How to make the most of social media in your practice

by Virginia Anderson, Senior Writer/Editor

October 2010 Issue: Oncology is a field that embraces cutting-edge technology, celebrating new imaging techniques and innovative personalized treatment regimens that can improve the lives of patients with cancer. Today, many forward-thinking oncologists are finding ways to put consumer technologies, specifically social media, to use in their practices.

Social networking sites such as Facebook and Twitter can be a vehicle for connecting like-minded individuals around the world with shared research interests, advocacy goals, or philanthropic missions. They can bring together patients with rare diseases looking for support and information, and they can be a powerful marketing tool for practices and physicians.

But how do you keep Facebook from devolving into a distraction? And is there really anything worth saying in 140 characters?

A practice’s perspective
Last year, Pacific Oncology and Hematology Associates—eight ASCO members in a community practice in California—began looking for new ways to market their extensive phase I clinical trials research and their expanding integrative oncology program. As the physicians contemplated the best way to accomplish these objectives, digital health strategist Gregg Masters approached Richard G. Just, MD, senior partner and President of the practice, with the concept of using social networking to reach an audience that flyers and speaking engagements at nearby cancer centers could not.

“Gregg opened our eyes to the possibilities,” Dr. Just said. As a result, the practice now features a Facebook page with information and announcements, and an active Twitter site with a following of 340 people.

One of Mr. Masters’ initial digital projects with Pacific Oncology was live-streaming a video of a presentation on the future of oncology arranged by the practice. “That was our first experience” in digital media, said Dr. Just. “It’s very enlightening to see, first, how easy it was, and second, how you can reach people in real time.”

Delegating duties
While immediacy is a major plus of social networking, time can also be a significant drawback—physicians who are already busy with practice, research, family, and personal activities can’t always carve out the amount of time needed to put together an effective profile or whip up engaging tweets.

“If someone in your practice is very facile with computers and familiar with these modalities, they can certainly test the waters, but as far as an organized marketing effort goes, I think everyone could use help,” Dr. Just said. He noted that he did not have a personal Facebook profile because of the time involved: “I can barely keep up with my e-mail!”

Making new connections
Dr. Just did find time to attend the “Tweet Up” (a face-to-face meeting with other Twitter users) at the 2010 ASCO Annual Meeting. “When I introduced myself, three people jumped up and said, ‘So that’s who you are!’ I realized that we’re reaching a broad audience—not only patients and physicians, but the media, pharma, and businesses. All of these people have been out there and we didn’t even know about it” until the practice started tweeting, he said.

Privacy concerns and changing perceptions
Privacy is a major concern when it comes to sharing information online. State and federal laws define the ways physicians can use patient information, including their contact information, and as yet there are no universal standards specifically for physician use of social networking. However, Dr. Just speculates that online communities may be in the process of changing patient perceptions and expectations about privacy, at least for a small demographic.

“There are patients with chronic and potentially lethal illnesses who are going online to find information that will help them, and they’re joining groups where they have to explain their particular situation. There’s a cadre of people who are not so interested in privacy— in fact, they’re more than willing to share their personal information,” he said.

“I’ve been thinking about how we could communicate lab results and X-rays, other than the time-honored method of phone calls,” which is cumbersome and time-consuming, Dr. Just continued. “If there was a way that we could put those results, especially those that are normal, on a site where people would have their own password, and we could have notes about next steps—something like that could ease the burden of information overload.”

As generations of young physicians and patients who have always lived in a world with social networking come into oncology practices, and as sites evolve and new platforms emerge, online communities will continue to intertwine with medicine.

Legal and Ethical Considerations
Common sense should guide any use of social media, but there are special considerations in the medical field. Legal and ethical protections for patient privacy are at the top of the list. There have been several recent media reports of hospital personnel fired or disciplined for discussing patients on Facebook or posting pictures of injured patients. “Friending” a patient may be seen as a public signal that the patient has cancer. Individual patients may have given instructions about the ways they want—and don’t want—to be contacted. Laws like HIPAA even restrict how a patient can be contacted about research studies.

