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Should Children’s Hospitals Do Social Media?

I [recently] participated in an interview for an upcoming publication. As the interview wound down, the dialog downshifted into small talk that included, among other things, hospital blogs.

The interviewer (who had recently been exploring the blogging community) asked me what I thought about Thrive’s (Boston Children’s Hospital blog) recent birthday nod to Seattle Mama Doc (Seattle Children’s Hospital blog). More specifically, did I think it was unusual that one children’s hospital would congratulate a competing institution on its one-year anniversary?

I thought the question was odd but it got me thinking: Do children’s hospitals compete in the social space? I don’t think so. They shouldn’t. And if they were competing, what would they be competing for?

Children’s hospitals are inherently regional. Parents of the northwest see Seattle Children’s as the end of the earth. In the northeast, Boston Children’s is the bee’s knees. And while specialty service lines like congenital heart surgery may draw patients from around the world, most kids come from their corner of the world.

Then there’s the broader question about the point of a blog for a children’s hospital. Is it a marketing gimmick or does it serve a higher function? Read more »

*This blog post was originally published at 33 Charts*

The AMA’s Policy On Professionalism In The Use Of Social Media

A new policy on professionalism in the use of social media was [recently] adopted by the American Medical Association (AMA). The AMA Office of Media Relations was kind enough to share a copy of the policy:

The Internet has created the ability for medical students and physicians to communicate and share information quickly and to reach millions of people easily. Participating in social networking and other similar Internet opportunities can support physicians’ personal expression, enable individual physicians to have a professional presence online, foster collegiality and camaraderie within the profession, provide opportunity to widely disseminate public health messages and other health communication. Social networks, blogs, and other forms of communication online also create new challenges to the patient-physician relationship. Physicians should weigh a number of considerations when maintaining a presence online:

(a)  Physicians should be cognizant of standards of patient privacy and confidentiality that must be maintained in all environments, including online, and must refrain from posting identifiable patient information online.

(b)  When using the Internet for social networking, physicians should use privacy settings to safeguard personal information and content to the extent possible, but should realize that privacy settings are not absolute and that once on the Internet, content is likely there permanently. Thus, physicians should routinely monitor their own Internet presence to ensure that the personal and professional information on their own sites and, to the extent possible, content posted about them by others, is accurate and appropriate. Read more »

*This blog post was originally published at 33 Charts*

When A Patient Contacts A Doctor On Twitter

When perusing my Twitter feed [one] morning, I stumbled onto this post directed to me:

Patients reaching me in public social spaces is becoming a regular thing. I’ve discussed this in the past, but I think it bears repeating. So here’s what I did:

I understood the mom’s needs. Patients resort to “nontraditional” means of communication when the traditional channels fail to meet their needs. Recognize that these patients (or parents in my case) are simply advocating for themselves. My specialty struggles with a shortage of physicians, so we’re dependent upon phone triage to sort out the really sick from the less-than-sick. It’s an imperfect system and consequently parents find themselves having to speak up when the gravity of their child’s condition hasn’t been properly appreciated.

I took the conversation offline. I don’t discuss patient problems in places where others can see, so my first order of business in this case was to get the conversation to a place where it can be private. I called the mom, found out what was going on, and rearranged her appointment to a time appropriate to the child’s problem. Read more »

*This blog post was originally published at 33 Charts*

A Two-Biscotti Physician

[Recently] I ate at one of my favorite Italian restaurants. I had eaten there many times before, but the experience this time was different. After ordering, I received a vacuous bread basket with precisely two pieces of bread. At the end of my meal I was offered two biscotti — and no more. Only the manager could offer an explanation: As a means of containing costs, the decision had been made to capitate bread and biscotti distribution.

I was disappointed. I had been eating here for years. When Colic Solved was released, my publication party was held here. After all those anniversaries, New Year’s celebrations, and birthdays, I’m shortchanged on cookies? It’s remarkable how a great experience can be shadowed by something so small.

Then I got to thinking: Perhaps I’m a two-biscotti physician. Like this restaurant, there are times when I don’t finish well. I may do a phenomenal job with assessment and diagnosis, only to delay a callback on biopsies or X-ray results. Perhaps I get it all right, but fail to get the detail right on the home health orders. Are there small pieces missing in my encounter that represent everything a parent remembers? I know that there are, and I know there are things I have to work on.

There’s a lot we can learn from a restaurant. I don’t want to be a two-biscotti physician.

*This blog post was originally published at 33 Charts*

The End Of Private Practice?

I didn’t need the Wall Street Journal to tell that the days of “private practice” are numbered. According to recent numbers, fewer and fewer medical practices are under the ownership of physicians. Even in my corner of the economically secure State of Texas, small practices are folding faster than beach chairs at high tide.

I was driven out of private practice in 2004 by rising malpractice premiums and plummeting reimbursement. In Texas at the time the trial attorneys ran the place and medmal insurance carriers simply couldn’t keep up with the greed.

Medical practices are just too expensive to run and the services that physicians provide are dangerously undervalued. You do the math. Sure it’s a complicated issue. But the end result is institutionally-employed doctors with institutional pay and the risk of institutional service. Read more »

*This blog post was originally published at 33 Charts*

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