Making The Office Visit a Value Exchange

Sunday night at 9pm EDT the #HCSM chat happens. It is one of the best online healthcare chats that I’ve participated in. It is fast, smart, well facilitated, and with some of the best and the brightest minds I have the pleasure of interacting with. The topics are well considered and examined in great detail. Each discussion drives me to think more and consider the changes occurring in healthcare. If you haven’t participated or lurked and you are interested in healthcare check it out, ” …as the dormouse said, ‘Feed your head’.”

I’m sure I am the most annoying participant with my continuous hocking about SM being a tactic and we need to identify strategies/goals and then overlay a tactic. Can’t help myself Donna and Alan beat me about the head for years to learn what a strategy is and how to use it. Sunday night #hcsm takes me back to sitting in the agency and having account people talk about tactics before they identify a strategy. Backing a tactic into a strategy is putting your shoes on and then your socks. 

Sunday morning along with the NY Times I get my mailing from Digital Tonto ( One of his posts was 4 New Marketing Paradigms: here
Within that post were nuggets that clarified my thinking about those HCSM chats. 

Greg the 4 new marketing paradigms:

From Making Contacts to Building Assets

 From Campaigns to Platforms

From Awareness to Activation

From Transactions to Experiences

Yes, his post is about consumer media and marketing but let’s get real. We have to think in terms of marketing, communications, and strategies if we are going to meet the needs of patients in this evolving digital world. 

It is the patient who is driving a need to know and learn because the www is allowing them in real time to seek solutions to problems they have, classic adult learning. To assume physicians who are struggling to keep up with an ever increasing work load and diminishing returns will jump into social media as a solution without first understanding what is happening is as likely as Mitt Romney is to have a cup of coffee.So we must look at strategies that engage both physician and patients and make that amazing unit of learning (patient & physician) work harder and produce better results. In a word use a strategy to show the physician what’s in it for them. 

In the section: From Making Contacts to Building Assets Greg states ‘What’s emerging is the concept of value exchange in the form of owned media assets.’ This is not about using apps and content (tactics) to capture ‘eyeballs’ (think patient office visits). It’s about building assets and creating engagement. 

The asset is the physicians knowledge and skill at delivering care. Creating engagement is helping patients replace or complement what they’ve learned at WebMD. Physicians should become MyMD to patients seeking knowledge. Make no mistake, patients trust their physician more then WebMD or they want to. Talk about a ready made gap to close, this is one that can be done.

Take away: The office visit is greater then the sum of its parts. It is a place to begin the ‘value exchange’. 

I will examine how Greg’s other models relate to health communications and social media over the next few days. And I will show an example of how to begin that value exchange. 

NYMC Seminar on Social Media and What I Learned

I attended the April 24th New York Medical College day of presentations on iMedicine- The Influence of Social Media on Medicine. This was an informative and forward thinking event on social media and healthcare. There were 10+ presenters including: Howard Luks, MD, Mark Ryan, MD, Brian McGowan, PhD, Ryan Madanick, MD, Lawrence Sherman, Kent Bottles, MD, and others:

The site is here:

Watching and listening I was struck by the depth of knowledge and experience each speaker had specific to SM and how well SM has served each one. As the day progressed I was filled with an overwhelming sense that SM in HC has the power to change, no improve, patient outcomes. Then Kent Bottles, MD spoke and shared the Gartner Hype Cycle. and  As he gently put it we may be drinking the Kool-Aid. 

The consistent thread throughout all the presentations was the value social media has for physicians, patients, and outcomes. Each presentation spoke to social media not just an important new technology bringing physicians, patients, and healthcare together but showed executing it in new and more productive ways. Five presenters highlight key take away messages:

Mark Ryan, MD @richmonddoc spoke about the long history of personal one to one care delivered by the family physician and how social media can return us to that model and what it means for care.

Natash Burgert, MD demonstrated how Tweeter, her web site, and other social media tools changed her practice and improved the care for her patients. She showed how a small investment in time produces durable and important outcomes with parents and patients. She is part of her local community and the community is part of her practice.

Ryan Madanick, MD @ryanmadanickmd presented was how his seeming late adoption of social media was not a barrier. In fact his coming into it as he did provided greater benefits for not just his patients but for his colleagues on both a national and global level. 

Howard Luks, MD @hjluks presented the way he integrates a blog, Facebook Page, YouTube Channel, and personal site to educate and engage with patients. 

Loring Day a patient spoke about how she was able to improve her care through social media and her physicians (Luks, MD) online presence. 

I am highlighting these presenters among the many equally excellent and illustrative ones because they connect the dots in social media and healthcare. Social media in healthcare is about learning. It is shared decision making at a macro level. Patients are adult learners. They want to find solutions to problems they are having. Each of these HCP is offering their patients and colleagues not just places but knowledge. They are providing solution’s patients are seeking directly and indirectly. The physician and the patient is the smallest functional environment of learning and what was shown are ways to extend that beyond and back into the office visit, and ultimately to outcomes. These are communities of practice for the 21st century built around technology and basic learning. 

Kent Bottles, MD is correct, in a way we are drinking the Kool-Aid believing social media is the answer to all out healthcare problems. We will see a period of dissolution with social media in healthcare and the plateau. We will NEVER reach 100% of patients. 

My observations:

Social media in healthcare works. It extends what once was to what is and will be, care delivered not top down but together. 

Are the audiences seen above a self-selecting small cohort? What can we do to move beyond self-selecting participants? Can we create a push pull? 

Can we demonstrate outcomes? What are they? 

Performing needs assessments to determine what problems patients are seeking solutions to and where on their continuum of knowledge/learning they reside? This will help to identify others outside the current users of social media. It will also give insight into learning needs that may differ between demographics with the same issue. 

Social media is only a tactic, a mere toy. These presenters use social media as part of a strategy that educates, engages, and motivates. This is how a tactic work best, as part of an integrated strategy. 

Whether each presenter deliberately identified a strategy or simple found where social media worked best is not up for debate. Social media works in healthcare. The question becomes how do we take these successes and extend it? How do we smooth out the Gartner Hype Cycle? 

It is time to approach social media and healthcare in a deliberate fashion, as educators seeking to understand learner needs and problems. In every practice there are 20 year olds in perfect health who have no problems they are seeking solutions to. For them thier physicians social media is about as useful as breasts on a bull.

At the same time there are a slew of 50 something patients with problems who are seeking solutions. With a little planning and work we can improve the percent of 50 year olds who engage with HCP to solve their healthcare problems. It is not WebMD but MyMD. That is where the future of social media and healthcare will meet and improve outcomes.