Physicians and social media: Follow the money

Physicians would not be well advised to use social media to connect with patients, said family physician Dike Drummond in a recent commentary posted to of the top social media sites for doctors. His view is evidently similar to that of the majority of his colleagues: while 84 percent of physicians use social media for personal reasons and 67 percent for professional purposes, few of them communicate with patients on Facebook, Twitter, or other social sites.

Some experts say that physicians are reluctant to use Facebook or Twitter for patient contact because of privacy or malpractice issues--and that's undoubtedly true in many cases. But Drummond observed that physicians are not paid for going on social media sites with patients unless they have concierge practices. Furthermore, he pointed out, studies show that a third of physicians feel burned out on any given work day. So the extra time and effort required to interact with patients on social media might be the straw that breaks the camel's back, he argued.

These arguments evoke the decade-old discussion about whether physicians should conduct online consultations with patients via secure email. Sure, there's a world of difference between a private, secure online dialog with a doctor and a patient about nonemergency medical issues and the kind of interaction that they might have on Facebook or Twitter; but the two activities are alike in that neither type of online communication is usually covered by insurance.

In discussions of accountable care and population health management, it's often pointed out that non-visit care is essential to improving the quality and lowering the cost of care. Online communications between physicians and patients are an important part of non-visit care. So if and when accountable care organizations spread to a majority of providers, one might expect that most physicians will do online consultations and use social media, as well. Until then, however, Drummond's observation will remain true for the bulk of his colleagues: no margin, no mission.

Meanwhile, consultants and pundits will continue to push social media on physicians, touting the numerous ways in which it can benefit them. A recent report by the CSC consulting firm, for example, noted that the U.S. lags behind some advanced countries in the use of social media in healthcare. The report said that social media could help physicians not only in marketing their practices, but also in patient care. Using international examples, CSC cited social networking activities in areas such as wellness, population and patient monitoring, care management, and care coordination.

A PwC report cited the results of a consumer survey in urging healthcare providers to take advantage of social media. One-third of respondents, PwC noted, already are using social media for healthcare discussions. But the survey turned up a sharp age division: more than 80 percent of consumers ages 18 to 24, for example, were willing to share personal health information on social media, vs. 45 percent of respondents ages 45 to 64. Since most people with serious health problems are older, this may be an indication that physicians need not take social media too seriously.

On the other hand, patients increasingly are likely to use social media sites to rate their physicians, and to share their experiences with individual providers--both positive and negative--on social networking sites such as PatientsLikeMe, the PwC report found. So some physicians may feel compelled to go on social media sites simply to defend their reputations.

So far, the vast majority of physicians haven't seen the point of using these sites to build their practices or interact with patients. Perhaps they'll change their minds if they can see a positive impact on patient outcomes. But my guess is that only when their incomes are at stake will doctors move to social media en masse. - Ken


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