Why social media is not a waste of time for a doctor - infographic, slides, video and paper!

In Decemeber 2013 - Professor Matt de Camp and I were asked to debate whether social media was a waste of time for doctors in the Journal of the Royal College of Physicians of Edinburgh. You can read the full paper here and see some discussion on PubMed commons about it here. This is my part of the paper with hyperlinks. I should mention that JRCPE is an open access journal who allowed me to retain my copyright. This is therefore published here, along with the infographic and my slides, under a creative commons license so feel free to reuse and remix as you wish.

Why does a twittering doctor tweet? - 10 reasons for a social media presence from Anne Marie Cunningham

These are the slides I used when giving my talk on this at #Dotmed13 in Dublin last December. You can watch a video of the talk below.




 Introduction 

Should you have a strong social media presence? I am going to give you ten reasons why I think you need one. Social media provides an opportunity to publish your thoughts and ideas and to share your experiences without having to go through a middleman. And many people are taking advantage of this. Globally half a billion tweets are posted every day. (1) Surely it must be possible to find something of value that could make it worthwhile for a doctor to start exploring these spaces? It is not nearly as difficult as you might think, because these pieces of information are not just floating unconnected to each other; they are disseminated and linked to through networks of your peers. Developing networks, and figuring out who and what to pay attention to, are some of the key learning skills we need in the twenty-first century. (2) I will convince you that it is worth developing these skills.

10 Reasons to have a social media presence

To connect 

The landmark report on ‘Health professionals for a new century’ suggested that we need ‘locally responsive but globally connected teams’ 3 but lamented that ‘most institutions are not sufficiently outward looking to exploit the power of networking and connectivity for mutual strengthening’.(3) But this is changing. It is now rare to attend a forward-thinking event without being encouraged to tweet with the conference hashtag. We are our institutions, and we are leading the way; we are making the connections.

To engage 

Social media is not just about getting your message out. It is also about listening. We can learn with patient leaders.( 4 )As Gilbert and Doughty, co-directors of the Centre for Patient Leadership, describe ‘[w]hen patients can both manage their own health and go on to develop the confidence and skills to lead and influence others, something special happens: new collaborative systems of healthcare take shape and positive solutions emerge to healthcare problems, locally and nationally.’ (4) Through their blogs and tweets you can engage with them.

To inform 

If you are trying to do things differently, changing the way you and your team work, where can you tell people about this? Consultant endocrinologist Partha Kar uses his blog, NHS Sugar Doc, to communicate how an award-winning team is involving patients in redesigning their service, meeting the challenges of modern healthcare.(5)

To reflect

Elin Roddy is a respiratory consultant. She also tweets (@elinlowri). During ‘dying matters’ awareness week, and prompted by discussions of end-of-life care on Twitter, she decided to write her first blog post: a reflection on how, during her working life, she has ‘been involved with death in many different guises and in many different ways.’ (6) Thirty eight people – health professionals and patients – left comments to say how they had been moved by her eloquent writing. She is now lead for end-of-life care in her trust and says this would not have happened without her learning through social media.

To share 

In a hospital in London a patient has the wrong foot operated on because they put a compression stocking on the wrong side. The checks and balances which the nominally implemented surgical checklist should have provided did not happen. (7) Fortunately the other foot needed operating on too. After investigations were completed the medical director of the trust gave permission for an account to be shared through social media. The story ‘Wrongfooted’ by anaesthetist Helgi Johnannson has been viewed more than 17,000 times. (7) When surgeon and medical director, Dermot Riordan, read the story he wrote on his blog that he felt ‘déjà vu, sadness and even anger’. (8)

.@traumagasdoc This make me both sad & cross. We had near identical case. Reported externally but no learning dissemination by @NHSEngland
— Dermot O'Riordan (@dermotor) October 19, 2013

A year ago nearly exactly the same mistake had occurred where he works. He describes the transparent and open approach that his team took to learning about this incident but he personally regrets that he did not share this learning with others in the way that ‘Wrongfooted’ showed it could be done. Social media is changing how we conceive of dissemination.

To be challenged 

Often the best way to learn is to be challenged. Earlier this year people who had experienced mental health care started tweeting their experiences using the tag #DearMentalHealthProfessionals. (9) Along with appreciation and thanks there were also tweets which expressed how it felt to be let down by a system that is supposed to help. To be able to change systems for the better we need to work towards understanding, and that starts with shifting our perspectives. Social media can help us to do this.

To be supported 

Sometimes we just need to know that we are not alone. #TipsForNewDocs are short messages of advice for newly graduated medics from doctors, other health professionals and patients. Like many social media activities it is hard to say who started this trend but Guardian healthcare(10)and the GMC(11) have both used the tag to support this important transition.

