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The doctor will see you now: How the Internet and social media are changing healthcare

dr keyboardYou wake up feeling a slight tickle in your throat. You try and shake it off and drink lots of water. After a few hours, it’s still there. Instead of calling your mom or making a doctor appointment, you head to the Internet.  Today, anyone with a computer and a connection can get online and find a variety of results, ranging from simple sore throat to the more serious, like bronchitis and asthma.

But just because we can doesn’t mean we should. In a world where almost everyone is online and can easily find and provide medical solace, is it really, truly a good idea to consider social media and the Web a reliable source of healthcare?

Doctors and hospitals are on the social media bandwagon

Today, more and more members of the medical profession are embracing social media for sharing helpful medical information and providing patient care. A Pricewaterhouse Cooper conducted survey asked over a thousand patients and over a hundred healthcare executives what they thought of the way many healthcare companies are utilizing social media and the Web, and results show the most trusted resources online are those posted by doctors (60 percent), followed by nurses (56 percent), and hospitals (55 percent).

le bonheur fb pageSocial media is becoming more and more utilized by hospitals and medical professionals as a means to convey general health information, sometimes even personalized help. Amanda Mauck, Interactive Marketing Specialist for Le Bonheur Children’s Hospital, thinks engaging with patients via social media is a great way to empathize with those who need comfort, not just provide relevant health news. Aside from the latest news about the hospital, Le Bonheur’s Facebook page mostly contains relatable family stories and parenting advice. “Our users love photos and [success] stories, [especially those] that showcase our team’s compassion and ability to go above and beyond for a family,” says Mauck. The hospital does receive private messages inquiring about specific medical conditions, but they never address them publicly on their Facebook page, usually recommending patients to direct their questions to the hospital’s general contact form or contact them by phone. “When a family posts a comment about a medical issue, we like to encourage the family to email our general account. We do this for a couple of reasons: One, to protect that patient’s privacy, and two, it is easier to put the family in touch with the right person on our team for help,” Mauck explains.

Kevin Pho, M.D., an internal medicine physician and founder of KevinMD.com, however, notes the potential for misinformation on the Internet is high. “The problem is, you can’t trust everything you read online,” Pho says. “For instance, consider that fewer than half of websites offered accurate facts on sleep safety for infants, or that pro-anorexia websites were shared more frequently on YouTube.”  According to Pho, health professionals need a strong social media presence to establish themselves as reputable sources as well as to properly point patients toward legitimate sites to be used as secondary sources.

While Pho uses Facebook more for personal reasons, he uses Twitter professionally on a daily basis to retweet provocative healthcare opinions and news stories, as well as curate information that’s relevant to his profession. “Health reform tends to drive many of the health opinions on the web.  To truly fix healthcare, I believe that we need solutions from both ends of the political spectrum, so I avoid sharing opinion pieces that are overly partisan or dogmatic,” Pho says. His “essential list” includes a variety of healthcare stakeholders, including physicians, social media experts, and policy analysts. 

The likes of Facebook and Twitter not only give medical professionals a platform to connect with patients, but with fellow doctors as well. Doximity is like Facebook for physicians, where general M.D.s can easily consult specialists for cases they need assistance with. 

The challenges to Internet healthcare

Of course there’s a downside to doctors becoming too available online. The Internet is almost always the opposite of private – sensitive subjects like physical and mental ailments can easily be revealed by the person suffering from them or the doctor treating them through a tweet or a comment. Social relationships between doctor and patient can also be easily muddled; many health institutions discourage staff from “friending” patients on Facebook and other social media platforms at the risk of jeopardizing treatment as well as reputations.

The Wall Street Journal mentions a survey published in the Journal of General Internal Medicine back in 2011 that revealed 35 percent of respondents who are practicing physicians have received friend requests from patients on their personal social network accounts, and 58 percent of them always reject them.

“I see Twitter as a higher-risk environment, as it’s basically an open forum.”

Thomas Lee, M.D. of the Orthopedic Foot & Ankle Center in Westerville, Ohio raises a valid point: Social media is a difficult media for a physician because of HIPAA, the Health Insurance Portability and Accountability Act. “It is very difficult to talk about medical care without personalizing the content, and you can’t personalize content without violating HIPAA,” Lee explains. “In addition, the practice of medicine requires a thorough history of the patient’s current condition and a thorough physical exam before we can render a diagnosis and treatment plan. A person with a severe headache for several months can range from a simple headache to migraines to an allergic reaction to a life threatening brain tumor. How would a doctor – or a computer program – differentiate between these diagnoses without physically talking and touching the patient? Without the opportunity to directly talk to a patient and examine them, our ability to be accurate is significantly mitigated.”

