The Doctor Will Tweet You Now

Physicians are often pigeonholed as technophobes because they fear that using technology might threaten patient privacy and their own incomes.  But, an increasing number of physicians are texting health messages to patients, tracking disease trends on Twitter, and communicating with patients via email.  Kansas City pediatrician Natasha Burgert is one of this new breed, offering child-rearing advice on her blog,  Facebook and Twitter pages, and answering patients’ questions by email and text messages.  According to Burgert, she sends messages between checkups and it’s easier than calling a lot of people back at the end of the day.

These tools are embedded in my work day,” Burgert said. “It’s much easier for me to shoot you an email and show you a blog post than it is to phone you back.  That’s what old-school physicians are going to be doing, spending an hour at the end of the day” returning patients’ phone calls, she said.  Burgert doesn’t charge for virtual communication, although some physicians do.  She believes that it augments but doesn’t replace office visits or other personal contact with patients.  Colleagues “look at me and kind of shake their heads when I tell them what I do. They don’t have an understanding of the tools,” Burgert said.  “For the next generation that’s coming behind me, I think this will be much more common.”

Sarah Hartley, whose daughters are Dr. Burgert’s patients, loves having e-access to her pediatrician and says that even emails late in the evening typically are responded to quickly.  “It’s so useful,” Hartley said.  “Sometimes parents get concerned about a lot of things that maybe aren’t necessarily big deals” and getting after-hours reassurance is comforting.

Writing for the Associated Press, Lindsey Tanner says that “So far, those numbers are small.  Many doctors still cling to pen and paper, and are most comfortable using e-technology to communicate with each other — not with patients.  But from the nation’s top public health agency, to medical clinics in the heartland, some physicians realize patients want more than a 15-minute office visit and callback at the end of the day.”

Dr. Steven Nissen, who is in his 60s, is experimenting with e-technology.  A cardiologist at the Cleveland Clinic, Nissen insists that he’s not a member of “the Twitterati.”  With technical assistance from clinic staffers, he recently led a live Twitter chat about things like heart failure and cholesterol problems, and found the process “in some ways maybe a little exhilarating.  This was an opportunity to use a different communication channel to find an audience to talk about heart health,” Nissen said.  “The downside is that we dumb it down,” he said.  “It’s very challenging for physicians, primarily because the messages that we have are not conducive to 140 characters.  If you ask me a question, you’re likely to get a five-minute answer.”

Some physicians are still technology averse.  Dr. Raoul Wolf, a pediatrics professor at the University of Chicago, doesn’t use social media sites in his personal or profession life and is concerned about the permanence of online communication.  “With anything on the Internet, it’s there forever. There’s no calling it back,” Wolf said.  “Ask any politician.”

A survey of 501 randomly selected doctors found that more than 20 percent sent emails to patients over secure networks.  Another six percent communicated with patients through other social media.

The American Medical Association recognizes the benefits of using social media, but also cautions doctors to protect patient privacy and “maintain appropriate boundaries” with patients.  In a case of technology use gone bad, a Rhode island state disciplinary board last year reprimanded an emergency medicine physician for “unprofessional conduct” and fined her $500 after she posted on Facebook about a patient’s injury.  Even though she didn’t post the patients names, others figured out the identity.  Hard numbers are scarce on exactly how many of the nation’s nearly one million physician communicate virtually with their patients, but anecdotal evidence suggests the numbers are on the rise.

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