To be a doctor and to blog is great, but you can never be more careful

Imagine this. You wake up with a throat that feels worse than sandpaper. You follow the drill—you gargle a bit to soothe the matter, but it just won’t go away. Now, instead of picking up the phone and booking a checkup with the doctor, what do you do? You head to the Internet and Google your symptoms to see if anyone else has faced them, and what they’ve done to cure the malady. If you browse WebMD, Google or various online forums for answers before a doctor visit, you are not alone. Increasingly, the healthcare industry is noticing a trend that a lot of folks try “Dr Google” before reaching out to a real doctor. But just because you can, does not mean you should, right? How good is the social web to find good healthcare advise, and how should the medical profession react to this ever-increasing trend of—“let us just ask folks on the Internet”? As internet-adept patients, going to the web is a natural, convenient alternative—to first look for quick-and-easy options to address a less serious medical issue before committing money and time to a doctor’s visit. Another reason often cited by patients is to be better prepared for the actual doctor’s visit, armed with the wisdom of the crowds, so to speak. Being better prepared can only be good? Not if you ask the doctors. Most doctors speak of the challenges of dealing with patients who had retrieved wrong or incomplete information from the internet, thereby spending time undoing bad information which they could have spent on the patient’s real issue (or attending to other patients’ needs). The common strain was that unlike doctors who are trained to give appropriate weightage to symptoms, patients are not, and tend to fixate on extreme diagnoses. In addition, Dr Google fundamentally changes the doctor-patient equation, where a doctor has to defend his diagnosis and views against what people have read on the Internet or on their social networks—a shift that many experienced doctors find hard to adjust to. In addition, as with any reputation-based profession, doctors often fret about the ease with which disgruntled patients use the Internet to vent and tarnish reputations, so much so that ‘googling’ a doctor could first show up negative reviews if patients are vocal enough about their dissent. And then there’s the concern of over sharing, this time on the doctor’s end—an inexperienced doctor may use social media in a manner which could be unprofessional at best and downright damaging at worst— discussing details which may identify a patient, for example—which may place themselves and their institutions at risk. How then should doctors harness the every day realities of the increasing importance of the social web, and not appear outdated by rejecting it outright? Remember, the institution of medicine is built on principles of following rules, while social media is not. Here are some common wisdoms that doctors should bear in mind. First, never ever post anything that can identify a patient. It’s not enough to merely change the details of the case, sometimes timing can be critical as well. Avoid terms that identify when the patient came in, more so if it is recent. Second, always assume the patient will end up reading your posts, be it on Facebook or on a medical forum. Don’t say anything about the patient that you wouldn’t say to them in person. Even if there’s been a disagreement in opinion or some degree of discord with the patient, do not post when you’re in an angry or perturbed state—remember the permanent nature of social media. Third, be extremely careful if patients send you friend requests on Facebook or other social networks. It’s not as if patients can’t be friends, but it may serve you better in the long run to create an official “Dr X” Facebook page and a separate identity for your personal relationships. Steer your patients towards the professional page rather than connecting directly with your non-work persona. Depending on your institution policy, you may want to avoid medical advice over SMS or emails, instead encouraging the patient to schedule an appointment (or go to the emergency ward, whichever is more time appropriate). Fourth, if you post on a hospital blog or your own blog, assume that patients will read what you post and abide by it. Even though they are not necessarily as peer-reviewed as medical journals, blog posts should never fall short in terms of accuracy. Lastly, educate yourself and do not fear social media—it is an amazing tool that can bring hospitals, doctors and patients closer together for the greater good of patient education and healing. Do peruse the following resources for some much-recommended reading on social media and healthcare.