This article is more than 5 years old. Information may no longer be current.
Social media offers orthopedic surgeons a novel collaborative opportunity
Click Here to Manage Email Alerts
As the influence of social media and networking continues to develop, physicians have found themselves in an interesting spot. Many of the tools provided by social media and networking are invaluable for collaboration and sharing of ideas, but the nature of the Internet and social media makes it difficult for physicians to know exactly what they can or should share. The solution, for many, has been to avoid it.
In response to the need for a safe social media and networking domain under which physicians can collaborate freely, numerous websites have been created. These websites include Sermo, Medscape Physician Connect, iMedexchange, and Ozmosis. Just one has been geared specifically toward orthopedic surgeons.
Jon Hyman, MD, is one of the creators of OrthoMind, a professional networking and collaboration site designed by and for orthopedic surgeons. Currently, Hyman said, the community is approaching 5,000 surgeons from the United States and abroad and has produced more than 6,000 comments, videos and dialogue around topics such as clinical scenarios, surgical implants, health care reform, politics, research and professional conduct.
OrthoMind offers the advantage of exclusivity, Hyman said, as it does not allow industry representatives, paraprofessionals, nurses, medical students or physicians from other specialties.
“Things like industry sponsorship and being open to non-physicians has led some sites to have limited adoption in the orthopedic space,” he said, adding that the creation of OrthoMind by orthopedic surgeons from premier institutions helps to foster a “safe and comfortable” environment.
|
Image: Chris Hamilton / Atlanta |
Staying informed
With patients frequently walking into physicians’ offices armed with printouts from a variety of websites, it is important for physicians to be updated on new information – and disinformation. The online platforms are one way to more efficiently manage this.
Bryan Vartabedian, MD, runs a blog called 33charts.com. He said he has seen the role of both patient and physician change significantly in the wake of social media’s rise.
“The biggest thing that social media has done is to empower patients,” he said. “For the better part of modern civilization, health information has been under tight control of physicians. With the open access, patients now have unlimited access to information, which puts them in a unique position. The role of the physician is being completely redefined in the face of social media.”
Physicians now have more options for social media and professional networking, Hyman said. Before working with the available platforms, however, they should first understand the inherent benefits, dangers and differences between popular standard social media sites and more specialized physician-centered efforts.
Not another Facebook
Although the first thing that comes to mind when many think of online social networking are sites such as Facebook and Twitter, physicians like Riley J. Williams III, MD, are quick to note there is a stark difference between more public, open-access sites and private sites like OrthoMind.
|
“OrthoMind is not a social networking site,” Williams said. “It is designed to focus surgeons on commenting, posting and participating in a medically-oriented forum that serves the individual doctor’s interests. Thus, when doctors sign into OrthoMind, they are typically trying to find out how their peers are handling a difficult clinical problem or to get some insight into issues that directly affect them as doctors.”
The distinction is important to make, Hyman said, because OrthoMind does have many of the tools that made websites like Facebook popular.
“Physicians have to distinguish a social media site like Twitter or Facebook from a site, for example, like OrthoMind, which has much of the same functionality … but an entirely different purpose,” he said.
He explained that for physicians, public sites are used more as educational and marketing tools rather than professional networking platforms. These platforms being more public and commercially-driven have caused hesitation among the medical community. Such issues are, Hyman said, lessened or eliminated with a private platform like OrthoMind.
Unlike other social media or networking websites wherein socializing is the primary goal, Hyman described OrthoMind’s atmosphere as “akin to a national O.R. lounge round table discussion” of issues pertaining to orthopedic practice.
“Orthopedic surgeons — like other professionals — should understand the difference between social media vs. professional media forums that are targeted at very precise groups,” said B. Sonny Bal, MD, JD, MBA. “OrthoMind is in the latter category. The site is unique in that it is only open to orthopedic surgeons, who must register to use the site and can share thoughts and perspectives using a log-in identity.”
Once confirmed, surgeons can use their real name or an anonymous screenname of their choice.
“For physicians desiring professional interactions with peers for whatever reason, this is the ideal forum,” Bal said. “There is no marketing agenda, no massaging of the message, no interference from non-orthopedic surgeons and no segregation of the user community based on education, background or nature of practice.”
Williams said, “In short, Twitter and Facebook facilitate social interaction; OrthoMind encourages the exchange of information on a professional basis.”
Professional collaboration
Shortening the feedback cycle is one way social networking websites can help save physicians time. Posting a clinical question can result in a large-scale second opinion in a short period of time. Learning curves can be shortened through shared experiences and ideas, and peers can be polled. For example, physicians on OrthoMind can use the tools available through the platform to scour literature based upon relevant interests. Though it is no substitute for reading the full article, Hyman said the functionality saves time and may drive adoption.
