The doctor will tweet you now
by Jackie Norris
By simply typing out 140-character tweets and sending it to the Web, Dr. Krupali Tejura has been able to make terminally ill patients' wishes come true.
"A doctor using Twitter may sound silly to some people," says Tejura, a radiation oncologist in Corona, Calif. "But it can and does change the lives of my patients."
She's used Twitter to help find bone marrow matches for children with leukemia and successfully solicited donations for airfare and hotel accommodations so a colleague's patient could attend a Pittsburgh Steelers game.
Most recently, she tweeted about her breast cancer patient, Heather, who wanted to dance on "The Ellen DeGeneres Show" and got two VIP tickets donated.
"I'll never forget it and neither will the others she's been able to help," says Heather, who is now in remission and declined to use her last name because her extended family isn't aware of the severity of her condition.
Tejura also has been blogging about cancer-related issues for six years, but the doctor — in her third year of practice at Wilshire Oncology Medical Group — says using Twitter has helped her connect to patients in ways she couldn't before.
"It's allowed me to do amazing things and is another way to let my patients know I'm human, too," she says.
More physicians connecting with patients online
A study by the Pew Internet & American Life Project shows more than 61 percent of adults are using the Internet to look up health care information and find providers.
Physicians are taking notice, with 60 percent saying they use or want to use social networking sites, according to a 2009 Manhattan Research report.
Dr. Kevin Pho, an internist in Nashua, N.H., and author of the blog, KevinMD.com, says doctors are using social media, such as blogs, Twitter and Facebook, to connect with patients personally and educate them on medical topics they're hearing or reading about in the news.
"Medical studies are breaking on a daily basis," says Pho, who has been blogging since 2004 and contributes regularly to USA Today and CNN.com.
"It's imperative doctors and hospitals have a presence so they can help patients and put information into context so they can interpret how it affects them," he says.
Janet Hinz of Whitefish Bay, Wis., says she loves reading the blog of highly rated Bayshore Pediatrics in Glendale, Wis., because it allows her to relate with her children's doctors.
"Each post helps me understand them as doctors and as parents themselves," says the Angie's List member and mother of three. "I feel as if I'm getting to know them personally."
Beverly Tyree, the clinic manager for Bayshore Pediatrics, says they started the blog almost two years ago. "The reason we started was to reach out to parents so they could see the lives of the pediatricians," says Tyree, who monitors the blog. "But it has also taken a different angle than what we intended."
In addition to making personal connections, both Tyree and Hinz say the blog has become a trusted place to visit for reliable information on health issues, like seasonal illnesses.
"During the swine flu, the blog was updated frequently and contained the most comprehensive information," Hinz says.
Receiving up-to-date health information from doctors is important to Angie's List member Dave Clark in Bothell, Wash., but he says his doctors at highly rated Veterans Affairs Puget Sound Medical Center in Seattle don't use social media.
"It's disturbing when you have a provider you trust but can only communicate with them in the office," Clark says. "It seems like doctors have a tendency to keep themselves closed off and inaccessible."
Ken LeBlond, a spokesman with the VA Puget Sound, says the hospital uses Facebook and Twitter, but doctors don't communicate with patients through social media.
"We're piloting 'My HealtheVet,'" says LeBlond, who adds the e-health program isn't a social media site, but a step in that direction since patients will be able to send secure messages to providers.
Dr. Bryan Vartabedian, a pediatric gastroenterologist at Texas Children's Hospital in Houston, who speaks at medical conferences about the benefits and challenges of social media, says there are still a lot of physicians who haven't embraced it.
"It's definitely gaining in popularity, and I think it's inevitable that we'll all eventually be communicating via these applications," says Vartabedian, who's been blogging since 2006. "But there are some pitfalls that make physicians hesitant."
Social media presents potential privacy issues
The biggest challenge both Pho and Vartabedian foresee with health care providers using blogs, Facebook and Twitter are potential privacy issues.
They say they've read doctors' posts that discuss patient cases, and while they remain compliant with the Health Insurance Portability and Accountability Act, the posts may still be viewed as a breach of trust by the patient.
"When you're on Facebook or Twitter, both the patient and doctor need to be careful not to provide personal information," Pho says. "It's so easy to press enter and it's out there forever."
Vartabedian says there are some guidelines patients can follow to help doctors avoid violating privacy, such as contacting the doctor directly instead of asking personal health questions online, but it's ultimately up to the medical field to come up with official social media rules for the industry to follow.
"It's still so new," he says. "But hospitals and medical groups have started taking a good look at privacy guidelines and are modifying them accordingly."
The U.S. Department of Health & Human Services says with the new age of electronic health care information, it's more important than ever to ensure the privacy and security of every patient. The HHS worked with Congress to enact the Health Information Technology for Economic and Clinical Health Act in 2009.
The act requires providers using social media to comply with HIPAA rules, including getting authorization from a patient to identify them and use their health information, or face increased penalties for violations.
"While physicians and patients increasingly engage in the online space, HHS has an obligation to guide standards and protect patients," Vartabedian says. "However, physicians also have an obligation to protect the interests and privacy of patients - independent of regulation."
Angie's List members split on health care providers using social media
Karlene Salyers of Ballston Spa, N.Y., says she's still concerned about problems with patients retaining privacy, and she's not alone. A recent Angie's List online poll on health care providers using social media indicated 44 percent of our members are indifferent and 28 percent like it, but Salyers, a retired technical writer, was part of the remaining 28 percent who thought it's a bad idea.
"I'd rather develop a relationship with my doctor in person," she says. "That's much more personal than exchanging messages on Twitter or Facebook for everyone else to see."
Other Angie's List members have utilized social media to help them find a health care provider. When Mike and Andrea Bender of Cleveland got new jobs and their insurance changed, they began following Dr. Paul Vecchio, a highly rated dentist in Elyria, Ohio, on Twitter.
"His dental advice and trivia grabbed us initially," Mike says. "But after following him, we realized we had shared interests in music, Scotch and the city of Cleveland."
When it came time for the Benders to schedule a dental appointment, they didn't have to think twice after seeing Vecchio was also highly rated on Angie's List. "We felt like we had developed a positive connection before we ever stepped foot in his office," says Mike, who adds they drive more than an hour to Vecchio's office for dental visits.
By interacting with the Benders, Vecchio says he was able to build a wonderful patient-doctor relationship: "It ended up being the perfect fit."
Mike agrees and says while he's in Vecchio's chair, even crown work can be enjoyable because they can discuss topics like their favorite single-malt Scotch.
"I can see where blurring the lines between personal and professional could seem weird," Mike says. "But I'm more apt to choose and stay loyal to a doctor or dentist I consider an actual human being rather than someone whose interaction with me is purely clinical."
What do you think about health care providers using social media? Share your thoughts at: firstname.lastname@example.org.