The cool thing about the Web, Mobile Stratosphere and Social Media is that no-one owns them and no one ever will. Health Care Social Media, or “#hcsm,” as it is known on Twitter, combines the different Healthcare Social Media Web/Mobile “platforms” and devices such as Twitter, Facebook, Portal Websites, Blogging, Applications, YouTube Videos, Podcasts, Smartphones and Webinars with often instantaneous global connectivity and growing virtual communities made possible by the Web and Mobile technological environments. The constant emergence of new platforms and devices and an increase in the global use of these technological environments for healthcare purposes makes the potential of hcsm limitless. Moreover, hcsm will always be defined, refined and influenced by the patients, healthcare professionals, medical school students, teachers, executives and attorneys who use it. In that way, hcsm will forever remain an ever-changing medium of valuable virtual communities, different usages and individual expression. This makes hcsm both an effective Tool and an invaluable Resource for the diverse healthcare industry end-user. But much like pre-Game Batting Practice in Major League Baseball, hcsm end-users have different needs and go about servicing them in different ways.

Some Major League baseball players use pre-Game Batting Practice to show off their strength trying to hit every pitch into the home run bleacher seats just as some in Healthcare use hcsm to simply market their wares damn whatever self-promotion complaints they are berated by. But other ballplayers have great reverence for Batting Practice and treat it as an opportunity to simulate In-Game Live At-Bats and/or Live Situational Hitting. This latter usage of Batting Practice by ballplayers, by analogy, is how many experienced patients and Web-savvy health care professionals value hcsm. They see it as a way to share (or gain) knowledge and experience with (from) others.

However, even within that seemingly wide spectrum of hcsm end-users, there is a divergence of underlying rationales regarding the value, potential and power of hcsm. In fact, some factions within the healthcare industry seem to act proprietary over hcsm or even privileged towards it, yet, as stated above, no one owns it.   This Blog Post, written by a chronic patient, addresses the unlimited potential of hcsm and theorizes that these differences in the perception of hcsm are caused by both generational factors and a new interpretation of the fast-evolving Doctor-Patient Relationship. If these differences can be replaced by a more collaborative spirit, hcsm can be a Game-Changer in Healthcare Reform.

The “hcsm” TweetChat – the Best “60 Minutes” on Sunday night

It starts out at 9:00 PM EST like any other TweetChat with people calmly introducing themselves and also explaining their healthcare industry interests; both, in fewer than 140 characters. It is fascinating to see doctors of almost every discipline, patients with various experience and differing attitudes, nurses, pharmacists, hospital administrators, drug company executives, health attorneys, medical school students and the like from all over the country eager to participate in this democratized “Conference” of sorts. Then, as the introductions speed up in anticipation of the professionally prepared Moderator introducing Topic 1 (of 3), you realize the TweetChat is actually comprised of medical professionals and hobbyists from all over the world.

There are definitely “Regulars” like myself who somehow manage nearly each and every Sunday Night to block out reality and step into this virtual world of such distinguished, passionate and dedicated folks but there are also “Lurkers” who simply watch and learn. What are they watching? They are observing some very smart and wise people who care deeply about the current and future state of healthcare trying to type as fast as possible to populate the #hcsm Twitter Feed with their insightful nuggets of information and experience so that their contributions are duly noted, possibly re-tweeted and hopefully expanded upon. At the same time, we are all genuinely interested in what our colleagues from a few continents away are writing about as they start their tomorrow or are just ending their work day.  Therein lay the physical and mental challenges posed by what I like to refer to as the best “60 Minutes” on Sunday night.

Regardless of the night’s discourse, I am always amazed at the ever-increasing amount and diversity of people who attend each and every week. I mean, Sunday night at 9:00 PM EST is usually reserved for the beginning of the upcoming work week’s “Sunday Night Blues.” Instead, it now marks the start time for this “Think Tank” of renowned healthcare industry brethren playing this game of “type, read or re-tweet.” There’s no tangible benefit to participating in the #hcsm TweetChat. It’s just pure mental stimulation for the purposes of someday soon making a difference in an industry or in just one (1) patient’s life.  It’s a humbling experience seeing virtual relationships being formed all over the world over mere thoughts and expressions. You don’t know where it’s going, and you don’t know what each night’s Topics will be, but you know you don’t want to be late and miss anything.

