some of what women are curating makes sense in the context of a healthy lifestyle.

Hey when grandma falls down and can’t get up, we want her to have a button to push for help. But when we’re trying to coach mothers, grandmothers and other adults we’re willing to let the purveyors of gimmicks lead the way. It’s time for an intervention.

Want more evidence in the case for your being present online?


From a recent study, 54% of patients are very comfortable with their providers seeking advice from online communities to better treat their conditions. It’s evidence that many trust that crowd sourcing of information from other likeminded individuals is reliable. This shows how people perceive social media to be beneficial for the exchange of information about their health. Why shouldn’t you be the one from whom they curate it?

Need a business reason?


41% of people said social media would affect their choice of a specific doctor, hospital, or medical facility. This shows that social media can be a vehicle to help scale positive word of mouth, which makes it an important channel for an individual or organization in the health care industry to focus on in order to attract and retain patients. Consumers are using social media to discuss everything in their lives including health and it is up to your organization to choose whether it’s time to tune in.

How about peer pressure?


Lest you think it’s just patient talking, here’s this from professionals like you: 60% of doctors say social media improves the quality of care delivered to patients.

Wow! So there are doctors (maybe you’re one of them) who believe that the transparency and authenticity that social media helps spur is actually improving the quality of care provided to patients.

So if you’re still saying, “My patient demographic and providers like me don’t take social media seriously” and that “neither patient or doctor is there” – I say, oh yes they are.

Want to talk about it? Hit me up on twitter @timbigfish

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, Your Year to Connect


This year you’ll have 1000s of additional codes to choose from when you’re commenting on a patient file. You’ll have the challenge of meeting somewhat subjective patient performance expectations to maximize insurance reimbursements. And you’ll have more checkboxes to click in the EHR on your way to proving meaningful use. Sounds awful.

So, how will you make this a great year? You’ll connect.

Oh, not to technology though it’ll be there to facilitate the connections. But to people in ways that have proven challenging for some but profitable for others. And by ways, I mean social media, smartphone apps, and iPads. Still it’s not about the ways, it’s about the connection. It’s about the patient.

So, I thought you might enjoy three ideas that could help you achieve your purpose – the best health for your patients – and frankly help you suffer the codes, surveys and systems. Choose any one of them and you’ll be back to medicine.

First, use Social Media.

By now you’re aware that the tools we call social media have permeated our culture. They’ve raised expectations for openness. And they created expectations of connectedness. Here, however, are three specific platforms and ways to improve connections.

Facebook – yeah, the growth of teens has slowed but they’re not your patient. Make Facebook a place to share information that is helpful to others but not about others. Do this one thing, find a trusted content source and wrap your brand around it.

Pinterest – women are the primary decision makers when it comes to healthcare. Start a Pinterest account and make three boards. One should be the role of diet on those who have health issues related to your specialty. The second, a board the features exercise tips that benefit your patient community. And the third board, inspiration. Offer encouraging quotes, images of famous survivors or champions, and images that rest the soul.

Instagram – yeah, you’re right it’s for pictures. It’s the fastest growing and most popular app among the next generation of decision makers. Know how to take a picture of anything from equipment, to your staff, to things that give others a glimpse into what you find relevant.


Second, find an app. Don’t make one. Find one.

Sure you could make one but that’s really not necessary. There are hundreds of health apps that can make a difference in the wellbeing of your patient and might even prove helpful to you. We’ve written about them in Memphis Medical News. Click here to learn more in less than 700 words.

Third, tell a story.

iPads and fancy e-readers are the top of a lot of Christmas lists this year.  And you can put them to work for your practice. This idea is especially useful if your patients have chronic illness (i.e. diabetes), potentially life threatening diseases (i.e. cancer) or are expecting children (i.e. obstetrics, gynecology or pediatrics). It starts by imagining that you’re sitting with a patient to tell them what you do, what they might expect through the time you spend together, who your referring specialties are, what technologies you’ll use, resources that others find helpful and are willing to do so in a manner that deepens relationship instead of sending them around the web finding these things on their own.

Hey Doc, 

Don’t do these things because everyone else is doing them.

Do them because it will help improve the connection between you and your patient community. It will improve the nature of the dialogue that occurs when you’re with a patient or trying to explain an issue to the patient’s family.

Do it because it creates a deeper connection between you and the patient. A connection that new codes and checkbox-rich EHR systems don’t understand but that you know will lead to better health outcomes.

Do it because you’re a care giver; a healer. You’re all about the patient.

Do it because in this age of systems and policy changes, the one thing that can always change for the better is your relationship with those who count on you; the patient.

Yep, this year you’ll be asked (heck required) to do a lot of things. So, why not do at least one thing you like?