When medicine met the Internet, there was a global expansion of medical information: some evidence based and accurate, others misleading and false; for professionals and patients alike to peruse and usurp. Soon, there were online appointments and the ever controversial doctor rating websites. Now, hundreds of millions of people take to the Internet every day to post their own views and stories in an endless sea of social media websites.
Twitter, a free microblogging website inviting users, or tweeters, to post 140 character tweets, now boasts 500 million active users. Whilst it may have started as being a portal into the celebrity world, Twitter’s demographics have boomed and now includes many doctors and those soon to be.
As part of a teaching project in my fourth year at medical school, I presented an interactive talk about Twitter. In the days that followed, I saw student after student sign up and send their first tweets. It’s new, it’s fresh and I feel that it’s an opportunity. The buzz of the social media hive is like nothing else and the growth of social media giants like Twitter as well as Facebook with over 900 million active users poses a new question.
What role does social media play in the modern day doctor-patient relationship?
I argue that whether we like it or not, their unification has already begun.
Social media has a place in almost every home. Laptops, iPads, tablets and now, in the palm of their hands, people accessing Twitter and Facebook on the go using their smartphones. More and more doctors are emerging on Twitter, some gaining an impressive following. Whilst most simply tweet their day to day lives, some make political references and use hashtags to contribute to debate and protest. This was particularly evident around the time of the UK’s controversial NHS health reforms with #SaveOurNHS a prominent trending topic. Using this example, does Twitter possess the power to unite doctor and patient in order to shape the health service?
Some doctors, including well known TV doctors, take Twitter one step further and answer medical questions and even recommend diagnoses and treatments.
If you are experienced, knowledgeable and willing to answer such questions responsibly, what is the problem? It offers an excellent way for people to gain simple advice quickly and easily, and has great potential for engaging with young people. I feel the problem is finding a place to draw the line. A consultant offering an answer evokes a different response to if a medical query was answered by an inexperienced Foundation Year doctor.
If an eight minute GP consultation is a time limited struggle, a 140 character tweet with no physical examination is not very insightful. As well as issues regarding false information and patient safety there are concerns regarding data protection. How can we keep patient information confidential if we plaster it over Twitter? A system with doctors communicating medical information to patients over social media appears chaotic and impossible to archive.
To include Twitter as a middle man between doctor and patient has the potential to negatively impact not only the patient, but the doctor. Twitter offers a platform to patients, which some inevitably will use to complain and may choose to name their doctor specifically. Concerns regarding doctor rating websites have been well publicised and Twitter offers a new way for patients to vent their anger about named doctors publically.
What better way is there to get to the heart of this topic than to employ social media itself? On the cusp of 8,000 tweets, I feel like a fairly experienced tweeter. Enthused by the topic at hand, I took to Twitter to put out three questions:
@mike__saunders: #1 What are your thoughts and feelings regarding doctors using social media, such as Twitter and Facebook? #socialmedia #NHS
“I feel indifferent because… doctors are people with lives outside of the hospital too.”
“I have several doctor friends and most hide their identities on Facebook and it rather disappoints me.”
A nursing student says, “… they are good social platforms with which to interact with other doctors.”
It seems that there is little concern regarding personal use, but what of the issue of professionalism? Whilst doctors retain the right to use social media in their free time, will they need to keep a constant guard to ensure they maintain a professional attitude? Inappropriate and unprofessional tweets could carry negative consequences in the workplace and allow patients to form pre-conceived ideas about their doctor.
@mike__saunders: #2 Could we use social media to improve the health of the general population? How? #socialmedia #NHS
“You could use it to advertise good health messages. Otherwise, I think it’s better to physically go to your doctor.”
“Hmm, I guess it would help indirectly – more on informing them about current health issues.”
There appears to be some doubt, though with Twitter offering promoted articles, I believe this can be used to engage the public in health campaigns.
@mike__saunders: #3 Do you think Twitter influences the modern day doctor-patient relationship? How? #socialmedia #NHS
“I don’t think it does influence it, unless (they) are communicating through twitter, which is… wrong.”
“(There is) ripe opportunity for connecting doctors and patients, especially in the States where a lot of us… often rely on WebMD (for insurance reasons).”
A junior doctor tweeted, “Twitter should not be used for Twitterconsults as it is no replacement for history and investigations. But it does make patients more aware of doctor’s politics, humour and attitudes. Potentially humanising. Potentially off putting.”
A tweeting blogger GP said, “Why do you think it would have any impact (at all)?”
A nursing student adds, “Connecting patients through FB or twitter is… a really bad idea. (You) need to encourage people to come in for physical examinations, not to @reply to their doctor. …can they even give out advice over (Twitter)? Nobody wants their doctor knowing everything about their lives and doctors don’t need patients knowing their personal information.”
Initially, this tells us that whilst doctors and the public see little reason for doctors not to tweet, both parties want to draw the line there and to avoid Twitter becoming a cyber GP surgery. As a side, it allows us to see the issues that are in the centre of the public interest. With such a quick responses from a diverse group of people, what better way to survey patients about health topics and to promote healthy living?
Where will Twitter take us?
Could we one day see doctors and patients communicating blood results via security encrypted social media sites?
Will patients be logging on to tweet their GP their morning’s blood pressure check or BM result?
I am not so sure, but it highlights that the possibilities here are endless. Social media is expanding daily, as does our capability to employ it in our working lives. I argue that Twitter is a new tool in medicine that we can use to reach out patients, to pool opinions, and shape the health service and methods of practice. That is why when I start work as a new doctor next August; I will remain just as addicted to Twitter as ever before.
About the Author : Michael Saunders is final year medical student at Peninsula College of Medicine and Dentistry, in Exeter, Plymouth and Truro in the United Kingdom. He is interested in general paediatric medicine, medical education and medical writing and is also a keen photographer and WordPress blogger. He is currently on an eight week medical elective in Galle (Sri Lanka) working in the general medicine and paediatric wards. He can be reached at : [email protected]
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