Doctor-Patient Relationships in the Modern Era
[Can We Talk – A Collaborative Shift in Bedside Manner?]
By Mario Moussa
By Jennifer Tomasik
The single biggest problem in communication is the illusion that it has taken place – George Bernard Shaw
Star Trek fans have seen the future of medicine.
Leonard McCoy, also known as “Bones,” describes himself as a “simple country doctor,” although he plies his trade using 23rd-century medical technology. A deeply caring humanist, Bones often spars with the hyper-logical Spock—half human, half Vulcan. But as the Star Trek saga unfolds through The Next Generation, Deep Space Nine, and finally Voyager, Star Fleet physicians become increasingly rational and less recognizably human. The Voyager’s “Doctor” is no person at all. “He” is an infallible computer program designed to mimic compassion, self-assurance, and other soulful qualities.
Introduction
Today, when patients communicate through instant messaging, Twitter, Facebook, and other Web 2.0 electronic mediums, they might feel that health providers are already more like the virtual “Doctor” than the all-too-human “Bones.”
Before long, according to one technology expert, 20% – 50% of all doctor-patient communication will be virtual. But we suggest you pause before rocketing ahead into this brave new future that advocates call Health 2.0—the application of social media tools to the health care environment.
Electronic technology in all of its forms has obviously had a profound impact on medicine. We focus here on just one of its most notable effects: the changing doctor-patient relationship. We believe Health 2.0 has the potential to deepen this relationship—or not. It depends on how you use it.
There are an almost overwhelming number of social media tools for managing the doctor-patient relationship. How do you choose the right ones? We offer some guidance in this essay by focusing on three issues:
- What matters most in the doctor-patient relationship?
- What counts as a good relationship?
- How should you use social media tools to build a relationship?
We have found that there is no one best way to use Health 2.0 technology. But there is just one rule. As the novelist E.M. Forster said, “Only connect.”
More here: BOOK ORDERS [Pre-Release]: http://www.springerpub.com/shoppingcart
Dictionary of Health Information Technology and Security: http://www.springerpub.com/prod.aspx?prod_id=49952
Business of Medical Practice 
More e-Links on:
Do Some Physician Bloggers Reveal too Much: http://medicaleconomics.modernmedicine.com/memag/Modern+Medicine+Now/Do-some-physician-bloggers-reveal-too-much/ArticleStandard/Article/detail/590412?contextCategoryId=44475
Doctors and Difficult Patients: http://www.kevinmd.com/blog/2009/03/doctors-dealing-with-difficult-patients.html
Twittering Doctors and Surgeons: http://www.kevinmd.com/blog/2010/01/twitter-advice-doctors.html
Twittering Doctors
Phil Baumann RN wrote an article titled 140 Health Care Uses for Twitter.
The list is also available as an ebook:
http://philbaumann.com/2009/01/16/140-health-care-uses-for-twitter
Barbara
On the Clinician-Consumer Health Advisory Information Network
http://www.ChainOnLine.org
This educational website offers expert perspectives, advice and guidance on drugs, biological products and medical devices. It is a destination site from the Agency for Healthcare Research and Quality’s Centers for Education and Research on Therapeutics.
CERT’s is a federally sponsored network of more than a dozen leading research centers nationwide that seeks to connect clinicians and patients with therapeutics information assisting medical practices and health care decision makers in areas where evidence is undergoing significantly rapid change.
Editors
“Karen represents a new type of patient we’re now beginning to see. She has a sharp intelligence and a great intrinsic curiosity. She knows how to use the internet. And she appreciates both the patients’ and the clinicians’ points of view.”
Patient-helpers like Karen don’t compete with what doctors do at all, Perez-Soler says.
“On the contrary, they can be wonderful allies for doctors. She finds the best, high quality online materials for lung cancer, classifies them by topic, and makes them easy for other lung cancer patients to find. It’s a wonderful complement to what we do at our clinic.”
Clinicians must keep up to date on a wide variety of medical conditions while seeing dozens of patients a day. Patient-helpers like Karen will typically know only about their one disease, but since they can devote a great deal of time to it, their knowledge within that single narrow niche can be impressive.