To lead 

How much impact can you achieve through social media? NHS Change Day has been lauded as the ‘biggest ever day of collective action to improve healthcare that started with a tweet’. (12) A conversation between some junior doctors on Twitter was the catalyst for a project which saw 189,000 people take action on 13 March 2013 to improve the care of the patients they served. (12)

To learn 

Free open access medical education – otherwise known as FOAMed (13) is on the rise. In the past we used databases to store and find these resources, but now we are increasingly depending on the power of distributed networks to help filter the best content for our needs. New educational initiatives are starting every week in social media. The case-based discussions of ECGclass (14) and Gasclass for anaesthesia (15) can give you a flavour of what is achievable.

To inspire 

Kate Granger is a doctor training in elderly medicine; she is also terminally ill with a rare aggressive abdominal sarcoma. During a recent hospital admission (16) she noticed that too many of the staff she met did not introduce themselves. She decided that something needed to be done, so she wrote a blog post with a simple idea – when health professionals meet patients they should say ‘hello, my name is’. (17) People started talking about her idea and doing what she asked. The campaign has reached so many people that it is mentioned in the Government’s response to the Francis Inquiry. (18)

Conclusion

Is social media a professionalism quagmire? Could your professional reputation hang on as few as 140 characters? Yes, norms are still being established but that means you can shape them. The truth is that if you respect your patients and your colleagues, like these pioneering physicians, you have little to fear. Instead, you should be feeling optimistic and excited that you can now easily tap into a global community who can help you to be a better doctor in a better system with your patients.

References

1 Naughton J. What’s Twitter’s real value? Don’t ask an economist. The Observer.2013 Nov 24.
2 Rheingold H. Net smart: how to thrive online. Cambridge: MIT Press; 2012.
3 Frenk J, Chen L, Bhutta ZA et al. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. Lancet2010; 376:1923–58. http://dx.doi. org/10.1016/S0140-6736(10)61854-5
4 Gilbert D, Doughty M. Quality: why patient leaders are the new kids on the block. Health Serv J2012; 122:26–7.
5 Kar P. Game-changer III: ward priority and transparency[Internet}. Partha Kar 2013 Nov 16 [cited 2013 Nov 27]. Available from: http:// nhssugardoc.blogspot.co.uk/2013/11/game-changer-iii-ward-priority-and.html
6 Lowri E. Dying matters[Internet]. Elin Lowri 2013 May 13 [cited 2013 Nov 27]. Available from: http://elinlowri.wordpress.com/2013/05/11/ dying-matters/
7 Wrongfooted[Internet]. 2013 Oct 13 [cited 2013 Nov 27]. Available from: http://storify.com/traumagasdoc/wrongfooted
8 O’Riordan D. Failure to learn[Internet]. Dermot O’Leary 2013 Oct 20 [cited 2013 Nov 27]. Available from: http://oriordan.co.uk/blog/ files/Failing%20to%20learn.html
9 Betton V. #DearMentalHealthProfessionals[Internet]. Victoria Betton 2013 Aug [cited 2013 Nov 27]. Available from: http:// storify.com/VictoriaBetton/dearmentalhealthprofessionals
10 Guardian Healthcare. #TipsForNewDocs[Internet]. 2012 [cited 2013 Nov 27]. Available from: http://storify.com/GdnHealthcare/ tipsfornewdocs
11 General Medical Council. #tipsfornewdocs[Internet]. 2013 [cited 2013 Nov 27]. Available from: http://storify.com/GMCUK/tips-for-new-doctors.
12 Bevan H, Roland D, Lynton J et al. Biggest ever day of collective action to improve healthcare that started with a tweet [Internet]. 2013 June 14 [cited 2013 Nov 27]. Available from: http://www. mixprize.org/story/biggest-ever-day-collective-action-improve-healthcare-started-tweet-0
13 Life in the fastlane. FOAM – Free Open Access Medical Education [Internet]. 2013 [cited 2013 Nov 27]. Available from: http:// lifeinthefastlane.com/foam/
14 Wetherell H. Keeping ECGs simple[Internet]. 2013 [cited 2013 Nov 27]. Available from: http://hcwetherell.blogspot.co.uk/
15 Gasclass. Gasclass: the web school of anaesthesia[Internet]. 2013 [cited 2013 Nov 25]. Available from: http://gasclass.wordpress.com/
16 Granger K. The other side live![Internet]. Kate Granger 2013 Aug [cited 2013 Nov 27]. Available from: http://storify.com/katemgranger/ the-other-side-live
17 Granger K. #hellomynameis[Internet]. Kate Granger 2013 Sept 4 [cited 2013 Nov 27]. Available from: http://drkategranger. wordpress.com/2013/09/04/hellomynameis/
18 Department of Health. Hard truths: the journey to putting patients first. Volume one of the Government response to the Mid Staffordshire NHS Foundation Trust Public Inquiry[Internet]. London: Department of Health; 2013 [cited 2013 Nov 27]. Available from: https://www. gov.uk/government/uploads/system/uploads/attachment_data/ file/259648/34658_Cm_8754_Vol_1_accessible.pdf