Lee avoids dishing out professional and medical advice on his Twitter and Facebook accounts, but admits that both help in making himself appear more accessible to his patients and staff. Although he posts frequently, it is unusual for him to engage in a dynamic conversation online.

“I see Twitter as a higher-risk environment, as it’s basically an open forum,” Dr. Rob Lamberts says of his minimal use of the micro-blogging site for his own practice; he only utilizes it occasionally to float a medical question to his colleagues. He has used Facebook in the past to advise people regarding a study on Zithromax, but other than that, Lamberts believes social networking sites are more for marketing and general communication than for medical application.

Scott Linabarger, Senior Director of Multichannel Content Marketing for the Cleveland Clinic, believes that nothing should take the place of having a conversation with your physician. “We cannot provide specific advice, nor can we diagnose users via social media. Our information is general and is intended to provide guidance. Our posts are about the users, not about Cleveland Clinic,” Linabarger explains. According to Cleveland Clinic’s over 450 thousand Facebook followers, they want health and wellness tips, information about diseases and conditions, and news about the latest in medical innovation from the hospital’s Facebook page. The general information is usually presented by Cleveland Clinic through images, a manner they have proven to garner a higher response rate compared to purely text content.

What about online therapy and similar practices that conduct virtual sessions? A study conducted by University of Sydney researchers on the effectiveness of Internet-delivered Cognitive Behaviour Therapy (iCBT) examined e-couch, a free online program that offers various modules that provide anxiety and depression assistance. The results reveal the program to be more effective in alleviating mild to moderate depression and cardiovascular ailments as well as physical health issues than other methods of searching for health advice online.

e couch“Essentially, online therapy will help serve the nearly 3 out of 4 people who have mental health problems but do not currently get any kind of help,” says Lawrence Shapiro, Ph.D., President of Talk to An Expert, Inc., a HIPAA-compliant e-therapy company that launched quite recently. “It is particularly important for people who cannot get to an office for conventional help because they are housebound, in remote areas, physically disabled, and so on.  Online therapy lowers the bar for people who need help.”

“There are a few studies that have been done suggesting that online therapy is just as effective as in-office therapy,” Shapiro continues. “According to the American Psychological Association, almost 25 percent of people with mental health problems don’t get the help they need with the current mental health delivery system. Online therapy extends the reach and reduces the cost of therapeutic services.” With the emergence and acceptance of e-therapy as a legitimate form of healthcare, any patient who cannot afford to schedule appointments during office hours or is undergoing a problem in a public place (think of someone with an intense fear of flying freaking out at the airport, or someone injured and traumatized at a disaster site) can receive instant psychological services.

Dr. Internet, at your service

According to a report compiled by the Pew Research Center’s Internet & American Life Project, one in three American adults have used the Web to figure out a medical issue. Of all those users hoping to find solutions online, 46 percent thought they needed to seek professional medical assistance to be certain, 38 percent believed they could handle their ailments in the privacy and comfort of their own homes, and 11 percent ended up doing both or something in between. The accuracy of accessed information online is a different matter all together – 41 percent of those who sought medical advice got diagnostic confirmation from actual physicians and an extra two percent only got partial confirmation. 18 percent were met with disagreement or a different diagnosis, while one percent got an uncertain reaction.

As an Internet savvy patient, it’s always good to be prepared – or to first look for alternative, quick, and easy (and risk-free) methods to address a less serious medical issue before committing money and time to a medical consultation and medication. Facebook is a rich source for fitness-focused pages that inspire users to adopt healthier lifestyles. In one click you can become a member of a community that will help you with any fitness-or-health-related questions through their personal experiences.

“I do my best to not complain a lot at home. Instead, I use social media sites like Twitter and Tumblr to express how I’m feeling without having to burden my loved ones.