Quite current, yes? No: this was Tom Ferguson, MD, founder of e-patients.net, writing in the British Medical Journal. Ferguson died in 2006 – and this article was published in November 2000. Nine years later, patients are still the invisible stakeholder, costs have risen another 97%, and quality is no better.
http://www.thehealthcareblog.com/the_health_care_blog/2010/01/why-america-needs-a-patientinchief.html#comments
Adam
Pity you/your publisher chose not to offer the kinlnidg to Africa (and others). Often this is oversight or misunderstanding. Hope you’re not just mean Anyway it reached 11 in the free charts (that I noticed) well done
YUn5Y3 mlzujomnlbci
Nephrologists Using Social Media Connect with Far-Flung Colleagues, Health Care Consumers
http://mobile.journals.lww.com/nephrologytimes/_layouts/oaks.journals.mobile/articleviewer.aspx?year=2010&issue=01000&article=00001
So this is news? The general patient population has been doing it for more than a decade. Get with it, docs!
It’s 2010; not 1999.
Barbara
On Patient Driven Referral Sites [PDRSs]
http://www.DR-Oogle.com
It is clear to some practitioners that Internet-based consumerism is the future of medicine; as well as dentistry, podiatry and osteopathy, etc. Regardless of the increasing number of complaints about managed care’s malevolent business model, managed care medical and dental plans are already wilting under the heat of transparency as well as the stifling economy. Market share continues to fall because of Adam Smith-like competition. These days, consumers are talking like a small town. Dentistry is no exception in the healthcare space.
Enter Doctor Oogle
Doctor Oogle is a health 2.0 platform, built on a social architecture of national participation where patients post comments and opine about participating providers; nice or nasty. It also offers a public database of dentists with patient feedback about dental practitioners. One can also read reviews, ratings, and recommendations; select a practitioner or schedule an appointment.
Ad-Driven Contrast of PDRSs
In contrast to WebMD, Servicegrades.com or other Patient-Driven Referral Sites (PDRSs), which sell dentists ad space, DR. Oogle is completely uninfluenced by paid advertisements because there are none. Participating dentists pay a flat monthly fee.
Defining Dental Quality
If one agrees that in dentistry [perhaps more than whole-body medicine] patient satisfaction is an important measurement of quality care, DR. Oogle is a natural measuring tool just begging to be used by patients holding preferred provider lists. In addition, DR. Oogle has the largest database of patient ratings of any other PDRSs.
Darrell K. Pruitt; DDS
“Speed Dating” for New Patients
Ob-gyn Emily Emmet, MD, was sitting at a table in a room at Texas Health Harris Methodist Hospital Hurst-Euless-Bedford when a teenager sat down to talk. The young woman wondered: Could Dr. Emmet be the right physician to perform her first pelvic exam? After five minutes, the conversation ended.
http://www.ama-assn.org/amednews/2010/02/08/bil20208.htm
Ann Miller; RN, MHA
Avoiding or Using Virtual Patient Relationships
The newest online annoyance with patients, potential patients or others is the ‘elationship’. Beware – these suitors aren’t interested in a real-life hookup, just the virtual kind.
Here are 15 micro-blog sites similar to Twitter: http://visionwidget.com/inspiration/web/349-microblogging-tools.html
Source: http://www.msnbc.msn.com/id/35338085/ns/technology_and_science-love_in_the_digital_age/?GT1=43001
What if a Patient “Friends” Me?
More specifically, should a doctor ever “friend” a patient on Facebook, or a similar social site? Some physician’s use them to diagnosis and treat, while others do not. Some use them for housekeeping tasks, such as prescription refills, scheduling and for answering general health questions.
Think: http://www.imvu.com, http://www.Xanga.com, http://www.opendiary.com, http://www.bebo.com and http://www.MySpace.com
Hope Hetico; RN, MHA
e-Patient Dave
The age of participatory medicine was likely formalized in October 2009 with an: e-Patients Connections Conference, in Philadelphia, PA.
It was launched by cancer patient Jeff Jarvis, an every man/women, just like us. Read his fascinating story, with video, here:
Link: http://e-patients.net/
Carol
“Power to the Patient”
Some doctors and hospitals really are giving their patients the tools to actively share in making decisions about their medical care. For example, the staff physicians of Group Health Cooperative, a Seattle-based multispecialty group practice and health plan, pride themselves on practicing evidence-based medicine.
That’s why they were shocked when they found up to twofold differences among themselves in the use of 12 elective surgical procedures such as hysterectomy and knee replacement
http://www.hhnmag.com/hhnmag_app/jsp/articledisplay.jsp?dcrpath=HHNMAG/Article/data/02FEB2010/1002HHN_FEA_power&domain=HHNMAG
Patient’s must self-advocate, today!
