AMA Policy: Medical Professionalism & Social Media

Facebook, Twitter, LinkedIn, Blogging & Physicians

A new policy on professionalism in the use of social media was adopted at the November 8th 2010 meeting of the American Medical Association. These basic guidelines represent one of the first steps by a major American physician organization to offer guidance in the appropriate use of social/new media.

It's pretty generic and basic stuff but it does recognize that Facebook, Twitter, LinkedIn, blogs and other social networks are destined to become intimately intertwined with medicine.

The Internet has created the ability for medical students and physicians to communicate and share information quickly and to reach millions of people easily.  Participating in social networking and other similar Internet opportunities can support physicians’ personal expression, enable individual physicians to have a professional presence online, foster collegiality and camaraderie within the profession, provide opportunity to widely disseminate public health messages and other health communication.  Social networks, blogs, and other forms of communication online also create new challenges to the patient-physician relationship.  Physicians should weigh a number of considerations when maintaining a presence online:

(a)  Physicians should be cognizant of standards of patient privacy and confidentiality that must be maintained in all environments, including online, and must refrain from posting identifiable patient information online.

(b)  When using the Internet for social networking, physicians should use privacy settings to safeguard personal information and content to the extent possible, but should realize that privacy settings are not absolute and that once on the Internet, content is likely there permanently.  Thus, physicians should routinely monitor their own Internet presence to ensure that the personal and professional information on their own sites and, to the extent possible, content posted about them by others, is accurate and appropriate.

(c)  If they interact with patients on the Internet, physicians must maintain appropriate boundaries of the patient-physician relationship in accordance with professional ethical guidelines just, as they would in any other context.

(d)  To maintain appropriate professional boundaries physicians should consider separating personal and professional content online.

(e)  When physicians see content posted by colleagues that appears unprofessional they have a responsibility to bring that content to the attention of the individual, so that he or she can remove it and/or take other appropriate actions.  If the behavior significantly violates professional norms and the individual does not take appropriate action to resolve the situation, the physician should report the matter to appropriate authorities.

(f)  Physicians must recognize that actions online and content posted may negatively affect their reputations among patients and colleagues, may have consequences for their medical careers (particularly for physicians-in-training and medical students), and can undermine public trust in the medical profession.

Of course, Freelance MD is all over social media. Here's just a few of the places that you can 'like' or join other physicians who want intellilgent information.

• Like Freelance MD on Facebook
• Join Freelance MD on LinkedIn
• Follow us on Twitter
• Get Freelance MD post emailed directly to your inbox

Doctors Are Terrible At Business?

You've heard it over and over again..."Doctors are terrible business people". I disagree.

Firstly, what do people mean when they say "businesspeople"? My definition is someone who runs a business and can sustain it profitably. Most docs I know who run their own practices (admittedly fewer and fewer as more gravitate to employed positions) do an admirable job keeping all the balls in the air, with minimal training, and seem to take home a paycheck every month.

Second, in addition to how successful physicians are as self-employed owners, the term "business person" also applies to physicians as entrepreneurs, leaders, and investors. Again, while lots of us suffered from the recent economic downturn with a hit to our pensions plans and investments, I haven't seen any evidence that docs did any worse than anyone else.

Finallly, there is considerable overlap between business skills and clinical skills-data acquisition and analysis, risk assessment, problem solving, interpersonal skills, accumulating "clinical judgement" i.e. learning from your mistakes, and lots of others. Docs inherently have business heads that overlap with their clinical heads.

People think doctors are lousy business people because practitioners place patient interests above the bottom line. The result is delivering services that don't generate a profit or inefficiencies in practice management. As more and more doctors pursue non-clinical interests, some for a profit, the unintended consequence and the good news will be a recognition of how good physicians actually are at business when that's the first priority. Unfortunately, it's also the bad news if you are looking for someone to manage your diabetes.

Creating A Medical Application For The iPhone

Medical applications for the iPhone.

I recently received an email from a doctor in India who wanted some advice about a medical iPhone app he created. I encouraged him to post the idea on the linkedin site for the Society of Physician Entrepreneurs and harvest the "wisdom of the masses". Shortly thereafter, he posted a beta version of the app, a clinical simulation tool similar to case of the week, and asked users to provide feedback. A few weeks later, another email relayed that "My iPhone application has been a smashing success - I've had close upon 7000 downloads so far and it is the 7th most popular medical application in the United States". In addition, he was chosen to present his startup idea to the Mumbai Seedcamp at http://seedcamp.com/pages/mumbai10

Here's a useful article about how to get your iPhone app approved and how to make money from the idea. This is yet another example of the Long Tail theory and how you can benefit.

