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: http://tiny.cc/wjbndw

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. http://tiny.cc/mlbndw and http://www.shockoe.com/blog/trends-in-tech-truth-or-noise/  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 www.kckidsdoc.com 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 www.kentbottles.com 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. 

Pain Management not Just a Global Issue

 It is well documented that patients with terminal illness in general do not receive what experts would consider appropriate and continuous pain relief. This is an issue even more acute globally. And the reasons are equally well documented: no access to morphine, HCP attitude, family concerns, lack of knowledge on how to treat.

On a very small scale and in many regards unrelated I witnessed this. Thursday I had to go to have a dental implant removed. It went from a scheduled procedure to an emergency one. I was able to contact my previous DDS who referred to a very good oral surgeon. Prior to him beginning I played 21 questions just to make sure I knew what was what. I asked about postoperative pain. “Do you have any ibuprofen at home?’ was his answer. After my WTF look and saying “you’ve got to be kidding me” he relented and said he would write a script.

The procedure was quick. I left the office with a ton of lidocaine on board. Not so bad. I got home laid down and within 30 minutes my face felt like I was hit with a brick. Acute, sharp, and relentless is how I would characterize the pain. Ibuprofen? In a pig’s eye? It would not even begin to touch this. Filled the Rx and found some relief behind the pain, not in front of it.

I will confess that within 24 hours the pain was resolved. Still, to feel like I needed to beg to get a strong analgesic that was in fact needed was a bit of an issue. This does not compare to chronic pain associated with terminal illness. I witnessed this with my wife in hospice and how well and professionally the pain management team kept ahead of her pain and was able, even when Donna could not communicate, to read her body language to know when they needed to change or increase medication. This was not the same. I do not expect an HCP who is board certified as a dental anesthesiologist and oral surgeon to understand pain and terminal illness. But he should know about pain and its effective management. Really now he should.

His first reaction was to not offer an analgesic unless asked. I was put into the role of a drug seeker. If I did not have that Rx I would’ve been on the phone demanding he call it in. Wasting his time and mine. At the very least he should describe the level of pain for how long and ask me what I thought I wanted. Not think he knew me better then he did at our first meeting. In some small small way this is the state of pain management.