June 11th, 2009 by MotherJonesRN in Better Health Network
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Life is good. I’m settling into my job at UGH (Undisclosed Government Hospital) and I have a couple of days off from work. I’m using my time constructively. My house looks like hell, but I am doing other important things like writing, reading blogs, and visiting Twitter.
Yes, I’m addicted to Twitter. I started tweeting when I hooked up with Pixel RN and Dr. Val at BlogHer last year. They showed the joys of micro-blogging and my life was changed forever. Twitter is great place to meet people using 140 characters at a time. You can hangout in cyberspace with people like Ashton Kutcher, Lance Armstrong, and Stephen Colbert. You can also hangout with a lot of great healthcare providers. I make new “friends” by putting the word “nurse” into the Twitter search engine. Then I sit back and see what pops up.
Yesterday, something very interesting caught my eye. Dr. Hess, a plastic surgeon, tweeted that nurses were being offered free plastic surgery. I love free stuff, so I followed the link in his tweet, and checked out his blog. He wrote a great post. I also checked out the link in his post to the New York Times. The upshot of the story is that some places in Europe are offering plastic surgery as a recruiting tool for nurses. The story talked about the enormous social pressure that some nurses are under to look good. It’s true. Even some hospitals in the United States are using young and beautiful nurses as a marketing tool to entice more patients into their facilities. Age discrimination is rearing its ugly head. I wrote this post about a nurse who lost her job because she was getting old and because she wasn’t pretty anymore.
I tweeted Dr. Hess. I told him that there wasn’t enough plastic on the planet that could make this sow’s ear into a silk purse. I also told him that I look forward to tweeting with him in the future. He wrote back and told me that he thinks that I’m charming. Just wait till he really gets to know me!
I’m going to Twitter my way through life.
*This blog post was originally published at Nurse Ratched's Place*
June 9th, 2009 by Bryan Vartabedian, M.D. in Better Health Network
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Let’s face it, Twitter isn’t that hard to figure out. The interface is intuitive and a little time on the application makes its basic function pretty obvious. But there are a couple of things that medical newbie’s might keep in mind before taking the leap on to Twitter. While I didn’t find myself in any kind of trouble, I had to figure a few things out on my own.
1. Follow and listen. Twitter is as much about listening as it is about talking. The best thing you can do to see how doctors are using microblogging to advance their platforms, practices and passions is look and listen. Pick a group of doctors (look at my follow list for some ideas) and follow them for a couple of weeks to see exactly what they do and how they interact with others. Don’t reinvent the wheel.
2. Goof around now, but ultimately think how you want to use it. You likely won’t have any idea about how to use Twitter when you first jump in. And that’s okay. You can’t understand it’s power until you reach a sweet spot of followers and cultivate relationships that have some history and meaning (in Twitter terms, of course). Ultimately you do want to think about connecting with those who will put you where you want to be – whether it’s just raising your profile as an author or specifically drawing patients for lapband surgery, or whatever. But also keep in mind that you may start by goofing off and never stop … like me.
3. You can follow whoever you darn well please. The world is full of self-ordained social media experts who spend their days working to make you feel like you don’t follow enough people. If you’re a physician with a real job you’re too busy to follow 30,000 people. Keep your eye on the ball and think about the network you want to develop. Whatever you do, don’t believe the nonsense that it’s ‘bad etiquette’ to not follow someone who follows you.
4. Your patients and your hospital are listening. Social media is interesting. While we type in the privacy of our boxer shorts, the world reads what we write. And that includes your patients. While my grandmother used to tell me before going out, ‘don’t do anything you wouldn’t do in front of the Virgin Mary, I’m telling you, don’t Tweet anything you wouldn’t want your patients to see. You represent your personal brand, practice, and profession with that very first tweet. Keep in mind that some hospitals have social media/blogging policies. You might look into this before taking the plunge. If you keep your hospital/institution off your bio, commit to never discuss anything relating to patients and always vow to be a really nice guy you should be good.
5. What happens on Twitter stays on Twitter. Remember that everything you type will remain etched in the infosphere for eternity. This can be retrieved by future employers, partners, soon-to-be-ex-spouses or anyone else interested in seeing or exploiting what you’re really about. Exercise intelligent transparency. Be smart and use your frontal lobe before hitting ‘update’.
I was interviewed by the AMA News last week on doctors and Twitter and that’s what got me thinkin’ about this post. I get a charge out of helping doctors recognize the power of connecting beyond their immediate environment. I hope this helps.
*This blog post was originally published at 33 Charts*
March 20th, 2009 by Dr. Val Jones in Health Policy
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What would it be like to have most of healthcare’s key stakeholders in one room, and allow each of them to take turns at a podium in 3 minute intervals? It would be like the meeting I attended today at the Institute of Medicine.
The goal of this public forum was to allow all interested Americans to weigh in on prioritization rankings for comparative clinical effectiveness research (CCER). CCER, as you may recall from my recent blog post on the subject, is the government’s new initiative to try to establish “what works and what doesn’t” in medicine. Instead of answering the usual FDA question of “is this treatment safe and effective?” We will now be asking, “is this treatment more safe or more effective than the one(s) we already have?”
