Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Latest Posts

Clay Shirky: Physicians And Patients Need To Fuse Their Online Conversations

New Media guru Clay Shirky was the keynote speaker at the Management of Change conference in Norfolk, Virginia. His recent book, Here Comes Everybody, is considered a must-read by most web 2.0 enthusiasts. Clay and I escaped the conference for a tête-á-tête at a local Starbucks where we wrestled with the thorny issues of healthcare and crowd sourcing.

Dr. Val: I’ve noticed that there is a difference between being right and being influential. Doctors are having a hard time adjusting their tone to be more compelling in a social media culture. What do you think physicians can do to be more influential online?

Shirky: The problem is that, since we all die eventually, everyone will be unhappy with their healthcare at some point. This creates a social dilemma that’s neither transitory nor small. First, there will always be snake oil salesmen peddling “eternal life,” and second, there will always be an unhappy faction who rail against the medical establishment. You should not try to stamp out that faction, but referee it. Federalist Papers No. 10 states that faction is the normal case of government – the trick is not to allow factions to gain disproportionate power. Physicians need to realize that patients have different priorities than they do, and speak to those as much as possible.

Dr. Val: What do you mean that we have different priorities?

Shirky: Take Medpedia for example – physicians are eager to write about rare types of liver cancer, but they don’t want to write about the basics of biopsy technique. For the physician, it’s perfectly obvious what a liver biopsy entails, so he/she doesn’t think to write about it. But the patient is probably more interested in learning about biopsy procedure than the scientific details of a rare liver cancer. The entries in Medpedia strongly reflect physician interests and priorities, though the resource is ultimately supposed to serve the educational needs of patients.

Dr. Val: What’s the best way to close that gap in priorities?

Shirky: We need to fuse the conversation between physicians and patients. The more they work together, the more valuable the content will be.

Dr. Val: What do you think about the trend towards “user-generated healthcare?”

Shirky: It’s important to have checks and balances. When lay people discuss medicine, their unguided conversation can degenerate into vitamin hucksterism. I think that whole movement was initiated when the FDA decided not to regulate the supplement industry – people have been used to getting input from others who aren’t scientifically qualified. Now everyone gives medical advice, and people listen.

Social media is a very new phenomenon. We have not figured out how to apply good checks and balances yet – amateurs’ opinions and voices can drown out the experts. We want to believe that everyone’s opinion is equally valid – but that’s just not the case. In the end, quality and clarity of messaging is a source of power.

What Will It Take To Make Online Health Work?

“Internet 2.0″ emphasizes social networking over simply downloading and reading “content”. The world of Twitter, blogging, facebook, e mail, and text messaging is revolutioning our society and rapidly becoming a major force in the way we work and play. It remains to be seen, however, how it will impact health care. There are many, many issues that are no where near resolution.

Although, at eDoc, we have been involved in online health for over a decade, we still run up against innumerable barriers and resistance factors that prevent this modality from truly becoming mainstream.

In order for this to occur, I believe the following needs to happen:

1. The team providing the service must be of high quality. This is difficult to determine in the best of circumstances and almost impossible in the often murky, even sleazy, world of internet
2.0. Until there is a better system for this, the user must be careful to scrutinize the credentials of the professionals involved and understand the business model behind the product. Check to make sure that the physicians are board certified. Beware of industry supported sites that are, essentially, using their web site to sell another product and “giving away” medical content or advice. If possible, find someone else who has used the service and ask whether the service is reputable. If you decide to try the service, dip your foot in the water and assess the quality of what you get back. If you like what you get, try again. If not, run in the other direction!

2. There has to be a widely available method for professional reimbursement. At eDoc, we developed a business model in which sponsoring corporations purchase the service on behalf of their employees or members. Most insurance companies do not cover on line visits with a physician but this is likely to be the case in the future; and, until that occurs, most docs won’t or can’t afford to, get on line to provide feedback or information to their patients.

3. Better tools are needeed. Although there are a lot of good web sites with good medical content, web tools are just starting to be designed to take advantage of the Web 2.0 world. Good, user-friendly, secure patient and provider portals will need to be connected to eprescribing hubs, will need to readily switch to search for internet sites to attach, will need to accept and view video footage, will need capability to connect through digital cameras for real time viewing and communication, and need easy to use, menu driven drop downs that guide the patient and provider through an online encounter.

For now, eDoc has a high quality team that uses a free form communication model and offers medical, dental, pharmaceutical and mental health professional advice. We are watching with eager anticipation to see what the future brings and, hopefully, we can stay ahead of the curve and continue to offer the highest quality online heath professional experience.

Your comments and dissenting opinions are welcome…

**This blog post was originally published by Dr. Charlie Smith at eDocAmerica’s blog**

The Friday Funny: Kids Today

pediatrician1

Latest Interviews

The Surprising Economic Burden Of ADHD (Attention-Deficit Hyperactivity Disorder)

If you can read this you need to download a more recent browser It is estimated that as many as million U.S. adults have ADHD Attention-Deficit Hyperactivity Disorder A recent research study publication-pending suggests that the economic burden of ADHD on America could be as high as billion annually. I…

Read more »

Is The Adderall Shortage A Harbinger Of Future Drug Supply Problems?

If you can read this you need to download a more recent browser Today most- if not all- Doctor’s offices are strained by the shortage of some prescription medication or vaccine. A month ago President Obama signed his executive order directing the FDA to take steps to reduce drug shortages…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: The First Step To Improve Health Care Is A Close Examination Of How It’s Delivered

My friend and former Chair of the CFAH Board of Trustees Doug Kamerow has written a book that I think you will like. Besides being a mensch and witty as heck Doug is a family doctor and a preventive medicine specialist. In his new book Dissecting American Health Care Commentaries…

Read more »

“Your Medical Mind” Explores Factors That Influence A Patient’s Medical Decisions

Recently I had a conversation with Shannon Brownlee the widely respected science journalist and acting director of the Health Policy Program at the New America Foundation about whether men should continue to have access to the PSA test for prostate cancer screening despite the overwhelming evidence that it extends few…

Read more »

Book Review: Food Truths, Food Lies

Food Truths Food Lies written by family physician Eric Marcotte M.D. may be the most refreshingly evidence-based diet book of the decade. You will not find a single mention of super-foods magical berries or supplement must-haves in the entire book. What you will find is the cold hard truth about…

Read more »

See all book reviews »