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Latest Posts

Who Follows Big Pharma On Twitter?

Do “normal” people – patients, doctors, nurses, pharmacists, life scientists, etc – follow Big Pharma on Twitter? I’ve long had a hunch that most of the followers (and by followers I mean people who are actually paying attention) of Pharma accounts are primarily consultants, marketers, PR pros, social media evangelists and others interested in Pharma’s use of the Web (including myself).

So I decided to gather the key words in the profiles of a select group of Pharma companies. I used the service TwitterSheep to generate tag clouds of these profiles. This isn’t a purely scientific approach, but it’s reasonable enough to provide some insight into whose following Pharma. My friends Silja Chouquet (@Whydotpharma) and Andrew Spong (@AndrewSpong) each provided great insight into Pharma and Twitter. You can read their posts here and here, respectively.

Based on the tag clouds, here are the top ten key words in the profiles of followers of selected Pharma companies: Read more »

*This blog post was originally published at Phil Baumann*

Online Advertising 3.0: Harnessing Social Media Users For Precision Targeting Of Friends

Do you advertise on your social networks? You might not think that you do, but every time you tweet or update your status on Facebook or post a picture to Flickr, you’re advertising – perhaps not with commercial or self-promotional intent, but you are advertising something: an item of news, a humorous post or a moment from your vacation. I don’t believe that Advertising is bad; but there is bad advertising, the kind that pointlessly interrupts and annoys and leads to no action.

As the Web expands and evolves from a tangle of static web pages towards social and real time streams, Advertising will need to evolve into a suppler and friendlier animal. Google may have perfected Advertising on the traditional web platform, but the door is open to new players who can socialize advertising. It’s not an easy task: the bull’s eye of targeting customers is getting tinier everyday. Enter MyLikes, a start up which has taken on the task of helping advertisers reach their base. Read more »

*This blog post was originally published at Phil Baumann*

Top 12 Features That Twitter Should Offer

Image representing Twitter as depicted in Crun...
Image via CrunchBase

After returning to Twitter after a week-long break, I’ve had the chance to look at the service with a freshened perspective. Twitter needs to stay simple – that’s what drives its success. Nevertheless, I believe Twitter needs to mature and provide exploits of its service. While the basics of Twitter aught to remain, Twitter, Inc. can build a wider ecosystem around those basics which could make it a true contender as an important part of the Web.

Services like Posterous and Friendfeed offer features such as replying via email. Although third-parties could develop similar features via Twitter’s API, it’s time that Twitter mature a bit. If Twitter plays its cards right, it could offer itself as much more than just as the modern equivalent of a telecommunications utility (which it is).

  1. Email content, replies, DMs. We should have an option to respond to replies & DMs via email. There are services out there such as Topify but they don’t provide the most secure methods. Read more »

*This blog post was originally published at Phil Baumann*

Social Media 2.0: When Real Experts Broadcast Themselves


Tweety Bird
Image by sirwiseowl via Flickr

Disclosure: I’m fascinated with Technology in general and social software and communities in particular. I’m one of Twitter’s biggest fanboys (here’s proof). I blog and tweet often about these media because I believe it’s important that we understand our relationship with Technology (and for me, Technology is more than just gadgets – for instance: I consider Law, Democracy, Religion and Capitalism technologies – but that’s another post).

I also believe that we need better or more original conversations about the Web and its deepening influences on our lives, our businesses, our sciences and our health care. Social Media pundits (or however they refer to themselves: gurus, evangelists, mavens) for too long have held the dominant voice in these discussions.

One phenomenon which our Web has engendered is the ability for virtually anyone to express their opinions and experiences and perspectives in accordance with their mastery of media. And therein lies a pesky issue: one’s accumulation of social attention for a particular field doesn’t always correlate with their expertise.

Over the last decade, many brilliant contributors have offered important and refreshing perspectives on the promises of the web. But some of these ideas have yet to be vetted and validated by closer scrutiny and scientific inquiry. The truth is not always intuitive. It’s easy, therefore, for appealing ideas to have fundamental flaws. Read more »

*This blog post was originally published at phil baumann online*

Democracy, Tyranny, And The Online Revolution

vertigo
Image by pomarc via Flickr

When status quos collapse, for whatever reasons, are their replacements necessarily better? Does the demise of traditional media powers mean that new media powers will lead to more Democracy? Will cultivated professions which require years of training and mistakes and experience – such as Medicine – give way to amateurs who can succeed in creating appearances of Authenticity?

Last century, not everybody could publish their thoughts without expending some form of considerable energy. Now, with Twitter, anyone can tell the world what s/he thinks at virtually zero expense (save the time value of their tweets). This is no doubt a radical shift in communications and publishing and connecting.