A lot of patients suffering from serious ailments also turn to Facebook for support. Dana Baker – a thyroid cancer survivor – has been a long-time sufferer of a long list of ailments, including chronic fatigue syndrome, fibromyalgia, anxiety, and depression. She is a member of various support groups on Facebook and uses them to sympathize with other people suffering from similar conditions. “When you are chronically ill, it is emotionally draining not on just yourself but also on your friends and family. It becomes very difficult for your loved ones, because they have to see you suffer, and the majority of the time there is nothing they can do to help you,” Baker says. “I do my best to not complain a lot at home. Instead, I use social media sites like Twitter and Tumblr to express how I’m feeling without having to burden my loved ones. I use support groups on Facebook to talk with other people, share our experiences with doctors, medications, and alternative treatments. We also share coping strategies.”

Aside from using social networking sites to keep in touch with fellow patients, Baker also uses Google to look up prospective doctors, sites like WebMD to look up any prescription medication, as well as condition-specific sites like  migraine.com and thyca.org (for thyroid cancer). She also uses an iPhone app that allows her to keep in touch with her doctors via direct message and they usually respond within the day.

The Internet can also bring the world’s home remedies to your desktop. Trusting the Web to prescribe a homemade concoction might sound sketchy, but by using the right keywords and employing responsible Internet navigation, you can find legitimate “all natural” solutions for common mild ailments. Sites like Home Remedies Web encourage healthcare at home – their list of natural cures address a wide range of common problems, from acid reflux to yeast infections. It also features comments from people who’ve tried the remedies so you have an idea what you’re getting yourself into.

Based on Pew Research Center’s findings, a large percentage of people online prefer taking matters into their own hands, thinking it’s enough to be armed with enough Web search prowess to beat any disease. The trouble is, the wealth of information leaves too much room for guessing – patients can easily underestimate a medical condition, and too often they lean toward inaccurate and scary data. This is confirmed by research conducted by the Hong Kong University of Science and Technology, which reveals that the less familiar you are with the patient and the condition (meaning being diagnosed by someone besides a search engine and your own queries), the better the chance you have at finding out what’s really wrong.

“I encourage patients to go online and inform themselves about their medical conditions.  Patients deserve to be well-informed, and the transparency of the Internet allows them access to information that used to be gated by a provider,” according to Pho. “The problem, as previously mentioned, is the quality of the information on the Web. There’s too much information available. Physicians need to act as curators of that information, and help patients sort out what’s helpful and what’s not.”  

The middle ground and the bottom line: social media and healthcare can go hand in hand

“Social media isn’t always a secure forum; there’s no way to confirm whether the person on the other end is a legitimate patient or physician,” Pho says. Most hospitals and medical institutions provide healthcare social media policies for their physicians and staff, and as long as these guidelines are respected, social media is a great tool to bring patients and doctors together. 

The problem arises when patients tend to believe that they have the worst diagnosis out of the many possibilities and create unnecessary anxiety within themselves.”

Patients should use this same compromising policy as well. “I don’t mind informed and well educated patients at all,” says Dr. Amit Malhotra, M.D. of Smart Health Technology. “The problem arises [when] patients tend to believe that they have the worst diagnosis out of the many possibilities and create unnecessary anxiety within themselves. It is important to educate yourself and then have a good conversation regarding your problem with your doctor [so he can] guide you through your problem and address your concerns.” Instead of looking up diagnoses, patients can use the Internet as a positive resource for ways to stay healthy and to research sites that provide credible health content. “Patients should ask, ‘who funds it?  Who’s writing that information?  Are there any commercial relationships?  Is there an agenda?’ As a rule of thumb, I recommend health information from ‘.gov’ websites, such as Medline Plus, or ‘.org’ websites that belong to hospitals or medical centers, like the Mayo Clinic,” Pho suggests.

According to Lee Aase, Mayo Clinic’s Director for Social Media, aside from posting general health information, it is also important to offer content that invites patient involvement. “We do a ‘Myth or Matter of Fact’ feature each week in connection with our Saturday radio program in which we post a frequently heard saying about a disease or condition, and then invite users to say whether they think the statement is true or whether it is a myth. We reveal the answer on the page after radio program airs,” Aase mentions.

The world today is technologically driven, and it’s in our best interest – whether you’re a physician catering to your patients’ queries or an individual seeking proper medical treatment – to keep up with these advancements, especially when it comes to accessing healthcare. But even the Internet needs to be taken with a grain of salt, and in the case of healthcare, it’s in everyone’s interest to proceed with caution and skepticism.