Are doctors on television just hams?

I recently came across a blogpost entitled “Everyone is Taking to the Camera- Pass the HAM please.” In it, the writer (a published author) says:

I have never seen more Doctors, Lawyers, Judges and ex-politicians on television than I have in the last few years….

Dr. Phil and Dr. Oz certainly must have been good Doctors, but think how much more they have learned on air with a staff and producers that can access any fact in minutes. Working for a producer doing new shows every day is much more demanding than working for patients. These Docs are quite camera friendly and seem to adapt well to the nuances of live TV; including pauses for commercials. Their message is popular and it seems that they here to stay.

….

What conclusions have I drawn from this diverse group of professionals that strayed into the small screen from other high paying professions? I believe deep down we are all HAMS looking for a modicum of fame.

I felt compelled to leave a response and, as you can see, it turned out to be a mini-blogpost. So I share part of it with you here and welcome your own thoughts and opinions.

I think I would have agreed with you on the “ham”-factor a few years ago. I guess I still do to some extent. Any person living in the public eye (including the one online) is likely to be craving an audience, after all. But, as a general practitioner earnestly interested in how accurately the media relays health information, I am less concerned these days about how people (doctors) got onto television and more concerned about the messages they are relaying.

A doctor might find himself deemed camera-worthy by producers after a stint on a matchmaking reality show. Or after being interviewed by Oprah. But what these professionals do with their position is ultimately what counts because their influence is huge. I cannot say whether working for patients or working for producers is more demanding, as I am in full-time clinical practice and have not done the latter. But to me, a big challenge is the fact that ratings (and not responsibility) drive content on television and that medicine discussed on television shows may be anything but “real” for the sake of viewership.

Luckily, more and more doctors are using social media to try to correct misinformation or relay more relevant medical issues without the sensationalism characteristic of television. These physicians might even use video to spread the word. We need good quality information, especially heath information, on television and it ultimately does not matter to me whether this comes from a HAM.

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Social Media Adoption by Physicians. It’s A Little Like Quitting Smoking

Today, Mark Britton, CEO of Avvo (a physician rating site that also provides answers to health questions), gave a presentation to our clinic regarding the role of social media in healthcare. He gave an excellent background on the evolution of social media, as well as general principles to consider when embarking on this path.

 “If you don’t have a meaningful web presence, you don’t exist.”

This quote, from Britton, is poignant and true – true, at least, to the many doctors already utilizing social media. But many doctors feel the opposite is true. They might say, “When I take care of patients, make phone calls, am physically present and working tirelessly in clinic or the operating room… that is when I exist. Social media is a fad for kids and I really don’t have the time for it.” This is the oft-referenced head-in-sand approach – never a good one. Others might feel that social media in healthcare is ALL about marketing and self-promotion. (By the way, the vast majority of physicians do the latter poorly, quite frankly. This is usually due to a fear of the impression it would make on others. In fact, for years, I deliberately did not reveal my profession to many non-healthcare acquaintances I encountered unless specifically asked. ) Some doctors feel their years of experience and employer reputation – rather than fancy web pages – should be enough to convince patient that they are good doctors.

All of these are valid concerns and points. As I have now been blogging, tweeting, and using LinkedIn and Facebook since November of 2010, I almost forgot that I was a nay-sayer once, too. It occurred to me today, as I observed the faces in the room during this social media talk, that educating physicians about social media adoption is akin to smoking cessation counseling for patients. That is to say, one will encounter differing levels of interest depending on which doctors you meet.

PRECONTEMPLATIVE STAGE

Typical response involves using the word Twitter with a sneer or not even recognizing it.  “I don’t do Facebook. I don’t do Twitter.” Doctors in this stage might also wonder, “Why would I change the way I practice now? I have plenty of patients. I don’t have time for this.”

CONTEMPLATIVE STAGE

An individual in this stage might be someone who already uses Facebook for personal reasons (keeping up with family, using Facebook as a photo album,  etc). He may be curious about how social media can work for him. Some doctors in this stage might want to get involved but are afraid of the time commitment. After all, EHR adoption and meaningful use requirements are eating up more of the limited time that is not spent in direct patient care.

