Some doctors join Facebook, Twitter; others wary
By Rita Rubin, USA TODAY
Go into any obstetrician/gynecologist's office and you're likely to see a large bulletin board covered with snapshots of babies.
But the docs at one Irving, Texas, OB-GYN practice have taken that ubiquitous display of cute kids into the 21st century. Their patients can post photos on the MacArthur OB/GYNFacebook page, where the doctors post news about their practice and the medical world at large. It has more than 600 fans.
Jeff Livingston, who spearheaded the practice's venture into social media, also manages the @ macobgynTwitter account, which has about 1,600 followers. He sees Facebook as an educational and, perhaps just as important, marketing tool. “People are looking for information online,” Livingston says. “I wanted them to look at our page.”
But few doctors have embraced social media as enthusiastically as he has. Concerns about time and patient privacy have deterred many.
“No matter how you parse it, doctors don't avoid the Internet and social media because they're simply Luddites,” Westby Fisher, an Evanston, Ill., cardiac electrophysiologist, wrote last month on his blog, Dr. Wes. “They avoid the Internet because they enjoy the benefits of anonymity, privacy, efficiency and legal protection that come with dropping off the grid.”
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Closely keeping tabs on posts
Those really haven't been issues for Livingston. In the two years since he launched the practice's Facebook page, he has had to take down content others had posted only three times.
“What I'm watching for is that no private personal health information gets relayed via social media,” says Livingston, who keeps close tabs on the page with his iPhone and iPad.
Recently, Livingston wondered whether one new patient's posted question — could her fetus acquire an infection if she swam in a public pool? — was too personal.
But then he remembered that many women ask that same question every summer, so he decided that posting an answer — “It is perfectly OK” — on Facebook would serve all his pregnant patients, not just the one who posted the query.
And, Livingston says, “the time is really not an issue. Just make it a part of your normal day.” When he comes across an interesting medical story, he posts it on Facebook and tweets it on Twitter. Still, he acknowledges, “just like breakfast, lunch and dinner can all get skipped during a busy workday,” so can posts and tweets.
As Nashua, N.H., internist Kevin Pho wrote in a USA TODAY op-ed piece in January, “there is little guidance on how physicians can incorporate (social media) into their medical practice.”
Acknowledging that problem, the American Medical Association's Council on Ethical and Judicial Affairs last month passed a resolution to “study the issue of physicians' use of social networking, as exemplified on sites such as Facebook and Twitter” and report to the AMA's House of Delegates at its meeting in November.
Another roadblock, Pho said, is that doctors usually get paid only for talking to patients in the examining room, giving physicians little financial incentive to reach out to them over the Web.
But, continued Pho, whose Twitter and Linked-In profiles refer to him as social media's leading physician voice, “doctors who are not active online risk being marginalized.”
Pho says his KevinMD blog gets 250,000 page views a month, and he has more than 22,000 followers of @ kevinmd on Twitter. “You need to have a diverse array of ways to reach patients,” he said in an interview. “Patients are on Facebook. Patients are on Twitter. Patients are on blogs.”
Livingston's patient Kristi Francisco says his presence on Facebook and Twitter sealed her decision to pick him as her doctor when she moved from Tampa to Grapevine, Texas, less than a month before her daughter, now 15 months old, was born. “I like the fact that he is so plugged in to the way everybody communicates,” says Francisco, a brand manager for Saber Holdings.
Pho says that although “I don't use my blog to market my practice, it does have a positive impact in terms of recruiting new patients. They know that I'm Web-savvy.”
Not everyone is all a-Twitter
In a comment on Pho's blog, Michael Laccheo, a rheumatology fellow at the University of Iowa, challenged the notion that doctors who aren't tweeting and friending and blogging away are in danger of becoming irrelevant.
Some “amazing” doctors don't even know how to type, Laccheo said in an interview. While he calls what doctors do with social media more pontification than communication, “I think having an online presence is a good idea” for tasks such as scheduling appointments.
Laccheo, who does blog, albeit infrequently, gives his cellphone number and e-mail address to his patients and posts them on his website. “They know they can get hold of me when they need me.”
When you talk to Livingston about his involvement in social media, he can sound more like a marketing expert than a doctor. SEO, short for search engine optimization, rolls off his tongue as easily as IUD, or intrauterine device, a birth control method.
And yet, he says, his role model is more Marcus Welby than Sanjay Gupta.
“If you go back two generations, doctors came to your house. They lived in your community. They probably went to the same church.”
With social media, he says, “what we're really doing is going back and creating a more personal experience with technology.”