In an era when we spend much of our lives online, does social media help or hurt our health care decisions?
If you gave Elle DeLacy a choice between her neurologist and her online stroke support group, it’d be an easy choice: the support group.
“I suffered a stroke and two concussions and now seizures — all leading up to great losses in my life,” says the Las Vegas woman, a member of the Facebook group Post Concussion Syndrome Awareness. “I joined this online group for help and support with my post-traumatic concussion syndrome. What great support and insight I receive from the group. They have helped me so much through the good and the bad. Really quite better than my own neurologist.”
Indeed, we all use the Internet to share pics, shop for stuff and keep up with the news. But how about diagnosing a medical condition or simply finding a sympathetic ear about your achin’ joints?
Don’t smirk. There never seems to be TMI on the Internet — particularly when it comes to our health. In an age when we divulge an increasing amount of our private lives on the public sphere of the web, people are increasingly seeking — and sharing — health information. Consider: According to a 2012 PricewaterhouseCoopers survey, 30 percent of consumers use social media to discuss health matters. And, according to the Pew Internet and American Life Project’s Health Online 2013 report, 59 percent of adults said they have looked online for health information in the past year. And 35 percent of adults have specifically tried to figure out what medical condition they or someone else might have.
It’s a relatively new phenomenon that piques a range of responses in the medical professional community. Some doctors embrace social media, others regard it with caution, and still others take a dim view of jumping online to research health-related concerns. But one thing’s for sure: “Like” it or not, the trend is as persistent as that long-lingering invite to play Farmville.
First, undo harm
Many physicians find themselves deploying social media as a Band-Aid after the fact, using services such as Facebook and Twitter to correct bad information.
“It’s tremendously helpful when we want to clear up misinformation online and promote healthy lifestyles,” says Kevin Pho, founder of KevinMD.com, a site for medical news. A practicing physician in New Hampshire, Pho himself has become something of a national pundit on health care issues, and is also author of Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices. “One of social media’s greatest strengths is to really increase that transparency between doctors and patients,” he says.
Transparency is great — as long as the information is trustworthy. Other doctors encourage users of social media to be cautious when seeking health advice online from their virtual circles of friends or from medical websites. Misinformation — often shared with the best of intentions — abounds.
“I think that the web, including Facebook, is a great place to find information,” Dr. Joseph Adashek of Desert Perinatal Associates writes in an email. “However, I think that patients think that just because it is written down that it must be indisputable fact. ... That said, I also love the fact that I can tell a patient a certain diagnosis that she may have, and she can go and read about it and then ask me questions and learn about it.”
“Patients need to know which are the sites with professionally approved clinical content. They also need to know that just because someone writes about or discusses a medical topic online, it does not mean that they are a doctor or their advice is appropriate for every patient,” adds Mike Coyne, CEO of QuantiaMD, an online physician community.
There’s a lot of material for would-be self-diagnosers to weed through. “Not all of it is reputable,” agrees Pho. (Thankfully, according to the Pew study, 53 percent of those who sought health information online talk to a clinician about what they’ve uncovered, presenting the opportunity to fix the bad advice they’ve received from “Dr. Google.”)
That said, let’s not discount the positive impact social media services have on public health. For instance, social media can actually help track — and thus prevent — the spread of disease. Data shared online at Google Flu Trends is available to anyone with a web browser. Being aware of outbreak areas can provide incentive to use protective measures like hand-washing. Plus, Google’s stats on the incidence of influenza-like illnesses come out two weeks sooner than those provided by the Centers for Disease Control. That early warning can be a huge help in dealing with a possible pandemic.
Should you ‘friend’ your doctor?
Patients and consumers must navigate a tricky terrain online, avoiding scams, bad information and possible quacks. Meanwhile, in the world of social media, physicians face a dilemma that is more subtle but no less challenging. In the examining room, the doctor-patient relationship is private, even sacrosanct, and also highly regulated. But what about on Facebook? Can a doctor also be a patient’s “friend”? Drawing those lines is an ongoing challenge for local doctors.
“I end up very close with many of my patients, so I have become Facebook friends with some of them,” Dr. Adashek writes. “Typically, my patients are of very similar demographics as me and we have a lot in common, and I have become true friends with some of my patients.”
Adashek’s open-arms attitude might be the exception. According to a 2011 QuantiaMD study, one-third of physicians said a patient had tried to “friend” them on Facebook — and three-quarters of them declined. Those who accepted got more friendship than they bargained for, and were left in an awkward position when patients messaged them with questions. To help navigate these murky waters, the American Medical Association has issued guidelines urging physicians to maintain appropriate boundaries with their patients and encouraging them to separate their personal and professional online personas.
Vegas cosmetic surgeon Michael Edwards follows the AMA’s advice. He has a Facebook page and a Twitter account just for his practice. Content is very specific. He focuses on educating patients about “aspects of health and plastic surgery I believe are important and timely,” he says. “I don’t correspond with patients there other than general comments or (saying) thanks.”
Meanwhile, Adashek sees close ties with patients as enhancing his care rather than complicating it.
“Both my wife and I have met some great friends through my practice. I do not really draw a line in the sand with my patients. I try and treat them like they were my sister and I give advice to them as though they were my family member. I don’t just give option A with the risks/benefits and option B with the risks/benefits — and then tell the patient to make a decision. I give my advice to them.”
Local internist Dr. Traci Grossman uses social media to weigh in on health-related topics, like the state of medicine or changes in health insurance. She’s careful to limit her comments to “general advice when a conversation about a certain medical topic is going completely sideways.”
Comprehensive Cancer Centers of Nevada might be one of the valley’s most avid users of social media, with Facebook, Twitter, Google+, YouTube and Pinterest in their toolbox — not to mention profiles on Healthgrades.com and entries in Wikipedia. But the goal is scrupulously sharing news with an audience they’ve grown organically. “We use it to communicate to our followers new happenings at CCCN, such as new physicians joining our practice, new research trials, awards or accolades our physicians have earned, cancer awareness days and other general health advice,” Director of Marketing and Public Relations Lisa Santwer writes in an email. “I think social media plays a positive role in health care as long as no patient information is exchanged and no medical advice is given.” (Still other doctors ask: Facewhat? CCCN oncologist Dr. Nicholas Vogelzang writes: “No social media, never have done it, probably never will. I’m busy enough!”)
There is a rapidly developing form of social media that physicians seem to embrace: online physician communities such as QuantiaMD. Think a Facebook for doctors where they can keep up on medical developments, share insights with other doctors and comment on the healthcare topics of the day. Perhaps most importantly, physicians also use these sites to consult with others in their field on issues they’re dealing with in their practices — and it’s helping patients. Coyne of QuantiaMD is proud of his website’s success stories when sharing information saves patients time, money and discomfort. In one scenario, Coyne says, after watching a QuantiaMD presentation about a patient with a partial small bowel obstruction related to taking an ACE inhibitor (a hypertension and high blood pressure drug), a member physician realized she had a patient with similar troubles. She successfully adjusted her patient’s treatment. “The doctors saved her patient from having to undergo some painful testing,” Coyne says. That’s definitely something we can all “like.”