PREPARATION

In this stage, the doctors are ready and researching tools. They might be observing the behavior of other social-media-savvy doctors. They might get inspiration or ideas from some of the physician bloggers/tweeps that I follow most frequently: SeattleMamaDoc, 33 charts, Dr. Wes, John MD , KevinMD, Clinical Cases and Images: Casesblog and – ahem- my own blog.

ACTION

Here, doctors are committed and are actively embarking on the social media path.

MAINTENANCE

This is tricky because social media CAN be consuming and it is easy to get frustrated (especially if you are only looking to increase revenue quickly).  It is doable, however,  and takes a little discipline – doctors are good at that, right? – to get just the right balance so that you don’t lose steam. It helps if you receive input on topics that you find interesting and relevant.

****

I was thrilled to see the number of physicians from my clinic attend the presentation. I underestimated the level of interest in the topic. Ultimately, no one should feel pressured into social media for the sake of social media itself or for the sake of generating quick revenue. One thing is true with social media; motives are more apparent than we would like to think.

If a doctor is passionate about his/her work in the healthcare industry, the realm of social media is one that cannot be ignored. To expand on Mark Britton’s words, not only do you not exist if you don’t have a meaningful web presence, you might even have an inaccurate and less than favorable existence, a web portrait painted by reviews on Yelp or Angie’s List or Healthgrades and generated from very limited interactions or experience. This might come as a shock to even the most experienced and well-meaning doctor.

Furthermore – and most important, in my opinion – patients get their information from the internet. If more reputable and qualified physicians are not there to direct them, someone else – even a celebrity without any medical training– will be more than happy to “educate” them.

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Filtering Helps E-patients, per MIT Media Lab

For those interested in a contrasting viewpoint – because there are always at least 2 ways to look at an issue – to my recent post about the potential effect of the “filter bubble,” I am using this post to present the other side of filtering. Filtering – in layman’s terms – is the way by which companies  like Google and Facebook (“gatekeepers”) determine what your search results will be, using algorithms that incorporate data from your prior search habits. Ian Eslick recently sent me a link to an article that explains the positive aspects of filtering. Eslick is a PhD candidate at MIT Media Laboratory and is studying how filters apply to healthcare information on the web. Here’s an excerpt from that article:

In an era of increasing information overload, the filter is a necessary and valuable tool and we’re only at the beginning of the technology curve.  In the context of health, filters are critical to improving the effectiveness of the rising class of e-patients.

This is a fascinating topic that is not new, but that I have recently discovered. I certainly don’t claim to be an expert, which is why I am posting the MIT Media Lab’s perspective, as well.

Do any of you out there have thoughts on the topic? How about filtering as it relates to healthcare information? Did you know about the concept of the “filter bubble” or personalized search results or is this also the first you have heard of it? Do you see other pros and cons to it? Does this topic even matter to you?

The Internet and Delusional Thinking: A Take on the Effect of the “Filter Bubble”

Some suggest that social media is full of illusions. Real life people creating an alternate reality through the web and social media is not unfamiliar. Sometimes the alternate reality becomes so infamous it creates real danger and harm, as in the case of Kiki Kannibal.

But there may be a greater collective societal harm in our use of social media and the individualized way we in which interact with the internet and other people. We’ve created a sort of “selective hearing” with the introduction of DVR, Facebook friending (and de-friending), RSS feeds, podcasts, and Twitter. Even if we are not creating a fake image of ourselves, we are living in a world designed around our own self-interests.

Long gone are people telling us things we don’t want to hear. We can tune them out and tune in messages from like-minded people. If I believed in life on Mars, I can “program” my inputs from various channels to be heavy on that topic by selectively following those with similar interests, searching for corroborating articles on the web, and highly rating similar topics on DVD.

The internet and our current technological advances do more than just encourage us to create illusions. For a much larger percentage of us, if not all of us, they help us create and maintain our own delusions (I am not referring to the actual medical term here). Delusions are technically defined as false beliefs, but in the tweeted words of Jan Henderson, there is “no one right conclusion that stands the test of time indefinitely.” So I would argue that we are delusional if we only look at the world from a singular or narrow perspective, being unwilling to accept or selectively avoiding other opinions/ realities.

