Tag Archives: patient education

Social media use: the new risk factor?

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Doctors already query patients about whether they drink, use tobacco or are up to date on their immunizations. Should they also be asking about the patient’s use of the social media?

The question was raised on Twitter recently by Jamie Rauscher, a consultant and strategist on digital communication for health care organizations. Then it was picked up by Dr. Elaine Schattner of the Medical Lessons blog, who reflected on the world of social media and why physicians should or shouldn’t blog or tweet.

Dr. Schattner writes that blogging, for her, is both liberating and fun: “As I’m no longer practicing, this wide-open world of shared facts, some questionable, and new ideas keeps me alert and, maybe, in-touch.”

Might this not be the case for patients as well? Rauscher joined the discussion, noting that when physicians don’t spend much time online, they can be unaware of what their patients are encountering, especially sources of information that are less than reliable.

And she makes an important point: Doctors “cannot help patients find credible resources unless they understand what patients are doing online.”

She writes:

I don’t mention my social media activity to my physicians because no one asks me and there isn’t a logical time to broach the topic during an exam. Perhaps doctors should start including questions about patients’ online activity, including social media use, in the questionnaires they give patients. This could provide an opening to discuss the topic.

I can think of many reasons why screening for this could help improve patient care. For one thing, it would identify where the patient gets most of his or her information and could help clinicians more effectively tailor their patient education. For another, it’s an opportunity to assess what the patient knows and to address misinformation or provide information that’s more detailed and in-depth.

But there’s the practical perspective to consider too. People’s online habits have a way of shaping their entire daily routine. When the National Sleep Foundation conducted a survey earlier this year, it found that the increasing use of technology is starting to interfere with a good night’s sleep. Six in 10 of the respondents said they spent time on their computer before bedtime and many of them reported lower-quality sleep and feeling drowsy during the daytime.

I’ve personally learned that the sedentary aspect of Facebook, Twitter, blog reading and online discussion can seriously interfere with the need for more physical activity.

It can be hard for doctors to offer helpful, appropriate counseling about insomnia or weight gain if they don’t take the patient’s online habits into account.

Then there are the emotional minefields of bullying and harassment, which prompted the American Academy of Pediatrics to issue guidelines earlier this year for pediatricians to be on the lookout for online trouble among kids.

Many of these issues are already being debated in the medical world: Should doctors be on Facebook? How should they interact online with patients and the public? What’s ethical and what isn’t?

Although there’s a growing consensus that health care organizations need to join the online conversation (for an example, check out the Mayo Clinic Center for Social Media), whether to routinely screen patients regarding their social media habits is a different issue altogether – and at least as far as I can tell, one that apparently hasn’t gotten much attention.

What do readers think? Should doctors ask patients more often about their use of the social media? Would it lead to better patient care?

Photo: Wikimedia Commons

Paging Dr. Google

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Three years have gone by since Time magazine published a now-infamous essay about patients who Google. According to the author, Dr. Scott Haig, Googlers were among the worst possible patients, armed with “a barrage of excruciatingly well-informed questions” and spewing sentences “burst with misused, mispronounced words and half-baked ideas.” His disdain couldn’t have been more clear.

Unfortunately Dr. Haig committed the classic logical error of assuming “this patient is a Googler, this patient is obnoxious, therefore all patients who Google are obnoxious.”

But the genie was already out of the bottle. Although many information-empowered patients were quick to denounce him, more than a few physicians must have privately applauded Dr. Haig for giving voice to some of their own misgivings about patients’ use of the Internet.

The medical world has always been rather ambivalent about symptom-Googling and online research by patients. Will patients overreact or draw the wrong conclusions from what they read online? Will they show up in the exam room with a stack of printouts? Most of all, will it alter the doctor-patient relationship when patients have better access to information?

The tide, it seems, might be slowly beginning to turn on this issue. Not too long ago, Time magazine printed another essay about patients who Google – only this time, it was titled “Googling symptoms helps patients and doctors.”

Oh, sure, the cast of characters included a supercilious, condescending, eye-rolling intern and nurse. But guess what? It wasn’t the patient who was the problem, writes Dr. Zachary Meisel: “The real problem was with my team: we weren’t well equipped to deal with her online homework – and it became a distraction.”

Dr. Meisel writes:

… To debate whether patients should or should not Google their symptoms (which a surprising number of doctors seem to enjoy engaging in) is an absurd exercise. Patients already are doing it, it is now a fact of normal patient behavior, and it will only increase as Internet technology becomes ever more ubiquitous. The average Joe has more health information at his fingertips – both credible and charlatan – than all the medical libraries ever built put together. So the real question is, What can professionals do to translate this phenomenon into better health for their patients and the public?

Hallelujah.

Although health care professionals will probably continue to struggle with this for many more years, there at least is a growing recognition that the Internet, when used appropriately and effectively, can be a powerful tool for patient care.

But what this entire debate seems to be missing is the significant number of Americans who don’t even have access to online health information, let alone the wherewithal to become Googlers.

The Pew Research Center recently released a report examining Americans’ information-seeking behavior online, and the results are concerning. Among the findings: People of color, people with disabilities, older adults and adults with limited income and education are among the least likely to obtain health information online. Among adults with a college degree, for instance, 93 percent of those surveyed said they went online for health information; for those who had less than a high school education, it was 38 percent.

Those who had broadband were more likely to go online than those who had dial-up access. Rural respondents also used the Internet at lower rates than either urban or suburban residents.

There’s already a health literacy gap between those who are well educated and those who are less so. Health disparities among Americans who are minority and poor have been well documented. Now we also have a growing health information gap between the Internet haves and have-nots.

Which should we worry about more: the fact that patients have access to Google and might misuse it, or the fact that hundreds of thousands of people are disadvantaged by not having online access at all?

Photo: Wikimedia Commons