Talking ‘bout my Generation

I always try to represent a strong patient voice during the #hcsm TweetChat and it always strikes me how the younger folks (I’m 49 years of age) are so eager to look at things from a patient-centric and technology-driven perspective yet, in my reality, as a 30-year chronic patient, these great intentions are almost always over-ridden by the problem at hand. In that sense, we tend to regularly get into an intellectual debate about the role of education in the Practice of Medicine and I always state that I don’t want to be educated by my doctor; I just want to be treated. Many TweetChat members mistake my ostensibly short-sighted position as me not wanting to know what is going on with my health when I converse with my doctor but that’s not the case. I blame this misunderstanding on the 140 character limitation of Twitter and how it makes me lean on assumptions probably too much because I assume it’s a given that everyone wants to know what’s wrong with them. I just don’t want to place more job responsibilities on my physician whose plate is already full due to the intensive administrative paperwork necessary to merely seek financial Reimbursement from my Health Insurance Company. Besides, if many physicians also possess teaching skills, their bedside manners would be substantially enhanced and as a patient I’d rather see those teaching skills utilized that way instead of for the purposes of enlightening me about the origins of prostate cancer.

Also, the younger generations of #hcsm TweetChat participants tend to place an emphasis on Medical Practices making it a priority to not only have a Social Media Policy but to also consistently “publish” Content on their websites or on other hcsm platforms to help educate their patient populations. As a patient always appreciative of such efforts (and I applaud these aspirations), I nevertheless am against holding my physician ALSO accountable to various Publishing Standards. Sure, they could hire someone to create these materials, and many do. But I’d prefer these extra staff focus on patient pharmaceutical financial assistance or disability programs if the medical practice treats patients who are chronically ill and often become disabled and financially strapped because of their medical costs. As for the establishment of a Social Media Policy, I am convinced this will be necessary in the very near future but I seem to constantly have experiences with top-notch physicians who nevertheless have problems with their Telephone Call-Back Policy! Again, I applaud the idea and intention but in reality, and at this place in time, I’d prefer to see all resources used to enhance patient care.

I think it is a generational issue and I commend the younger folks for starting out with such patient-centric plans, but I want my health care professionals to simply treat me. I don’t want to learn how my situation stacks up against that of other patients and I don’t want my doctor taking time out of being on the “cutting edge of treatment” to publish a rather innocuous article, for example, about the symptoms of Crohn’s Disease which, given the professional, ethical and legal limitations he or she is up against, turns out to be no more than a marketing piece, despite the best of intentions to help patients. Maybe my simplistic perspective is due to the nuanced-filled complications of my chronic illness (i.e., Crohn’s Disease), but my doctors always seem so busy with one emergency after another that I just don’t understand when they would have the time to act as educator and publisher on top of being a doctor, which these days means more staff, more administrative work and higher malpractice premiums, all for less money than doctors typically made Ten (10) years ago. Let’s face it, these days, it’s tough being a Patient or a Doctor.

The Evolving Physician-Patient Relationship

I think the different perceptions of hcsm which indicate its more limited usage and potential are still held by intelligent, informed and dedicated healthcare professionals but these folks don’t account for the fast-changing Physician-Patient Relationship which is evolving every second, of every day, of every year, thanks to Social Media and to the Web/Mobile technological environments. Sure, mutual respect is still a mainstay in that relationship but mutual trust implies a familiarly between the two parties and with economic decisions increasingly forcing patients to “work their health insurance plans” and choose In-Network physicians, that trust often doesn’t get enough time to develop because employers could conceivably change their policies annually as premiums are raised.  Thus, many Physician-Patient relationships only last as long as the policy makes financial sense for the employer. As a result, many employees are forced to change Internists or Gate-Keeper Physicians on an almost annual basis.

Alternatively, what I see more of in my experiences as a patient since the evolution of hcsm is “Collaboration” between Physician and Patient. This Collaboration seems to be a direct result of the opportunities for e-patients to learn more about their conditions and treatments via hcsm prior to their real life encounters with their doctors. This is making healthcare “transactions” more efficient and therefore more productive. Perhaps e-patients are more experienced because, like me, they must battle some type of chronic medical condition. That said, not all doctors are cut out to treat chronic patients as that necessitates an on-going relationship as opposed to the occasional “stop by” patient each time he or she has a problem. It’s not dissimilar to a man or woman more comfortable in casual relationships than in monogamy.