It’s easy to call this democratizing. But is it? Read more »

*This blog post was originally published at phil baumann online*

Latest Interviews

How To Make Inpatient Medical Practice Fun Again: Try Locum Tenens Work

It s no secret that most physicians are unhappy with the way things are going in healthcare. Surveys report high levels of job dissatisfaction burn out and even suicide. In fact some believe that up to a third of the US physician work force is planning to leave the profession…

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Caring For Winter Olympians In Sochi: An Interview With Team USA’s Chief Medical Officer Dr. Gloria Beim

I am a huge fan of the winter Olympics partly because I grew up in Canada where most kids can ski and skate before they can run and partly because I used to participate in Downhill ski racing. Now that I m a rehab physician with a reconstructed knee I…

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Latest Cartoon

Richmond, VA – In an effort to simplify inpatient medical billing, one area hospitalist group has determined that “altered mental status” (ICD-9 780.97) is the most efficient code for use in any patient work up.

“When you enter a hospital, you’re bound to have some kind of mental status change,” said Dr. Fishbinder, co-partner of Area Hospitalists, PLLC. “Whether it’s confusion about where your room is located in relationship to the visitor’s parking structure, frustration with being woken up every hour or two to check your vital signs, or just plain old fatigue from being sick, you are not thinking as clearly as before you were admitted. And that’s all the justification we need to order anything from drug and toxin screens, to blood cultures, brain MRIs, tagged red blood cell nuclear scans, or cardiac Holter monitoring. There really is no limit to what we can pursue with our tests.”

Common causes of mental status changes in the elderly include medicine-induced cognitive side effects, disorientation due to disruption in daily routines, age-related memory impairment, and urinary tract infections.

“The urinalysis is not a very exciting medical test,” stated Dr. Fishbinder. “It doesn’t matter that it’s cheap, fast, and most likely to provide an explanation for strange behavior in hospitalized patients. It’s really not as elegant as the testing involved in a chronic anemia or metabolic encephalopathy work up. I keep it in my back pocket in case all other tests are negative, including brain MRIs and PET scans.”

Nursing staff at Richmond Medical Hospital report that efforts to inform hospitalists about foul smelling urine have generally fallen on deaf ears. “I have tried to tell the hospitalists about cloudy or bloody urine that I see in patients who are undergoing extensive work ups for mental status changes,” reports nurse Sandy Anderson. “But they insist that ‘all urine smells bad’ and it’s really more of a red herring.”

Another nurse reports that delay in diagnosing urinary tract infections (while patients are scheduled for brain MRIs, nuclear scans, and biopsies) can lead to worsening symptoms which accelerate and expand testing. “Some of my patients are transferred to the ICU during the altered mental status work up,” states nurse Anita Misra. “The doctors seem to be very excited about the additional technology available to them in the intensive care setting. Between the central line placement, arterial blood gasses, and vast array of IV fluid and medication options, urosepsis is really an excellent entré into a whole new level of care.”

“As far as medicine-induced mental status changes are concerned,” added Dr. Fishbinder, “We’ve never seen a single case in the past 10 years. Today’s patients are incredibly resilient and can tolerate mixes of opioids, anti-depressants, anti-histamines, and benzodiazepines without any difficulty. We know this because most patients have been prescribed these cocktails and have been taking them for years.”

Patient family members have expressed gratitude for Dr. Fishbinder’s diagnostic process, and report that they are very pleased that he is doing everything in his power to “get to the bottom” of why their loved one isn’t as sharp as they used to be.

“I thought my mom was acting strange ever since she started taking stronger pain medicine for her arthritis,” says Nelly Hurtong, the daughter of one of Dr. Fishbinder’s inpatients. “But now I see that there are deeper reasons for her ‘altered mental status’ thanks to the brain MRI that showed some mild generalized atrophy.”

Hospital administrators praise Dr. Fishbinder as one of their top physicians. “He will do whatever it takes to figure out the true cause of patients’ cognitive impairments.” Says CEO, Daniel Griffiths. “And not only is that good medicine, it is great for our Press Ganey scores and our bottom line.”

As for the nursing staff, Griffiths offered a less glowing review. “It’s unfortunate that our nurses seem preoccupied with urine testing and medication reconciliation. I think it might be time for us to mandate further training to help them appreciate more of the medical nuances inherent in quality patient care.”

Dr. Fishbinder is in the process of creating a half-day seminar on ‘altered mental status in the inpatient setting,’ offering CME credits to physicians who enroll. Richmond Medical Hospital intends to sponsor Dr. Fishbinder’s course, and franchise it to other hospitals in the state, and ultimately nationally.

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Click here for a musical take on over-testing.

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Latest Book Reviews

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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Unaccountable: A Book About The Underbelly Of Hospital Care

I met Dr. Marty Makary over lunch at Founding Farmers restaurant in DC about three years ago. We had an animated conversation about hospital safety the potential contribution of checklists to reducing medical errors and his upcoming book about the need for more transparency in the healthcare system. Marty was…

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