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When Emma asked me to write this ‘blog’ – with my (known-for) brutal honesty intact to give insights into the physician’s perspective and use of social media, I confess to a little trepidation.

By Graeme Moyle on Oct 30, 2012

Firstly, I’ve never written a ‘blog’ and the evidence-based practitioner in me prefers to blindly randomise and await results rather than promulgate opinion in an unsubstantiated manner. Secondly I am ‘time-poor’ and media-shy; I have neither the opportunity nor the inclination to indulge in what has appeared to me to be a somewhat more vanity project than direct communication and targeted education. Accordingly, it would seem that I’m appropriately distanced from the hyperbole that surrounds the impact of social media on medicine. I’m not sure this was quite the response that was hoped-for when such a proselytizing social media evangelist made the initial request.

At a first glance, it appears as though medicine is saturated with social media. Certainly, medicine and medical matters have always been headline-grabbers in traditional media. Charlatans espousing quackery, snake-oil,  and worse, all have frequently influenced patients and the content and manner by which they seek reassurance, dialogue and counsel with their doctor. It is always the message not the medium that counts. Physicians have always had to employ tolerance ahead of diagnostics. As such, this enhanced modality of social media is nothing new. But it certainly is disruptive,  providing so many new portals in which we can access frightening diagnoses, indulge our anxieties, be victims of venal advice . I don’t have a smart phone. I don’t blog, tweet, follow nor press buttons to afford an attitudinal like/dislike. But my patients do. Increasingly so. They are becoming invested in apps, trackers, forums, info-seeking on health platforms  and to-date I have only witnessed the benefit of this engagement insofar as we all know that for patients with chronic conditions, the greater the engagement with genuine education and understanding of their disease, the greater the adherence to treatment and commitment to their personal well-being.  Furthermore, the major medical societies and health organisations are putting social media to use. Perhaps, then, this is where this KOL starts to open up to the potential value for social media in medicine?

Let’s dissect  the reasons behind my apparent social-media reluctance using the three key relationships that a physician has:

1.       Peer-to-peer connections:

As a hospital-based physician if I need to seek a colleagues’ expert opinion I can simply walk down the corridor to see them. That’s why I have little interest in the doctor networks. But I concede that for other physicians the opportunity to confer with colleagues and mentors is highly-attractive and needed as travel budgets tighten and we all struggleto afford to journey to conferences – the mainstay for scientific exchange.

2.       Physician-patient conduct:

I manage a unique patient group who have always been highly-invested and responsible about the quality of their care – with or without a digital catalyst. The egalitarian relationship that a person with HIV has with their doctor is well-documented as marking a paradigm shift towards more participatory practice. Usually on-top of their condition, my patients now use trackers and tools where once they had hand-made charts. As I like spending  time with patients ensuring holistic physical and pastoral care, I can certainly see the merit in these tools to help patients compare, control and communicate about their condition.

3.       Relationship with industry:

Realistically, the convoluted regulatory environment – where industry is increasingly distanced from interacting with physicians, especially those in academia, even when product data is in the public domain – is stymieing the potential for social media tools to develop that futher-facilitate the exchange of medical knowledge. This is a concern and is not doing ‘social media’ any favours. Information portals that are founded by industry become redundant quickly because the industry disables itself through legal self-flagellation or ‘users’ raise issues that distract the sites away from their original intentions. Companies that are braver and bolder will have better relationships with KOLs if they use social media platforms and tools to bring transparency and engender trust between participants.

What can I conclude, therefore on reflection from my apparent, initial scepticism about the value of social media? My current nihilism is individualised and changing; for non-hospital-based doctors who are more isolated, have a difficult-to-motivate patient population or don’t have the access that I have to conference exchange, certain social media tools are evidently of value. And that is the majority of doctors. The logical next step is to inject the over-consumption / rein-in the hysteria with scientific meaning such that physicians don’t abuse the channels as part of a vanity project but understand their reach, relevance and rightful place in our little black bag of physician tools. To achieve that, we need clarity and confidence about social media – which starts with education and acceptance that being medically sociable, participating, is The New Normal.

That’s my first blog done. Am I a social media convert now? Not quite – but that’s my first tentative step on the journey to be made. To retain leadership of opinion you have to be present in the favoured channels. That’s where patients and physicians are, therefore that’s where I am inevitably heading.

Graeme Moyle is Director of HIV Research and Strategy at Chelsea & Westminster Hospital