Physicians need to adapt to practicing in a digital world

Jeffrey Benabio, MD

Jeffrey Benabio, MD

From electronic medical records to Facebook to Yelp, health care professionals are living in the digital world, whether they like it or not. In short, physicians need to accept the realities of practicing medicine in 2014, which includes making good use of social media platforms and patients rating them online.

“Everyone is having to deal with this transformation in their businesses — from Starbucks to WalMart,” said Jeffrey Benabio, MD, director of the Friday session “e-Dermatology and iDermatology 2.0.” “This is health care today — electronic medical care records and digital monitoring.

“Today, more people have access to a mobile phone than have access to a toothbrush. You can understand how that has an impact on medicine.”

Ignoring this new medical world order is fruitless, said Dr. Benabio, a physician director at Kaiser Permanente who is working on a master’s degree in business administration. A recent survey by the Journal of the American Medical Association showed that 60 percent of patients use the Internet to learn about their physicians, just as they try to choose a restaurant for a night out.

“Patients are Googling us, and it is helpful to them. For most of us, that’s good, that’s really good,” he said. “They were doing that before with friends and family, and now they are just using social media to do that.”

The reality is that younger generations of patients are coming of age, and they like the transparency offered on websites such as Yelp, Healthgrades, and Vitals. These websites not only give patients the opportunity to rate physicians, many also include information about procedures and the prices of those procedures. One of these websites showed that 84 percent of patients said tattoo removal was worth the effort, and that the average price for the procedures was $850.

“Physician, Google thyself. Fifty percent of patients are doing that,” Dr. Benabio said, adding that 90 percent of online reviews of physicians are actually positive and that if physicians wait, over time reviews tend to be favorable.

Physicians who do get a bad review online should not get angry, but address it in a constructive manner. Dr. Benabio said he has sent notes to patients saying, “I’m sorry,” or “I’m concerned about you. Please call my office.” Neither is an admission of malpractice.

“It shows you care. That is what patients want,” he said, adding that once an issue is addressed, a physician can ask a patient to change a poor review. “Patients equate service with quality. What do they expect? A good bedside manner, a supportive staff, and no waiting.”

Meeting those expectations requires good communication from a physician and his staff. That can be accomplished with a well designed website and intelligent use of social media, said Robert Dellavalle, MD, PhD, MSPH, a dermatologist and Facebook editor for the Journal of the American Academy of Dermatology.

“You communicate to influence, teach, learn, recruit, and make a difference,” said Dr. Dellavalle, associate professor of dermatology at the University of Colorado School of Medicine and Colorado School of Public Health. “Social media teaches us to do that at a higher rate than ever before.”

Dr. Dellavalle reviewed how the Colorado Cancer Coalition used social media to educate the public about the dangers of tanning and the threat of melanoma. Those efforts included posting videos on YouTube featuring a mother whose daughter died of melanoma, a younger woman who has melanoma, and a terminal patient talking about melanoma. All three cases were tied to young women using tanning beds.

“Engagement takes time and energy. It is not necessarily how many things you do on the Internet, it is the amount of time you put into it,” he said. Dr. Dellavalle suggested that health care professionals pick up social media tips at Webcina, which has information about a variety of news sites, blogs, podcasts, and other platforms for communication.

Another method of educating the public is the low-tech medium of texting, said Joseph C. Kvedar, MD, director of the Center for Connected Health, part of Partners Healthcare, Brigham and Women’s Hospital, and Massachusetts General Hospital.

Several years ago, when fewer than 10 percent of people owned smartphones, the Center for Connected Health began sending texts to educate patients about what they should be doing during pregnancy. Eventually, the Center added texts with tips to stop smoking, while another texting program sent weather forecasts with reminders to use sunscreen.

That effort has since expanded to Twitter and other social media platforms.

“We see a lot of opportunity,” Dr. Kvedar said. “We are taking a cue from the advertising industry and teeing up content to change behavior. We think we can do the same sort of thing with health care delivery.”

Dr. Kvedar recommended practical steps, such as using the Academy’s popular Dermatology A to Z mobile app to improve practice and educate patients. Other steps to improving the use of digital information include having younger members of the office staff who use social media oversee a practice’s Facebook page with content approval from the physician, and asking a website designer to make the practice website use responsive design so it will look better on smartphones.

“The pros and cons for proactive patient engagement are that it enriches your practice for young, upscale patients and projects that you are a leader in the movement toward patient-centered care,” Dr. Kvedar said. “But, be thoughtful about privacy and the regulatory landscape. Set up office policies and procedures.”

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