As I was pondering the above in recent weeks, I come across a video that, quite frankly, sent slight chills up my spine. It was a video of a TED talk given by Eli Pariser, author of his new book, The Filter Bubble, which deals with the notion that the major players in the internet world (like Netflix, Google, and Facebook) are tailoring your searches based on your previous online behavior. They acquire data regarding your pattern of clicking, your location, etc., to personalize your results. “You actually start to have – without you really knowing it – your own views fed back to you,” Pariser said in a recent radio talkshow. Why? To increase the likelihood you will click on the links presented. “You can make more money if you can show people stuff that they’re going to like.”

He explains this more clearly in the video (well worth watching for the 8-min duration)…. By the way, after watching the video, you get the sense that you have inadvertently sold your soul by engaging in a technology that, without which you would be considered obsolete and nonfunctional.

What are the implications of “the filter bubble” for healthcare? Potentially huge. People are now “researching” online for their healthcare information. And this is only going to increase over time. If I have a tendency to click on naturopathic medicine links and I get diagnosed with breast cancer, the first two pages of my google search regarding treatment might be related to alternative approaches because “personalized media is showing you the things… it thinks you want to see.” This type of filtering may affect my decision on who I call first and thus my treatment plan. It doesn’t take into account that I may have changed my mind about which approach to treatment I would prefer.

It is concerning to think that internet companies “have a lot of power to shape what you see and don’t see.” The web will assume our preferences for us, feeding us the information that substantiates our underlying tendencies. Even outside of the specifics of healthcare, there is potential for our biases become more deeply entrenched with personalized media. And I suspect that would not be good for the evolution of human consciousness. I personally feel fairly reassured because I believe I have a critical way of searching on the web. But other people (with less formal experience researching information) may feel they are just as objective, but in actuality, have less discernment. (This is exemplified in the case of a sensational article circulated on the internet recently.)

As it is, to be open to new ideas and evolve into broad-minded human beings requires much attentiveness and deliberateness, which can easily get lost in our fast-paced lives. The internet is now making it that much harder.

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Social Media to the (Timely) Rescue

Yesterday, I read an e-mail from someone who wanted my thoughts on an article entitled, “Scientists cure cancer, but no one takes notice” The article published on HubPages.com  (which, by the way, “Helps Everyday Experts Publish & Earn”) was scientifically unsound, poorly written, and painful for me to read. It proposes that that dichloroacetate is a simple wonder drug for cancer but is so inexpensive that no one cares to study it further. I looked into it and it turns out that the original research that led to this article was done in 2007 – a long time ago in the field of medicine!

Of course, I tried to find out whether there were any more recent references to dichloroacetate. I won’t say I actually researched it, though. (After all, “googling” is to “research” as watching TV drug ads is to getting a pharmacist degree.) Interestingly, the very same day that I read my friend’s e-mail, this was posted on Twitter by Gary Schwitzer, Publisher, HealthNewsReview.org.

Science blogger @pzmyers deflates sensationalism of “Scientists cure cancer, but no one takes notice” story – http://ht.ly/4VF6O

It turns out that this is a resurrection of a sort of “conspiracy theory” on the web, one that was circulated a few years prior. “Science blogger,” PZ Myers, is a biologist and an associate professor at the University of Minnesota, Morris. His post, published online just two days ago begins with this sentence:

So many people have sent me this sensationalistic article, “Scientists cure cancer, but no one takes notice”, that I guess I have to respond.

Well, thank you, Dr. Myers for your timely response. Mostly, though, thank you for responding in a way that not only points out the sensationalism of the popular article, but also teaches your readers about the mechanism of how dichloroacetate works, its potential, and the issues surrounding research of it. Thank you for providing a link that I could forward to others who ask about it (because the “written” word seems to carry more weight than the spoken word). And I also hope that your article, which currently has 1,698 “Likes” on Facebook, eventually supercedes the number of “Likes” of the Hubpages.com article, which happens to be a mere 362,000, and counting….