A doc, a Tweet, an Island

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Emergency physicians can be an ornery bunch, often opinionated and not afraid to speak out on a wide variety of issues. As emergency room (ER) overcrowding in Canada is seen as an early-warning signal for more wide-ranging problems within the health care system, having ER doctors who are willing to be vocal about their concerns is not necessarily a bad thing. (It’s worth noting that arguably the most high-profile media physician in Canada – Dr. Brian Goldman @NightShiftMD, host of the Canadian Broadcasting Corporation’s White Coat Black Art is an ER doc).

Combining an ER physician with Twitter, as you can imagine, can be a potent mixture.

Nowhere has this been more dramatically demonstrated than last week in Prince Edward Island, a province of only 140,000 individuals and about 235 physicians

Dr. Trevor Jain (@Jainbrae), is an ER physician at the Queen Elizabeth Hospital in Charlottetown, the province’s largest acute care facility. On August 27, he posted a series of tweets expressing concerns about staffing levels in the hospital’s ER noting that one physician had quit and another was considering leaving over safety concerns. Now, Dr. Jain is not highly active on the Twitter and at the time of these tweets he had about 250 followers and had fewer than 450 tweets to his credit.

However, the tweets came to the attention of the regional CBC news bureau which wrote a story based solely on their contents, as Dr. Jain declined to be interviewed. In the story, the hospital’s medical director admitted the staffing situation in the ER had caused “considerable consternation” but was only temporary. The story in almost identical form was picked up by the other major network in the province as well as the province’s only daily newspaper.

Dr. Jain has told us he has been criticized for using Twitter to express his concerns but he is unrepentant. Certainly, I am sure many in the hospital bureaucracy would have preferred him to have gone through the proper channels to express his views. Without knowing the specifics of the hospital policies or bylaws on this topic it is hard to say whether Dr. Jain was actually doing something that was formally forbidden. Given that many hospitals in Canada continue to lack social media policies, it may be that guidance or rules in this area were lacking.

While Dr. Jain may be on the receiving end of criticism for the approach he took, it is undeniable that it was effective. Numerous messages of support have appeared in his Twitter feed and the CBC news story was retweeted by many, including possibly the globe’s most active social media physician advocate Dr. Berci Meskó, who at last count had 33,678 followers.

This situation serves as a case study to how – without ever communicating with established media – a physician can bring attention to a local health care issue he feels is of concern. Given the growing concern in Canada about undue restrictions placed on the right of physicians to speak out about such issues by local authorities, here again, surely we have a demonstration that social media is changing the playing field.

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