Why Radiologists Should Tweet, Blog, and Exploit Social Media

Since the passage of the DRA, and through subsequent hits to reimbursement for imaging, one question has been perennial in the radiology community: How can radiologists raise their profile with patients without sacrificing productivity (or profitability)? John A. Patti, MD, chair of the ACR® board of chancellors, suggests that radiologists should give up 10% of their reading time in favor of practice-building activities, such as consultation with patients. At the 2012 CIO Forum (sponsored by the College of Healthcare Information Management Executives and the Healthcare Information and Management Systems Society) on February 20 in Las Vegas, Nevada, a physician from outside the radiology field had another idea as to how physicians can forge stronger relationships with their patients. Wendy Sue Swanson, MD, a pediatrician at Seattle Children’s Hospital, presented “Physicians and Patients in the Time of Twitter: Trusted Relationships, Social Media, and Opportunities in Health,” suggesting that physicians take to social media to reach patients where they are most likely to be seeking health information. Swanson presents some compelling statistics to support her case. According to the Pew Internet & American Life Project,¹ most US Internet users look up health information online; it is the third most common use of the Web. “How we get information is dramatically changing,” she notes. “We know our patients are online. The role of a physician, and how we get patients new information, is dramatically changing as well.” Swanson presented her own experiences using social media as a test case. With the blessing of Seattle Children’s Hospital, she started a successful, patient-oriented blog (www.seattlemamadoc.seattlechildrens.org) about current issues in pediatric health care; in one recurring feature, called If It Were My Child, she recaps current research on a specific issue and offers her opinion on how parents should interpret it. The Radiology Connection One doesn’t have to use one’s imagination to see how Swanson’s blogging might be applied to radiology—at least, to pediatric radiology—because Swanson’s husband is a pediatric radiologist, and she routinely features his ideas about current topics in pediatric imaging. In an entry dated May 9, 2011, Jonathan Swanson, MD, writes that if his child needed to go to an emergency department, he would take the child to the nearest children’s hospital. He then recaps research supporting his assertion that children’s hospitals tend to be more successful at providing children with lower-dose imaging, and he answers questions from readers in the blog’s comment section. Swanson does not limit her social-media use to the blog, however. She also has an active Twitter account (as @SeattleMamaDoc) with more than 8,000 followers, and she posts videos to a YouTube page. “If 80% or more of mothers are online searching for health information, it is my ethical obligation to be online,” she says. Swanson notes that there is no mechanism in place to reimburse physicians for time spent connecting with patients via social media, but using these platforms allows physicians to “create repositories of information that we can share with patients later, reducing the amount of time we have to spend in that exam space,” she says. She offers the example of another physician power-user of Twitter and the Web, Howard Luks, MD, chief of sports medicine and arthroscopy at Westchester Medical Center, Valhalla, New York; he tweets as @hjluks and blogs at www.howardluksmd.com. In a tweet dated March 11, Luks describes his presence on Twitter as humanizing his practice; on his website, prospective patients can watch videos explaining how common orthopedic procedures work, and can read his thoughts on emerging treatments. Again, using Luks as a test case, one does not have to go far to see potential applications for radiologists hoping to educate their patients. In a blog entry, Luks looks at the overutilization of MRI scans in the diagnosis of athletic conditions. “Please do not approach your physician with the thought that an MRI is necessary in all situations where your knee, your elbow, or your shoulder bothers you,” he writes. “Not all recent injuries require an MRI evaluation (some do).” Information Versus Misinformation Swanson makes the case that this kind of communication with patients is invaluable. The viral nature of misinformation—for instance, fear regarding radiation dose in the wake of media reports about excess radiation at respected organizations—can only be opposed by strong, qualified, and credible voices. Online, “there’s not a paucity of health information,” she notes. “There’s an overabundance. Until we join those spaces, we won’t have true expertise in the conversation.” The AMA has issued guidelines² for clinicians who are establishing social-media presences; however, these guidelines “are extremely cautionary and not very exciting, and I don’t necessarily believe in them,” Swanson notes. For instance, the AMA recommends separating personal content from professional content. “I believe storytelling is what makes people change decisions,” Swanson says. Instead, Swanson offers four guidelines based on her own experience: never discuss patient-specific issues without the patient’s permission, never be anonymous, be nice, and remember that everyone is watching that conversation unfold. “Your patients and communities deserve it, and I really don’t think you have a choice. Everyone else is using these means to get their ideas out,” she says. She concludes, “Let’s join our patients where they are. Let’s not be left behind again.”