“These features save time, money and headaches for physicians and for patients,” he said.
|
Ineffective or even dangerous devices and techniques also can be weeded out more quickly with the shorter cycle of feedback. Thought regarding a perplexing case no longer has to be contained to the physician’s office; in a matter of minutes the issue could be shared with physicians from around the world and collaboration could reach a satisfactory answer.
Another advantage includes the “consolidation of information,” Hyman said, which involves “aggregating knowledge into easily accessible or searchable databases” in the effort to make learning and collaboration more efficient. Further advantages include networking, job listings, more functional CME and research studies.
According to Williams, websites like OrthoMind are critical in the continuing effort to make sure information is being spread as quickly and efficiently as possible throughout the medical community.
“Sharing information in medicine has been traditionally very difficult to do,” he said. “Prior to OrthoMind, individual surgeons would learn about difficult cases by calling colleagues or attending meetings. OrthoMind increases the flow of information exponentially, which serves our knowledge base and improves patient care.”
Democratization of information
Bal said the “democratization” of information is one of the major features of OrthoMind, as it ensures each perspective receives equal time — “devoid of the conflicts, politics and pecking order considerations that can permeate other professional forums.” Surgeons on the website can expect equal treatment and maintenance of privacy, he noted, adding it is a “jarring and relatively novel” concept.
Hyman said there is not as marked a generational gap in the OrthoMind user base. Most users are in the middle of their career, with a slight preponderance of younger doctors outside of the main cohort and a third category of older physicians.
“It is not exclusively the younger generation, which is what we thought it might be when it started,” Hyman said.
Hyman said many of the doctors are in solo practices or in communities where they do not have many peers to collaborate with or a department of orthopedics down the hall, so there is a significant presence of other physicians using the website to collaborate and expand their peer networks.
“They can collaborate with peers they might not have had access to, whether they be subject matter experts, thought and opinion leaders, or just other orthopedic surgeons out there in their own practice,” he said.
The extensive exchange of information across groups of professionals otherwise separated by massive gaps in geography or experience allows for physicians to get the most out of their individual experience at a streamlined, professional networking site.
“A site like OrthoMind can facilitate information exchange primarily by placing information and its exchange squarely in the hands of the individual user,” Bal said. “From open-access online journals to specialty groups, the ability of forums such as OrthoMind to attract targeted groups, provide a forum for exchange of ideas and support that forum with content and information relevant to that group, is the premium means of facilitating exchange of information, in this instance, between orthopedic surgeons.”
Importance of privacy
It is important to understand the inherent potential of these sites, but equally important to understand the dangers in trusting a site that is not as private as one may think. Bal said there is a significant distinction between a private professional social networking site and the much more public and easily accessible realms of Facebook, MySpace and Twitter.
“My conservative suggestion would be to limit exposure to public media and social networking sites when a physician is doing it as a professional, in a professional capacity,” Bal said. “The general rule is that people should recognize once you are on social networks, nothing is private and everything is permanent.”
“If someone is [using social networking] to say hello to their daughter or blog around, that is fine,” he added. “The difficulty — and I have personally encountered this — is with social media such as Facebook, you are going to get a lot of patients who want to be your friend. That raises issues concerning privacy.”
The risk, Bal said, is accidentally setting up a doctor-patient relationship. Other risks include security, as some social networking sites have had major privacy leaks. The nature of social networking, however, means that users may not necessarily have a reasonable expectation of privacy.
The Health Insurance Portability and Accountability Act (HIPAA) of 1996 makes the confidentiality of patient information paramount. As such, it is important to avoid releasing patient information in an effort to gain alternative opinions that could help the case.
“HIPAA compliance has been raised by curious physicians as an issue, but as long as the doctors are not transmitting unique patient-identifying information, legal counsel has indicated that physicians collaborating online is HIPAA compliant,” Hyman said.
“OrthoMind has taken several steps to ensure compliance and other physician-only sites have done so as well,” he added. “I am not aware of any reported violations,” Hyman said.
Although the focus of websites like OrthoMind is the individual physician and their sharing of information with the medical community, the goal is providing better care for the patient. Williams said the potential benefit to the patient carries more weight than the potential disadvantages in using these sites.
“I don’t see any major disadvantages to using sites like OrthoMind,” he said. “Of course, HIPAA rules and patient confidentiality must be maintained. However, I think potential disadvantages such as these are far outweighed by the potential benefits to patients.”
According to Vartabedian, it is up to the individual physician to determine whether the potential advantages gained from sharing HIPAA compliant patient information outweigh the potential dangers of accidentally letting slip patient details that are not HIPAA-compliant. The social media experience may simply not be for everyone.
