The Doctor Will See You Now??
Recently, a friend of mine went out to his car late one night to run an errand, only to find that it would not start. He was immediately concerned as he had an early AM meeting that he couldn’t miss. He had just replaced the battery so knew it must be something else. Knowing nothing of cars, he did what any of us would do, he Googled it. One brief phrase – “Infiniti QX56 won’t start battery new”—and presto, up popped three online mechanics, one at $15, one at $25, and one at $45. Choosing the middle of the range, he clicked on the link and there was his trusty online mechanic at 11:30 PM to answer his questions and hopefully solve his dilemma. After a brief history of the problem, the mechanic quickly shared with him what he thought to be the most likely answer – it was a relay switch. Fortunate for him, this particular model has 6 other relays that are identical, one of which was to the fog lights. The fix was simple; he would just need to switch out the two parts. Knowing that my friend was not adept in the ways of car repair, the mechanic, e-mailed him a diagram of where to find the correct part, he switched it out, and like magic, his car started up. Thirty minutes after getting online – Problem solved.
As I thought about this story, it made me wonder about how we continue to care for patients today. My physician’s office is one of the very few places in my life that I have to wait for an appointment in order to receive the information I want or need. A friend of mine called last week for an appointment as a new patient with a specialist she needed to see. First available appointment – 6 weeks.
Much of the discussion we are seeing is about how physicians must change the way we practice in response to healthcare reform and the new law. Although that is undeniably true, there are other forces of change at work in the world of healthcare. Given that nearly everything else in our lives has become designed around immediate access, it is only a matter of time until physician practices must find a way to get on board.
- New models of care, using social media tools and immediate access such as hellohealth are emerging. Follow @jayparkinson on twitter to see more.
- Jennifer Shyne Dyer, MD, [@endogoddess] is using texts and tweets to monitor her diabetic patients.
- The Mayo Clinic recently launched its new Center for Social Media with the tagline Bringing the Social Media Revolution to Healthcare.
If physicians are to survive and thrive in this new healthcare world, they will need to join in this “revolution,” developing new and creative ways to care for their patients and make information immediately available to them. How long will it be till your patients are really able to see you…now?
Excellent post! You're right, the revolution is coming. As Christensen says in The Innovator's Prescription (and his earlier books on disruptive innovation), it is always a challenge for what he calls "incumbent" organizations to disrupt themselves. With the Center for Social Media, we're seeing the trend in society and embracing it, looking for ways it can help us better serve patients. It's certainly a tumultuous time.
I really like your analogy and new blog. Patients do want immediate access to healthcare. It would be nice if they were as easy to "fix" as a car with an instruction manual. Luckily you have a "jump start" with some excellent ideas from innovative providers.
@mkmackey
If doctors were incented to take patient encounters social it would happen in a heartbeat. Doctors continue to be devalued and most are struggling to keep their lights on, let alone innovate.
But good ideas nonetheless.
Excellent Post, Dr. Browne. It is amazing how technology can give us, and patients access to information and People 24 hours a day. I also think that with the new healthcare legislation, social media is one of the vehicles to meet patient's needs.
With healthcare's changes, I expect the entire face of healthcare to change. Today patients want immediate access to their doctors, improved customer service, at a lower cost. To meet these needs, technology and infrastructure will become integrated. Doctors in different specialties, and even in different practices will have to deliver as a team. For example, I envision information being readily available to the urologist to tell the patient it is time for their flu shot. With globalization and outsourcing, I also think physicians and their patients will need to embrace delivery of "virtual medicine".
Its exciting to see what new opportunities technology provides us. It will be up to physicians and all healthcare systems to work together to solve the huge burden facing medicine. I totally agree - physicians need to join in, embrace the future, and thrive.
Very interesting article. This is a practical example how social media is making a difference in our personal lives and that our services need to be adapting how the public engages with them.
There clearly are some difficult hurdles that would need to be overcome in the healthcare sector for social media to play a key role but it is definitely the future.
Nice post, Mark, thanks!
