Deanna Attai, MD
Online forums have peeled away some of the barriers to understanding her patients, says Deanna Attai, MD, a well-known clinical professor of surgery at the David Geffen School of Medicine at the University of California Los Angeles. Attai is co-moderator of the Breast Cancer Social Media (BCSM) Twitter community, a regular Monday open forum.
“When you see two women in the middle of the night having a real raw conversation about their chemotherapy side effects, it is very different from what you see in the office,” says Attai.
Social media – which broadly defined encompasses many different forms of Web-based exchange – has the potential to make a deep imprint on oncology practice, but many clinicians are still reluctant to participate, physicians interviewed by Oncology Business Management
In some instances the reasons for holding back are a lack of time and skepticism that an investment in posting online will advance their practices in any material way or contribute much toward patient welfare, says Don Dizon, MD, an oncologist at Massachusetts General Hospital and chair of the Social Media Working Group for ASCO, which is tasked with evaluating and guiding social media participation within the society and for its members.
Many use social media to further their professional education and stay current, but a huge concern among physicians is the danger of compromising their reputations as community professionals and potentially violating patient privacy rights. For example, Attai noted that an innocent post could lead to a harsh response from a special interest group. “That’s not something we expect as physicians, and we don’t really know how to deal with it,” she says.
Nevertheless, many practices from the administrative end have embraced the potential of social media and are encouraging their physicians to participate. “There’s a heavy investment in a social media presence at the institution level,” says Dizon. “It’s all about exposure and making sure that name recognition is increased in a comparatively more competitive environment for patient attention.”
These institutions all have the same problem, though. “Every single one of them, I believe, is struggling with how to get buy-in from their providers,” says Dizon. “What’s happening [online] isn’t necessarily reflected at the physician level in any of those institutions or health practices. You cannot force someone to join Twitter or Facebook or write a blog, and you certainly can’t post in someone’s name, because that would be unethical.”No Credit for Tweeting
Academics don’t receive credit for tweeting, and they may feel that writing a grant application is a far better use of time, Dizon says. Physicians, meanwhile, may be pulled in many directions by their workplace obligations. They may have to see inpatients or do administrative shifts in a hospital. “It’s all about work-life balance. If you’re doing so much at work already, how much time do you have to devote to something else?” he asks.
This situation is frustrating for administrators, who feel that participating in social media is important for establishing a practice in the community and for building brand. “One of the questions I am always fielding is, ‘How do we get our people to tweet?’ And I don’t think anyone at the institutional level or at the marketing level of any one institution or practice has the answer for that,” says Dizon.
Don Dizon, MD
Attai is in the camp of social media converts who believe that patient confidentiality can be respected with proper training and that, although physicians are busy, social media is something they can do if they are dedicated. “As with anything, you have to figure out how involved you want to be, how important it is to you, and then figure out how to manage your time. It took me a little while to learn,” she says.
Recognizing the growing influence of social media in oncology, ASCO put out a set of guidelines for physicians in 2012.1 Dizon was the lead author. The report noted the inherent risks of publishing material online, while praising the value of disseminating good quality medical information that would serve as a useful resource to doctors, patients, and others. Although physicians use social media in different ways, the report said, giving patient advice directly over the Web is least often done, and the authors expressed doubt that that it can be done in a manner that satisfies patient privacy and regulatory requirements.A World of Patient Experience