“I frequently encourage doctors to make a decision about where they want to live in the social media world,” Vartabedian said. “For me, I live on my blog, which is the hub of my social media existence. Twitter and Facebook are outposts for what I do on my blog.”
Hyman said there are obvious dangers to discussing any patient information or dispensing advice to patients on public social media sites.
“Physicians using social media tools to interact with patients carry some risk of misinterpretation of information and the distortion of medical advice,” he said. “Due to concerns about patient-doctor relationships, privacy and professional reputation, the AMA, AAOS and other professional organizations have issued precautionary advice in this regard. There continues to be no substitution for in-person patient-physician interaction.”
Helping educate physicians further
Hyman said one major step in furthering adoption is reaching out to physicians who do want to partake in professional social media networks, but are reluctant to do so because of HIPAA compliance or other concerns.
“There is a lot of trepidation and anxiety about being involved in this space,” he said. “There is an apprehension in general, and it is not just limited to any specific age group or demographic — mainly because people are concerned about security, privacy and legal liability.”
OrthoMind and other networking sites dedicated to the medical field are “run in a very HIPAA-compliant manner,” Hyman said. “Patient-identifying information like names and identity numbers are not on the media uploaded or discussed on the site.”
The creators of OrthoMind have received legal opinion about potential liability issues, and such discussion can be found on the site prior to activating an account.
Additionally, the AMA released a policy concerning professionalism and the use of social media in November 2010. The guidelines include confidentiality standards, privacy setting use and the maintenance of patient-physician relationships. The guidelines suggest that physicians bring colleague’s unprofessional content to his or her attention, and should the colleague fail to take appropriate action, the AMA suggested the physician should then report the colleague to appropriate authorities. Any improper action undertaken online, the policy stressed, could permanently impact a medical career.
Future
Although there is still some way to go in terms of acclimating the medical field at large to the potential advantages and dangers of social media for public and private use, Hyman believes it is only a matter of time before the technology catches hold and large-scale adoption occurs.
Williams said he has noticed the tide starting to shift toward physicians making more use of websites like OrthoMind.
“As much of our practice moves toward digital technology, it is only natural that we turn to the Internet to exchange information as a specialty,” he said. “All one needs is a bit of time and a computer, and our entire community of colleagues and their collective experience is open to probe using OrthoMind.”
“In essence, there is very little downside and huge upside as we harness this collective experience in the application of care given to our patients,” he added.
According to Bal, it will be OrthoMind’s ability to set itself apart from other professional networking websites that will carry it far in the effort to facilitate the sharing of information across the orthopedic community.
“Moving forward, the key challenge in the crowded world of information exchange will be to create distinguishing customer value and keep building on that value,” he said. “In this regard, OrthoMind is off to a very good start.”
Younger generations will aid this transition, Hyman said.
“Younger physicians are generally more familiar with the use of these tools and their benefits,” he said. “As a group, orthopedists are exceptionally bright and talented. We think social media adoption will be reasonably paced at all age levels in our profession as well.”
Hyman hopes to see the collaboration on OrthoMind take place in a more dynamic way, with mobile devices facilitating communication on what is known as the “cloud” — an infrastructure where data processing, transmission and storage is happening outside of the mobile device — and thus, enabling surgeons in countries without access to smartphones to access information and participate in discussion without needing the same infrastructure.
“It is an exciting time to engage with our peers and use these tools to help us collaborate and enhance our lives and our patients’ lives,” Hyman said. “Social media tools are not like scalpels or drills. The more we use social networking tools, the sharper and more powerful they become. Since none of us is as smart as all of us. It will not be long before these collaborative applications are integrated into the daily practice of orthopedic surgery. It is happening now.” — by Robert Press
References:
- www.33charts.com
- www.ama-assn.org/ama/pub/meeting/professionalism-social-media.shtml. Accessed April 20, 2011.
- www.orthomind.com
- B. Sonny Bal, MD, JD, MBA, can be reached at Missouri Orthopaedic Institute, 1100 Virginia Ave., Columbia, MO 65212; 573-882-6762; email: BalB@health.missouri.edu.
- Jon Hyman, MD, can be reached at 3903 South Cobb Drive, Suite 220, Smyrna, GA 30080; 770-363-8770; email: admin@orthomind.com.
- Bryan Vartabedian, MD, can be reached at Texas Children’s Hospital, 17198 St. Luke’s Way, Ste. 300, The Woodlands, TX 77384; 936-321-0808; email: fox42@mac.com.
- Riley J. Williams III, MD, can be reached at Hospital for Special Surgery, 535 E. 70th Street, New York, NY 10021; 212-606-1855; email: williamsr@hss.edu.
- Disclosures: Bal, Hyman, Vartabedian and Williams have no relevant financial disclosures.
