November 11, 2012

Is Social Media Bad for Doctors?

I was recently asked to participate as a speaker in a panel discussion on social media next year in Canada and while preparing my thoughts on this subject, I was pondering several big questions regarding the why and pitfalls of social media for healthcare professionals.

There's the obvious "WHY" a physician should participate in social media.

But perhaps even a more basic concern for a physician deciding whether to pursue social media or not is whether it may even be a bad idea.

Beyond the obvious medico-legal issues regarding private medical information (HIPAA, HITECH, etc, etc), there is perhaps an underlying fear of having their online persona hijacked by negative publicity, whether warranted or not.

In essence, as Sensei Marketing pointed out succinctly in a blog post, could social media actually create bad customers or in our case, patients???

It happened to McDonalds when their hashtag #McDStories was hijacked by a mob of angry trolls as well as real customers with negative stories.

Sensei Marketing's belief in the evils of social media was summarized quite simply:
"people deep down are bullies or at the very least indifferent to bullying."
Assuming the general populace, which includes patients, are all bullies deep down, social media allows for (borrowing from Sensei Marketing):
  • No Guilt - Easy to condemn or accuse
  • The Mob - If lots of people are doing it, it just makes it that much easier for an individual to justify doing it too.
  • Anonymity - Being unidentifiable allows for those who ordinarily would have exercised restraint, to vocalize (or type) without fear.
  • No Accountability - With anonymity, there is no repercussion or punishment 
  • Streisand Effect - If an individual (or doctor) tries to combat a negative rating or comment, it just brings more attention to it. More on this effect as it pertains to physicians here.
There are already numerous doctor rating websites where patients are encouraged to critique their doctor. Doctor rating sites are also universally reviled by physicians for one reason or another.

Could social media be just another further extension of doctor rating websites, except now the physician is doing it to himself inviting another avenue for public ridicule or even attack?

The answer is yes...

BUT, a physician should not avoid social media for fear of risk. In fact, a physician should pursue social media not just for (free) marketing or informational purposes, but also to control risk! I also have a more optimistic view of human nature (we are NOT all bullies deep down).

Unlike doctor rating websites where a physician has little recourse to combat negative comments justified or not, social media CAN be controlled, shaped, and monitored by the physician.

Bullying or negative comments will occur online whether a physician likes it or not. Whether through a doctor rating website or not. Whether there is a social media presence or not.

As such, the absence of a social media presence may in fact promote physician brand negativity given there is no public competing positive voice... namely, your own.

Furthermore, even if you are a wonderful doctor without a bad word anywhere online, in this day and age... an absent presence is increasingly becoming interpreted by the public as a negative, especially when a google search, which takes into account social media presence, often decides who a patient ultimately decides to see.

Is Social Media Bad For Business? Forbes 11/11/12

Social Media is Creating Bad Customers. Sensei Marketing
Fauquier blog
Fauquier ENT

Dr. Christopher Chang is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat. Located in Warrenton, VA about 45 minutes west of Washington DC, he also provides inhalant allergy testing/treatment, hearing tests, and dispenses hearing aids.


Anonymous said...

From "The Legal Infrastructure of Business"

In April 2010, Dennis Laurion accompanied his parents to a neurologist appointment with Dr. David McKee after Mr. Laurion’s father had been hospitalized for a stroke. After a 10-15 minute visit with Dr. McKee, Mr. Laurion returned home, upset with the visit and posted the following review online:

My father spent 2 days in ICU after a hemorrhagic stroke.   He saw a speech therapist and physical therapist for evaluation.   About 10 minutes after my father transferred from ICU to a ward room, Dr. David C. McKee walked into a family visit with my dad. He seemed upset that my father had been moved.   Never having met my father or his family, Dr. McKee said, “When you weren't in ICU, I had to spend time finding out if you transferred or died.”   When we gaped at him, he said, “Well, 44% of hemorrhagic strokes die within 30 days.   I guess this is the better option.”   My father mentioned that he'd been seen by a physical therapist and speech therapist for evaluation.   Dr. McKee said, “Therapists?   You don't need therapy.”   He pulled my father to a sitting position and asked him to get out of bed and walk.   When my father said his gown was just hanging from his neck without a back, Dr. McKee said, “That doesn't matter.”   My wife said, “It matters to us; let us go into the hall.”   Five minutes later, Dr. McKee strode out of the room.   He did not talk to my mother or me.   When I mentioned Dr. McKee's name to a friend who is a nurse, she said, “Dr. McKee is a real tool!”

The facts in these types of cases typically fall into the “my word against theirs” category. Below I discuss some of the arguments in the case to highlight how granular the distinction can be between what is a fact versus opinion.

1. “I had to spend time finding out if you transferred or died” – Dr. McKee maintains that he made a lighthearted comment to the effect of I had looked for him up in the intensive care unit and was glad to find that, when he wasn't there, that he had been moved to a regular hospital bed, because you only go one of two ways when you leave the intensive care unit;  you either have improved to the point where you're someplace like this or you leave because you've died. While the comments are substantially similar, Dr. McKee maintains that the “sting” is very different. In Mr. Laurion’s version, Dr. McKee seems to blame the patient and joke about their death, but in his statement, expresses happiness for the patients improved condition. Therefore, if a jury believes Dr. McKee’s recollection, then the statements by Mr. Laurion are not substantially accurate.

2. Mr. Laurion asserts that in response to the patient’s gown not covering his backside, Dr. McKee said, “That doesn’t matter” – Dr. McKee maintains that he said something to the effect of “I thought it would be fine” or “It looks like it's okay” to indicate that the gown was sufficiently tied. While these statements are similar, to a listener they can come across very different with the first implying that a patient’s concern doesn’t matter, while the second can be interpreted as reassuring a patient. Again, the distinction between these comments has large implications on whether Mr. Laurion’s statements are substantially accurate or not.

3. “A friend who is a nurse, she said, “Dr. McKee is a real tool!” – The court is not evaluating whether what the nurse said is fact or not, the court is evaluating whether there is in fact a nurse that made the statement or not.


Court Watch said...

Video: Lawyer tells Supreme Court how to safely rate a doctor online

In David McKee MD vs Dennis Laurion, Minnesota Supreme Court Case A11-1154, the plaintiff’s attorney told the Minnesota Supreme Court the correct way to critique a doctor at a rating site.

Taken from comments to Minnesota Supreme Court:

He may have been upset at how Dr. McKee treated his father. Apparently he was, and he’s entitled to say that. He can say that “I’m upset. Doctor McKee did not treat my father well. He was insensitive.” He can make statements like that: “He didn’t spend enough time in my opinion.” He can make factual (sic) statements, he can make them on the Internet, he can make them in letters, he can write a letter to the editor, he can stand in front of St. Luke’s Hospital with a placard saying those things if they are opinions . . .


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