There are many different treatments we could study – but let’s face it, 1.1 billion isn’t a whole lot when you consider that some CCER studies (like the ALLHAT trial) cost upwards of 100 million a piece. So we have to think long and hard about where to channel our limited resources, and which treatments or practices we want to compare first.
The public forum attracted most of the usual suspects: professional societies, research organizations, industry stakeholders, health plans, and advocacy groups. But the imposed time limit forced them to really crystallize their views and agendas in a way I’d never seen before.
I “live-blogged” the event on Twitter today and if you’d like to see the detailed quotes from all the presenters, feel free to wade through the couple of hundred comments here.
For those of you more interested in the “big picture” I’ll summarize my take home points for you:
Almost everyone agreed that…
- The process for establishing research priorities should be transparent and inclusive of all opinions.
- More information is good, and that CCER is a valuable enterprise insofar as it provides greater insight into best practices for disease management.
Most agreed that…
- Preventive health research should be a priority – so that we can find out how to head off chronic disease earlier in life.
- CCER should be considered separately from cost effectiveness decisions.
- One size doesn’t fit all when it comes to patient needs and best disease treatments.
- Physicians should be included in the CCER research and clinical application of the findings.
- Research must include women and minorities.
- CCER should not just be about head-to-head drug studies, but about comparing care delivery models and studying approaches to patient behavior modification.
- CCER should build upon currently available data – and that all those who are collecting data should share it as much as possible.
Some agreed that…
- There is a lack of consistent methodology in conducting CCER.
- We need to be very careful in concluding cause and effects from CCER alone.
The best organized 3 minute presentations:
In my opinion, the industry folks had the best presentations, followed by a powerful and witty 3 minutes from the American Association for Dental Research. Who knew the dentists had such a great sense of humor? Here are the top 4 presentations:
#1. Teresa Lee, AdvaMed – best all around pitch. In three short minutes, Teresa persuasively argued for transparency in CCER priority-setting, presented her top disease research picks (including hospital acquired infections and chronic diseases like asthma, diabetes, and clinical depression), the importance of physicians and patients making shared decisions about care (rather than the government imposing it), and the need to distinguish CCER from cost effectiveness.
#2. Randy Burkholder, PhRMA – “Without physician input, the questions we pose via CCER will not be clinically relevant.”
#3. Ted Buckley, BIO – “What’s best for the average patient is not necessarily best for every specific patient.”
#4. Christopher Fox, American Association for Dental Research – he said that “his good oral hygiene made it possible for him to deliver his presentation today.”
Most innovative idea
Dr. Erick Turner of Oregon Health and Science University suggested that FDA trial data be used as the primary source of CCER-related data analysis rather than the published, peer-reviewed literature since journals engage in publication bias – they tend to publish positive studies only.
Most shocking moment
Merrill Goozner, from the Center for Science In The Public Interest, essentially told the public forum hosts that the event was a terrible idea. He suggested that industry stakeholders were inherently biased by profit motives and should therefore not be allowed to influence the IOM’s CCER priority list. The crowd squirmed in its seats. For me, Merrill’s suggestion was like saying that a plan to reform the auto industry should exclude car manufacturers because they have a profit motive. Sure profit is a part of it, but reform is just not going to happen without buy in and collaboration. As I’ve argued before – there’s no such thing as complete lack of bias on anyone’s part (patients, doctors, nurses, dentists, health plans, advocates, or industry). The best we can do is be transparent about our biases and include checks and balances along the way – such as inviting all of us biased folks to the table at once.
I’m glad that happened.
March 3rd, 2009 by Dr. Val Jones in Announcements, Expert Interviews
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Will Twitter wonders never cease? I was recently contacted by one of my Twitter followers from Spain – Alain Ochoa Torres, a journalist with Diario Medico (Spain’s leading publication for healthcare professionals). Alain has spearheaded a creative new social media strategy: the Twitterview. I am the eighth interviewee in a series featured on Twitter. Tomorrow (March 4th) at 10:30am EST I’ll be typing back and forth – live – with Spanish physicians who have questions about American medicine and the media. You can tune in by following me “drval” on Twitter, or by searching for this word on Twitter: #dm8 (that stands for Diario Medico, interview #8).
For those of you who don’t know about Twitter, it’s a micro-blogging platform that is limited to 140 characters per post. That means I’ll have to master the “sound bite” in my interview responses! To see how I do… you can watch the interview live or search for it later on Twitter by entering #dm8 in the search box at the bottom of the Twitter home page.
This is a really innovative use of Twitter technology – and one that brings together physicians from both sides of the Atlantic. I’m really honored and excited to be part of this social media event and hope to do more of them.
And the good news is that this interview will be in English (my Spanish vocabulary is limited to things like “where is the pain?” and “turn your head and cough” – hardly substantial enough for a Twitterview.)
Hope you’ll join the experiment with me.