Kent
Twitter?
Will it become an essential tool for medical practice?
http://casesblog.blogspot.com/2010/03/will-twitter-soon-be-essential-tool-for.html?utm_source=feedburner&utm_medium=twitter&utm_campaign=Feed%3A+CasesBlog+%28Clinical+Cases+and+Images%3A+CasesBlog%29
What do you think?
Paul
An essay on the worst time to go to the hospital?
http://www.nytimes.com/2010/03/18/health/18chen.html?ref=health
For both doctors and patients.
Kathy
More on Patients, Doctors and the Internet
http://content.nejm.org/cgi/content/full/362/12/1063
From the NEJM
Jake
“A Free Diabetes App for the e-Patient”
http://ping.fm/yl8T4
Bant
“Medicine operates like a private club of self-styled deities where the entrance requirement is an MD.”
Peter Pronovost MD in a Wall Street Journal article on physician resistance to checklists and Health 2.0 collaboration.
Rex
This New Study Finds Twitter Is Used to Spread Misinformation about Antibiotics and Other Medical Topics
http://www.hcplive.com/primary-care/articles/twitter_medical_misinformation?utm_source=Listrak&utm_medium=Email&utm_term=http%3a%2f%2fwww.hcplive.com%2fprimary-care%2farticles%2ftwitter_medical_misinformation&utm_content=MarcinkoAdvisors%40msn.com&utm_campaign=Primary+Care+eDigest%3a+Study+Finds+Twitter+Is+Used+to+Spread+Medical+Misinformation
Gregory
Top 50 Health 2.0 Heroes on Twitter
http://govfresh.com/2009/07/50-must-follow-health20-heroes-on-twitter/
Hope Hetico; RN, MHA
[Managing Editor]
Physician Ratings and Social Networks
Patients today, are able to find financial, divorce, DUI, criminal, civil and/or malpractice information – on their MDs – in some cases; and for dentists it’s https://www.dr-oogle.com.
And, they are not restricted to individual practitioners. Entire medical institutions may be negatively implicated, as in the matter of patient Pam – and her husband Don – concerning John Hopkins Hospital in Baltimore Maryland.
http://healthcarefinancials.wordpress.com/2010/01/10/a-story-all-doctors-and-patients-should-re-read/
Therefore, some large practices and hospitals have entire teams that monitor the social media spectrum for their mentions, using services like Meltwater, Radian6 and Google for 24/7 alerts.
Kemper
Advancing the role and prevalence of patient and family engagement in the healthcare 2.0 era
The Institute for Interactive Patient Care (IIPC) is a healthcare organization dedicated to empowering patients and improving health outcomes through direct patient engagement. Their mission is to foster widespread adoption of patient and family/caregiver engagement strategies, which are proven to optimize patient care outcomes.
IIPC is a not for profit 501(3)(c) organization.
Link: http://www.instituteipc.org/research/
Ann Miller RN, MHA
Healthcare Uses of Social Media
Created by: Phil Baumann RN
Jane
More on doctor-patient communication
Good post and comments; all.
There are also other innovative practice communication models like DocTalker Family Medicine and TelaDoc, where the telephone and email is an integral part of the medical practice business model.
Dr. David Edward Marcinko MBA
[Editor-in-Chief]
Crumbling Relationships
Despite ongoing health care reform efforts, one thing does not appear to be changing: the physician-patient relationship. The unique relationship that physicians originally shared with their patients was severed when third-party entities took control of the transactions between parties.
http://www.hhnmag.com/hhnmag_app/jsp/articledisplay.jsp?dcrpath=HHNMAG/Article/data/06JUN2010/062810HHN_Weekly_Jackson&domain=HHNMAG
Today, we are attempting to “reform” a fragmented health care system that isn’t designed to reward healthy lifestyles and high-quality, low-cost medical care.
Pam
Positive changes seen in physician-patient relationship
While we often comment on work that needs to be done to improve physician-patient communication and the numerous strains on this relationship, recent changes in the way doctors and patients interact have overall been positive, according to Dr. Alan Christensen of the University of Iowa, who studies patient-provider interactions and health services.
http://www.fiercepracticemanagement.com/story/positive-changes-seen-physician-patient-relationship/2011-03-02?utm_medium=nl&utm_source=internal
Ann Miller RN MHA