Evolution of a revolution

The College of Physicians and Surgeons of Ontario (CPSO), the licensing body for the jurisdiction with the largest number of physicians in Canada, has just published social media guidelines for doctors.

The guidelines are succinct, reasonable and would not prompt most physicians to hide under their desks the first time reference to Twitter or Facebook is made.

The document, adopted by the College council in May, starts by noting:

“Many physicians are now using social media in their practices to interact with colleagues and patients, to seek out medical information online, and to share content with a broad audience.”

It goes on to state that if physicians comply with all existing professional expectations:  “social media platforms may present important opportunities to enhance patient care, medical education, professional competence, and collegiality, among other potential benefits.”

These kinds of statements show how far the Canadian medical profession and the regulatory authorities that govern them have come in their consideration of social media. The same is true of other countries such as the United Kingdom and the U.S.

When the Canadian Medical Association – which advocates for all physicians but does not regulate them – published their rules of engagement for social media 18 months ago, some were uneasy that the document talked about the potential benefits as well as the risks of social media (“While use of social media could potentially increase the exposure of physicians to disciplinary and medico-legal issues, those physicians who choose to use social media can help shape how these tools can improve health care in the future.”)

The CMA document came out at a time when regulatory authorities similar to the CPSO in Canada were either mute on the entire issue of social media or were cautionary in the extreme. One such body urged its members to stay away from Facebook entirely just because of the chasm of unprofessional behavior that might open before them should they be lured to the site.

The CPSO is not the only physician-related organization to have published social media guidance in recent months and most of these guidelines go over the same ground and at least acknowledge that some physicians are using social media and that some benefits may accrue to themselves and their patients as a result.

The content of the best guidelines are best encapsulated by this 12-word policy from Dr. Farris Timimi, Medical Director of the Mayo Clinic for Social Media: Don’t Lie, Don’t Pry, Don’t Cheat, Can’t Delete Don’t Steal, Don’t Reveal

Frankly, what many physicians interested in social media want now are practical tips on using the tools rather than high-level policy guidance. And that is what we should give them.

A patient or E patient?

Those of us who live on Twitter and work in that space called the patient engagement world are very familiar with Dr. Larry Chu.

A Stanford University anesthesiologist, Larry is better known to many as the executive director of Stanford Medicine X (@stanfordmed), not only a cutting-edge conference on the use of emerging technologies (including social media) in health care but also a conference that actually sets aside 10% of delegate places of patients. For e-patients worldwide it is clear that Larry gets it and lives the ideal of “nothing about us, without us.”

Inviting Larry to speak to Canada’s premier conference for physician leaders – the Canadian Conference on Physician Leadership – resulted in an interaction that was interesting to say the least.

Co-sponsored by the Canadian Medical Association (CMA) and the Canadian Society of Physician Executives (CSPE), the conference attracted an overflow crowd of about 430 Canadian doctors in leadership positions or who aspire to lead.

As the second keynote speaker on the morning plenary session, Larry had to follow a very dynamic presentation by  Linda Duxbury, a business professor who had the audience in stitches with her assessment of Baby Boomers, Gen X and Gen Y and what they want out of life.

Larry was facing an uphill battle from the start.

On questioning the audience he found only a handful of people admitted using Twitter on a regular basis (despite which, #ccpl13 has a thriving meeting stream). And what many in our perhaps insular social media/patient engagement world would find almost unthinkable was that only 5-10 delegates, in that standing-room only audience of Canada’s possibly most thoughtful physicians, had heard about e-patients.

So, the world of @AfternoonNapper, @HeartSisters and @mindthecompany et al is a complete mystery to most of these doctors who are making important decisions about the future of the health care system in Canada.

The responses did not faze, Larry who proceeded to give an eloquent and entertaining presentation on why patient engagement matters and why doctors and patients have to work together to better the system.

What the lack of knowledge about the e-patient community demonstrates to me is a caution to those of us communicating about patient engagement on an ongoing basis that not everybody has the same heightened level of awareness about these issue as we may do.

The delegates at CCPL are by no means ignorant or uncaring about patients – I know these physicians are hugely committed to the betterment of health care and the wellbeing of patients.

What is not on their radar is true patient engagement and bringing patients fully into the decision-making processes for the health care system. And what Larry did was clearly and articulately explain why this matters and how it can work in a new technological environment.

I am convinced, Larry’s trip to Canada was not in vain and I am convinced he has made a few important people ponder about things upon which they had not previously thought.