For modern doctors not to use social media to communicate is akin to not using the telephone to talk with patients 50 years ago. That said, I see three main constraints. The first is, of course, time. It takes a bit of time to learn media and use it on a daily basis. The second is, of course, money. Insurers begrudgingly reimburse phone appointments, but still no hope for email or skype. Forget twitter! Third is the Sword of Damocles - malpractice. What if I say something wrong and there is an adverse outcome.
All of this occurs when envisioning social media for doctors as an extension of individualized medical care. Jen Dyer has done that most effectively, but most doctors are not prepared to text blood sugar instructions. However, if you think about time spent with a patient, fully half of each appointment is educational in nature, and repetitive over the course of a day.
How much easier (and how much MORE information can you give) to have patients follow your information flow, ask general questions and start to talk amongst themselves while on your FB page or twitter feed. It's an amazing feeling to put educational information "out there" and have people learn and ask and grow from your 30 second investment.
Ultimately, social media taps into the reason we all went to medical school - which is to make a difference in people's lives.
Yes, of course there are rules of conduct and here they are..
LinkedIn is the office
Twitter is the water cooler at the office
Facebook is the bar after work
MySpace is the bar at closing.
Everywhere is the elevator, never say something you wouldn't say with other people listening.
Everyone knows you're a doctor and you are expected to behave as one 24/7 (you can be a human being too, not a robot doc). You cant make an ass out yourself on social media anymore than you can get away with it at your high school reunion.
Last rule - social media is MY elevator. If I dont like your demeanor on MY page or MY feed, I give you the block boot. Makes for a nicer milieu and better conversation for everyone else.
How many tweeting docs can we get? I hope all of them, and not just about what they had for lunch!
Best, Sara
Mark,
I don’t think the question is whether or not doc’s ought to embrace this revolution, but rather are patients willing to pay for healthcare the same way your friend paid for the relay advice?
How inclined do you think a mechanic would be to give immediate advice over phone or the web when few are willing to pay to receive advice this way?
Consider this.
Imagine that the only way the mechanic could be paid for the relay advice, was if he made your friend bring the care in.
Now, also consider that the mechanic from the story didn’t get paid $25 before providing the advice, but rather had to provide the advice upfront and then submit a claim to the patron’s car insurance company with a series of codes that described everything the mechanic did (his diagnostic, history, evaluation, exam etc). Then, wait 30 to 45 days to find out if the claim was rejected or paid.
The claim finally returns, but it isn’t paid at the original price of $25 but rather discounted to $18 just for the privilege of offering services to a person with that car insurance.
The patron’s car insurance company also informs the mechanic that the patron’s policy doesn’t cover advice on relays at 100% so they are going to reimburse the mechanic only $5 and that it is his responsibility to collect the $13 from the owner of the Infinity.
Months have gone by now, and the Infinity owner gets a bill for the $13. “Thirteen bucks?” Says the Infinity owner. “Insurance should have paid for that” and throws the bill in the trash. The mechanic now has to hound the Infinity owner for the 13 bucks.
Oh, I forgot to mention that the mechanic now is liable for the next 10 years for the relay advice. If it is later determined that it wasn’t the relay, but rather a fuse, and as a result, the car suffered some kind of damage, the Infinity owner can sue the mechanic for malpractice.
This is what doctors have to put up with everyday.
So I’d argue that it isn’t the doc’s unwillingness to jump on this “revolution” but rather patient’s failure to realize that in order for the chance to happen, change has to happen.
Help doctor’s remove the barriers to providing better care, and patients will get the care they deserve.
Very interesting and well written blog, Mark. I'll read it regularly and become a better Trustee at Atrium.
The move toward instant access is accelerating. And toward continuous access in the case of remote patient monitoring. It strikes me that the former is primarily in the domain of "sickcare" . Today continuous access holds promise for "sickcare" and, Heaven forbid, might be seen as a tool for central agencies to monitor us for the sake of "healthcare" (and, oh by the way, C-O-S-T).
Perhaps proactive "healthcare" requires a third kind of access: "ready" ? To education, to personal health measures, and even to the elusive but critical human relationships we all need to become better people (e.g. via social networking).
interesting post. One thing that would concern me here would be the temptation to cut corners, and ending up with a service where instead of real doctors you'll end up with people "trained" to give out medical advice online.