Do you think the benefits of online professional networking outweigh the risks? Why should physicians get involved and how should they proceed?
Online professional networks amplify your ability to connect with peers
|
|
Professional networking is not a new thing. Physicians have always relied on a professional network of close friends and colleagues to turn to when they felt the need for advice, technical assistance or just plain old moral support for a case gone bad. But that professional network was limited by the friendships one made with colleagues during training, partners in practice and, if one were lucky enough to travel to a number of professional conferences, strangers that one happened to connect with at those conferences. The Internet changed all that. The technology enables one to “meet” new colleagues without restriction to time zone or geography. During the past 2 decades, Internet technology has blossomed from the excitement of exchanging simple text in an email to the point where videoconferencing on your iPhone is no big deal. For some, this is liberating. For some, it represents a scary prospect.
Online professional networking is fundamentally no different from any other networking – one still needs to have a clear understanding of who is involved in the discussion, and be prudent and thoughtful about what one “publishes.” The “Facebook faux pas” is a common horror story these days and has convinced many orthopedists that the risks outweigh the benefits of participating in the Internet conversation. I think that is a mistake.
The online professional networks that are evolving to serve orthopedists can dramatically amplify your ability to connect with peers and access human resources that dwarf that “friends and family” network of yesterday. The relative ease of capturing and sharing multimedia clinical data, such as digital images and video, has made it nearly effortless to communicate using a rich palette of information to support any online discussion. We all have the ability to be both producers and consumers of this information. The key enabler in this scenario is the protected virtual space that allows one to “discover” new colleagues and mediate the discussion in a secure environment. That’s what a service like OrthoMind provides.
But just like networking in the real world, online professional networking requires some effort. Without a critical mass of participants, the professional networking sites resemble a poorly attended cocktail reception. They are not exciting, stimulating or useful.
Randale C. Sechrest, MD, is the Medical
Director at Montana Spine and Pain Center, in Hamilton, Mont.
Disclosure: He is chief executive officer of Medical Multimedia
Group, LLC.
Establish a firm, well-executed digital footprint
|
|
Human beings are innately social. Health care is social. The 500 plus million people on Facebook – 75% of whom utilize the platform each day – cannot be wrong. On April 20, 2011, the President of the of the United States gave a speech at the Facebook [headquarters]. Email as a form of communication is losing ground to personal and enterprise-based social media platforms – and the younger generation clearly prefers short message service as their communications standard. The digital world is rapidly evolving and physicians need to take notice. To ignore it, is to risk obsolescence in 3 to 5 years.
The intersection of health care and social media is still in its infancy. The groundwork has been laid by a number of early adopters over the past few years. These early adopters include physicians, nurses and other allied health professionals who are actively engaging on various social media platforms such as Twitter and Facebook. Over the last year, a clear trend has emerged, demonstrating that more and more physicians are attempting to establish a digital presence.
The Pew Internet group has identified that nearly 75% to 80% of patients are actively searching for health care information online. They are researching their condition, their provider, their medications and the institutions where they may chose to seek care. Yet, much of the information available to patients searching for information online is commercially biased, misleading and potentially dangerous. Physicians have an obligation to improve their patients understanding of conditions and diseases. Does that obligation extend to social media?
Many physicians are reluctant to establish a digital footprint. They believe they do not have the time to commit to this pursuit. They believe, rightly or wrongly, that there is too much risk involved and most physicians’ eyes simply glaze over when the term social media is mentioned.
Whether or not you want to be online, you are. Your patients are talking about you online. They are commenting about your office, your staff and perhaps your abilities on various platforms. You should know what they’re saying about you. Reputation management is simply one of the many advantages to having an active social media presence. In addition to reputation management, you are able to brand yourself, and you can control the message by creating content and posting information about yourself that an online patient is capable of finding and perhaps identifying.
The world has become flat. Empowered patients are walking through your doors every day. The number of patients searching online about you or their disease process is also increasing on a daily basis. You have the ability to control your destiny. Social media provides you with the tools to establish an online presence, deliver your message and to manage your brand. It is not nearly as time-consuming nor cumbersome as you believe. You will also find the return on engagement to be satisfying from a financial perspective when these empowered patients insist on seeing an engaged provider.
Establishing a presence online should be done in a well thought out manner. You must be cognizant of privacy laws and any social media guidelines the entities who employ you may have. We as orthopedists deal with risk-benefit ratios on a daily basis. This is clearly a condition where the risk of not engaging is very clearly outweighed by the benefits of establishing a firm, well-executed digital footprint.
Howard J. Luks, MD, is the Chief of
Sports Medicine and Arhroscopy at University Orthopaedics, PC in Hawthorne,
N.Y.
Disclosure: He has no relevant financial disclosures.