Facebook messages to and from patients may not be secure—and may be considered part of the medical record. Giving any actual medical advice over the Web can raise medical licensure and malpractice concerns. Even consultation with other doctors through a social network raises the possibility that you are consulting with someone who is not competent—or is not even a physician.

Consult your lawyer before launching a social networking tool in your practice. With your lawyer, you can check the privacy and security policies and social networking policies of institutions where you practice. A lawyer can help with disclaimers that help minimize liability risk. As with any new practice activity, it may be wise to check in with your insurance carrier to see if there are any limitations.

Twitter Tips
To craft more effective tweets, Twitter novices and experts alike can try the following tips: 

• Having trouble sticking to the 140-character limit while still including links to exciting information? Use URL-shortening tools like tinyurl.com or http://ow.ly (the shortest available at only 18 characters).
• Feel free to abbreviate in order to save characters. Twitter is an informal communications vehicle; fellow users will understand that you have limited space to get your message across.
• Use hashtags to track conversation topics within the entire Twitter community; for example, to see what all Twitter users are saying about oncology, search for #oncology at search.twitter.com.
• Use tools that make managing tweets, followers, and hashtags easier. ASCO and Cancer.Net use HootSuite (hootsuite.com), which allows multiple users to tweet immediately and schedule tweets for future times, monitor @ mentions and hashtag usage, and track URL clicks.
• If you have a web-enabled phone, download a Twitter app (such as TwitterBerry for BlackBerry and Twitter for iPhone) so you can tweet on the go.
• For a list of physicians who Twitter, visit twitterdoctors.net 

ASCO-related tweets at 2009 ASCO Annual Meeting: Approximately 1,000
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ASCO-related tweets in one day at 2010 ASCO Annual Meeting: More than 5,500

ASCO’s Social Networking Opportunities
Visit ASCO Connection online at ASCOconnection.org to:

• Read and comment on blogs by leaders in the field
• Post your own blogs/questions/comments in the Discussion Forums
• Expand your professional contacts
• Promote your work, recognitions, publications, etc., through announcements in Member News
• Access the interactive online edition of ASCO Connection as well as online exclusives
• Explore oncology-related TwitterFeeds

ASCO offers additional networking opportunities on Twitter, Facebook, and LinkedIn:

• Visit twitter.com/ASCO and select “Follow me on Twitter.”
• Become a fan of the American Society of Clinical Oncology and Cancer.Net on Facebook
• Join the “American Society of Clinical Oncology” members-only group on LinkedIn.

According to a 2009 Medimix International survey, 34% of physicians use social media. A 2009 Manhattan Research survey puts that number even higher, reporting that 60% of physicians use or want to use social networking sites.

“Virtually every industry feels the impact of social media platforms like Facebook and Twitter, and healthcare is no exception. As physicians and providers discover the benefits of online collaboration and learn to guard against the risks, peer-to-peer communities will flourish in the years to come. Our recent survey shows the trend is well underway,” said Alex de Carvalho, Social Media Director at Medimix International, in a press release on the survey.

Connect with Pacific Oncology at twitter.com/PacificOncology or search “Pacific Oncology and Hematology Associates” on facebook.com.

Further Reading
Read more perspectives on how social networking intersects with medical practice:

• “Practicing Medicine in the Age of Facebook,” by Sachin H. Jain, MD, MBA, New England Journal of Medicine
• "Medicine in the Age of Twitter,” by Pauline W. Chen, MD, The New York Times
• “Brave New World of Social Media,” by Paul Wynn, The New Physician
• “A doctor’s request: please don’t ‘friend’ me,” by Katherine Chretien, MD, USA Today
• “Social media consults may harbor dangers,” by Arthur R. Derse, MD, JD, American Medical News

If you’re new to social networking, this article can help you get started:

• “For Those Facebook Left Behind,” by David Pogue, The New York Times