So, I was listening to a CBC radio program White Coat, Black Art which is a weekly program about medicine from the viewpoint of doctors. This week’s program reviewed the role of social networking on the doctor patient relationship.
This prompted me to think a bit more about the role Social Networking should or should not play in the relationship of a patient and physician. When I look at my use of handheld computing, I am finding that I use my smartphone in almost every patient encounter. I use the phone to look up answers to my patient related questions, and I use it to send consults all the time to many local physicians and ancillary medical folks (i.e. PT, OT, etc). I also use e-mail to communicate with patients, if they wish, to keep up with patients when they are away from the local area (as many folks are who work in the Alberta Oil Fields). Is it really that big a step to move forward to communicating via FaceBook direct message?
Many of my patients enjoy the fact that I have a website (www.docgrimes.com) where they can access information that I find valuable. Some of them have commented that they appreciate it that I have a place where they can go and get answers that they feel that I have pre-screened for value. A few have commented on the fact that I post Tweets to the site of things I find fascinating or useful, it provides some insight into the way in which I look at some of the non-patient aspects of medicine. All of them like the ability to look at my schedule of when I am going to be in clinic seeing folks, and when I am in the walk-in clinic. All of this seems pretty straight forward.
I do have a FaceBook page for my clinic Doc Grimes Clinic, but I limit some of the things that can occur on the site. It really reflects (quiet literally) the content of the website albeit a little late. There is no real way to contact me through FaceBook, but via my page you can send me feedback. I know that some folks, especially teens and young adults, use FaceBook to communicate. What do you think? Should your physician be available via FaceBook? Should they be available through Twitter or E-mail? How about via SMS or Text?
I admit that I am a little fuzzy about what is to much or not enough availability, after all, I live in a small town, people stop by my house when I am out working. Everyone already knows what I am doing (building a barn, tilling the new garden, buying a horse etc) so it is not like I am losing any more privacy, just changing my accessibility. Let me know what you think.
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Hi Gil! Marci Goolsby (Ernsberger) here, your old student. I am now in NYC working as a primary care sports medicine physician. I personally have always seen accessibility not only as one of my best qualities for my patients, but really a mandatory part of practicing medicine...in some places. I think it depends on your field, how your office is set up, what kinds of illnesses and patients you see, etc. I think it should be an individual decision for each physician. I, personally, decline friend requests from patients and their family members as I use facebook socially and do not want to have to police my page i.e., a picture of me with a drink in my hand, nothing too scandulous, just not something I would like to mix with business. Having said that, I consider myself very friendly and open with my patients and do give out my email (and, on some occasions, my cell) as I feel accessibility and some degree of transparency is important in the patient-doctor relationship. Glad to hear you are doing well! Many thanks for your mentoring. Marci
Wow, now that question is a tough question for the modern physician. In my grandfather's day, that is the day when the family doctor delivered half of the county while pronouncing the other half, a good doctor was one who was a doctor when he "went to bed at night and when he woke up in the morning." I'll interpret that statement as a 24/7/365 shift-work. Dedication obviously means different things to different doctors. The level of dedication is proportional to sacrifice, which, of course, is foreign to modern physicians. In a world dominated by "now" and "me," what the hell is a sacrifice. Are the eleven years of one's life dedicated to training a sacrifice worthy of great rewards and compensation?
So down to my answer to the question about social networking... NO.
You wouldn't twitter or facebook your banker, the man who fixes your car, or the local grocer. Why? Because there is a line between friendship and professionalism. With patients, availability should not be confused with social access. Just as it is advised not to doctor ones friends, one should not befriend his patients. What??? Yeah, that is my thought. Nothing but friendly, professional interactions that, in a most caring and loving way, get to the task at hand, which is the relief of suffering.
So back to that small town doctor of another day, who had his phone listed in the phonebook, and would answer it every time it rang... It is what was said over the phone that set this scenario apart from the more dangerous scenario that we face today. Then an answer would be direct, appropriate and to the point--usually ending quickly with "I will gladly address this issue in clinic on Monday" or perhaps with a more serious "I think you need to come into the hospital for admission, I'll be right there." The difference is formality. So if you are to work on accessibility, my recommendation is to not lose the mark of a professional. After all, we are not wedding coordinators subject to the emotional moments of our clients, but rather professionals delivering a high quality product and entitled to a mutually respectful relationship.
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