Similarly, patients must understand that someone touted as a great doctor might not be the right one for them, especially if they have a chronic illness. Likewise, doctors must now be more careful in picking their patients because the needs of a chronic patient are much different than those of a normal patient with occasional medical problems. Accordingly, once a healthcare end-user accepts “Collaboration” as an integral part of the “new” Physician-Patient Relationship, the potential of hcsm comes more into focus since the basic and driving healthcare relationship is now more “democratic” than ever before.

Power of hcsm to help Reform Healthcare

In the beginning stages of hcsm, I read many stories about how patient-formed business ventures on the Web couldn’t possibly succeed without the inclusion of a medical professional as its focal point. I always laughed at that because people of this opinion never understood the uniquely useful value in a Virtual Patient Community such as, which makes Crohn’s Disease patients feel comfortable enough to share and be candid about their experiences in an environment comprised of only similar patients. What medical professionals did not realize is that with the advent of hcsm many patients now feel more comfortable talking about their symptoms with other patients on a preferred hcsm platform as opposed to talking with a doctor in the sterile environment of a Medical Practice when the doctor must quickly assess the situation so he or she can move on to treat the next patient.

Strangely, the intimacy of the doctor’s office has in many instances been replaced by a virtual “room” of people with similar medical problems. Thankfully, some very smart medical professionals listened to their patients and picked up on this and the power of virtual organized patients is now recognized and the necessary inclusion of medical professionals in Web business ventures is no longer the prevailing business theory just as “Return on Investment” or “ROI” is being abandoned as the short term touchstone for success of hcsm business ventures. There’s just no precedence to rely upon to make any realistic ROI forecasts.

At its core, hcsm is no more than a grassroots movement which, due to its timing, has been powered by technology such that it is now an influential worldwide phenomenon.  In that regard, there are active hcsm affiliates in many countries throughout the world including, but not limited to, Australia, New Zealand, Asia, Austria, Canada, Europe, India, Latin America, Sweden, France, Ukraine and the United Kingdom.  With Social Media objectives that are no different than that of the Entertainment and Music industries, hcsm strives to make Healthcare more: personal; readily available; user-friendly; efficient; and profitable. In doing so, these virtual hcsm patient interactions are becoming more intimate and patients are noticing by becoming more comfortable and candid.

This combination of intimacy, candor and commonality amongst virtual patient communities will soon make real-life Healthcare “transactions” more efficient, more productive and less expensive. After all, a patient with more tried and tested medical knowledge makes for a smoother and faster customer and that enhances the quality of real-life Healthcare transactions. Participation in hcsm provides patients with this type of “seasoned” information and that will also make their exchanges with medical professionals more efficient.  The benefits of these time and quality patient efficiencies will eventually grant more people the opportunity to afford healthcare insurance to then obtain the medical treatment they need. This may seem like a rather attenuated connection but hcsm is quickly becoming relied upon by patients as one of their foundations when they seek medical treatment.  No-one ever thought people would trust the Web with their banking needs but now people from all walks of life are conducting secure banking transactions with their cell phones.  The benefits of technology are finally creeping into patient care and if banking is any barometer of its acceptance, hcsm will soon be a formal part of Patient Treatment Plans.

As hcsm becomes a part of everyday life and, like banking, there are television commercials praising its ease, even with a cell phone, the multifaceted interests of patients, doctors and hospitals will then merge because of hcsm.  This alignment of interests will form a formidable foe for the Health Insurers who, ironically, have no interest in efficiency and increased productivity for fear each would reveal the GROSS inefficiencies which have kept them “in power” for so long.  It’s no secret Health Insurers want to maintain the status-quo otherwise a Multi-Billion Dollar Industry would not be operated via handwritten doctor notes and medical records.  So hcsm, no matter how it’s used, will organically negate the Health Insurers’ oil cartel-like business practices and then regardless of one’s perception of the power of hcsm, it could be that Game-Changer we’ve all been waiting for in our pursuit of Healthcare Reform.

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