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Outsourcing Relationships And Peddling Influence: Why Social Media Is Not Fun Anymore

When I first started blogging in 2006, the medical blogosphere consisted of a small group of physicians, nurses, and patient advocates. We knew each other well, and spent time each day visiting our favorite blogs and posting personal comments of encouragement and insight. We developed real friendships, and were optimistic about our brave new online writing frontier. We thought we could change the healthcare system for the better, we believed that our perspectives could influence policy, and we were sure that our writing could help our patients lead healthier lives.

I remember with great fondness the medical blogger conference that I attended in Las Vegas in 2009. It was the first time I’d met most of my blog friends in real life (IRL) – it was like seeing your favorite pen pals after years of correspondence. We talked all night, had marveled at how a love of writing had brought together a surgeon from South Africa, an ER nurse from California, and a Canadian rehab physician, among others. We figured that social media was the glue that held us all together. Since then, I am sad to say that for me, the glue has lost its stickiness due to dilution by third parties and a glut of poor quality content dividing attentions and exhausting our brains’ filter system.

Fast forward 7 years and most of my email correspondence is from strangers wanting to embed text links in my blog, people selling SEO services, or PR agencies inviting me to provide free coverage of their industry-sponsored conferences and webinars. I can’t think of a single friend who has left a comment on my blog in the past three months. Sure we see each other’s updates on Facebook and occasionally on Twitter, but I can’t remember the last real conversation we’ve had. Social Media has become irreversibly cluttered, and I’ve never felt more isolated or guarded about the future of medical writing.

My thoughts on this subject gelled when Twitter announced that LeBron James was following me (along with a select 80,000+ others). Obviously, LeBron has no idea who I am, and I’m almost certain he had nothing to do with his Twitter account following me. He, like many others, has outsourced his online relationship-making. It’s the ultimate irony – using social media to distance yourself from others, while maintaining an appearance of engagement. Sort of like sending a blow up doll of yourself to a party.

So what keeps some people going on these social media platforms? Perhaps it’s the allure of influence – the idea that many people are listening to you gives a sense of importance and meaning to your efforts. But take a cold hard look at your followers – do you know who most of them are? Or is there a large group of “hotchick123″ type Twitter accounts counted among them? I used to block followers who didn’t seem real or relevant, but it became so much of a chore that I couldn’t keep up. I was overwhelmed by the Huns.

One could argue that my social media fatigue  is my own fault – I didn’t screen my followers properly, I didn’t follow the “right” people, I haven’t curated my friendships with as much care as I ought to… But I know I’m not alone in my pessimism. A recent Pew Research poll suggests that people are leaving Facebook at a rapid rate. And as far as Twitter is concerned, it’s not for everyone.

I guess the bottom line for me is that social media isn’t as much fun as it used to be. I miss my blog friends, I miss the early days of being part of an online community. I don’t write as much as I used to because I don’t know my audience by name anymore. This “party” is full of strangers and I don’t like the familiarity that continues in the absence of true friendship.

Time to spend more of my energy on my patients, family, and friends IRL. And that’s a good lesson for a doctor to learn…

Diabetes, Jet Lag, And Adjusting To The 24-Hour Clock

I traveled by small, wooden plane.  The flight from Boston to London took just over six hours.  The time change was five hours ahead of Boston, so when we landed at 6 pm, I was only ready for lunch.  The trek from London to Dubai was almost seven hours, pushing the clock ahead a full nine hours from Boston, making my head hurt because how was it Wednesday morning when I was still on Tuesday’s timetable?

(I wrote about the impact of changing time zones for an Animas column last month, but I seriously had no idea what I was in for when I decided to take the trip to Dubai.)

That first day there, the Wednesday, everyone gave me the same advice:  “Don’t go to sleep.”  (It felt like A Nightmare on Elm Street.)  “Work through the exhaustion and just go to bed on Wednesday night on Dubai time, and you should be good the next day.”

For the first few hours after landing, Read more »

*This blog post was originally published at Six Until Me.*

Sex And Your Defibrillator

Have a defibrillator and feel like getting frisky? For the first time that I can recall, there’s a very helpful article published in Circulation addresses the concerns of implantable cardiac defibrillator (ICD) patients and sexual activity. There’s all kinds of helpful tidbits, like this one:

A study of 1,774 patients who had experienced an acute myocardial infarction showed that sexual activity was a likely contributor in fewer than 1 percent of cases. In fact, regular physical exertion, such as that associated with sexual activity, was associated with a decreased risk of cardiac events in patients.

Now that’s helpful!

Recall that defibrillators are designed to detect rapid, potentially life-threatening arrhythmias. Most of the time, sexual activity does not lead to heart rates at a level that ICD’s would consider elevated during intercourse. (This, of course is patient specific). While your doctor can tell you the rate cut-off at which your ICD might possibly fire, watching your heart rate rise with a monitor during those moments might be a bit of a, shall we say, turn-off. Read more »

*This blog post was originally published at Dr. Wes*

Doctors Are Human, Too

It’s all too easy to try and quantify everything in medicine. We are, after all, under the widely held delusion that medicine is like physics. A thing that follows fixed, predictable mathematical models. A thing reproducible if only algorithm A is followed for this disease and algorithm B is followed for that disease.

This belief is also held by the government, which doesn’t want to pay for readmissions or mistakes. Because it is believed that all things in medicine can be known from an exam, some labs, some tests, and some studies.

Nevertheless, things happen. Disease are transmitted in public or by families. Medications don’t always work. Bodies change. Bodies age. Humans are non-compliant. Humans are suffering from physiologic phenomena we can’t yet comprehend. Viruses are synergistic with other diseases.

The immunity of our patients is affected by their happiness, their diet, their work history, their family. The algorithms necessary to make medicine anything like physics would be mathematically beyond comprehension. Read more »

*This blog post was originally published at edwinleap.com*

Just Rest

“I’m tired,” I recently told a friend. He looked at me with a hint of a smile and gave the obvious answer: “Then you need to rest.”

This simple yet elusive answer hit me squarely. I spend a large portion of my life being tired, yet I don’t know how to rest. Sure, I waste a lot of time doing things that are unproductive, but they’re more of a distraction or an escape — they aren’t about rest. Read more »

*This blog post was originally published at Musings of a Distractible Mind*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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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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