5 Reasons For Physicians To Start An Online Business

Can you build an online business outside your medical career? An unequivocal YES!

When I started my business that originated from a hobby several years ago, I was only able to work on my internet business from 5am – 7:30am. Why those hours? The reason being, that was the only time period I had available outside of my clinical hours. Building a business these days is different from how it used to be. Today businesses can be built virtually with little overhead. Here are five reasons why you need to be starting an online business today.

1. An online business is inexpensive to startup. This isn’t the case with most medical practices. You can start a business with the price of a domain name (around $10 from Godaddy.com) and monthly hosting (such as from Hostgator.com). I have personally built businesses for the price of a cost of a good dinner for two.

2. An online business can be run from nearly anywhere. I have run a business from sitting at the back of a Starbucks, to flying at 30,000 feet with airplane wi-fi, to sitting on the beaches in Australia. Wherever you can bring a laptop and a decent internet connection, you can run the day-to-day your company – what other type of business can you say that about?

3. An online business can be outsourced. I have a physical office with less than 10 employees for my software company, however I also hire workers as independent contractors from around the world. I have writers who are based in the United Kingdom, programmers in Eastern Europe, and web designers in the Philippines. They all do quality work but they don’t need to be in my office for me to maintain it. You can work with independent contractors with sites such as elance.com or odesk.com  (For more resources check out my blog at IncomeMD.com)

4. An online business can start out small. Great websites start from simple ideas. Who would have thought businesses would have started from sending DVDs by mail (Netflix), project planning software (Basecamp), and coupons for local businesses (Groupon)? However, don’t feel you have to have a killer idea to start a sustainable business. Can you improve on an existing idea that will save people time and money?  If so you have the foundation for a successful business.

5. An online business can be scalable. Once you have an offer that works, you can grow your business in a systematic, simple approach. Most initial methods to market your practice can be done free or inexpensively, so there are fewer startup costs compared to a franchise or brick and motor company, and then you can reinvest your profits back in your business.  Unlike most practices, you no longer have to be the sole breadearner for your business. Hopefully this article sparks your imagination - I'd love to hear your ideas!

Physicians' Role in Medical Device Development

Just came across this lecture by Dr. Paul Yock of Stanford. In this particular clip, Dr. Yock discusses the role of clinical physicians in the development of new medical devices.  

Physicians can be active participants in the development of medical devices if they know how best to use their knowledge and skills. We'll be exploring this topic in depth on FreelanceMD...stay tuned!

ER Doctor Feels "Used"

Emergency Medicine in the United States is at a breaking point.

Emergency Medicine News published an editorial  recently by Dr. Edwin Leap, an Emergency Physician living in South Carolina. Dr. Leap writes an article that could have been written by any person working in any of the many Emergency Departments in the United States. You can read the full article here .

In the article Dr. Leap discusses how those in Emergency Medicine are manipulated and used by "evil" people who work the system in an attempt to get free housing, free food, and/or narcotics. He also discusses how the government and other groups in medicine abuse the Emergency Department, using it as a means of working up patients to be admitted or as a place to initiate the latest bureaucratic policy.

Emergency Departments around the country are overrun by patients and understaffed. Doctors and nurses working in our nation's Emergency Departments are expected to save the lives of critically ill patients while soothing the egos of the unsick waiting in line for a bed. Patient outcomes have been replaced by satisfaction scores as the means of evaluating caregivers, and good men and women are being driven out of the specialty by burnout, injury, lack of appreciation, and abuse (both verbal and physical).

I appreciate Dr. Leap's honesty and hope that policy makers are listening. For those unsung heroes slogging it out in our nation's Emergency Departments, thanks for your efforts.

Are You An Entrepreneur?

I read a great post recently by Anthony Tjan entitled Entrepreneurial DNA: Do You Have It? on the Harvard Business blog.

In the article, Mr. Tjan argues that entrepreneurs have a distinct profile that is obvious to those familiar with it.  He says,

"Entrepreneurs hold an idealism and risk profile that makes them fundamentally different. They don't think about security--in fact they are often uncomfortable with it. And they have the guts to bet it over and over again. They think less about what they lack and more about what they can achieve with what they have. In a sea of ambiguity, they forge ahead with an incredible fortitude."

It's an interesting read and good food for thought for any physician considering entrepreneurship as a career.