Facebook + Physicians

By Jay Scrub

Your patients tweet from your waiting room. They describes their symptoms on Facebook. They ask about that 'funny rash' on Quora. They looked you up on LinkedIn.

Your patients are engaging in social media - are you?

Not just personally, but professionally - the expectations have changed. Medicine ultimately is a service industry, and like all service industries, the expectations of our customer, our patients, have changed. They are online and expect us to be as well. The question facing most practices is, to what degree? With practices stretched thin already managing work in the office, how can they devote resources to having an online presence?

These questions do not have simple answers, but like any medical problem you encounter, the first step is to gather more information. Think about your patient population - how active online are they in general? Clearly, there will be a big difference between a pediatrics practice and a geriatrics one. If your patient population is quite broad, another approach is to [drum roll] ask them! Many patients would be happy to let you know where they look for medical information and what ways they find convenient to communicate with your office.

As you have determine what your patients want, you also have to ask yourself how much are you willing to devote. In this day and age, being absent online is no longer an option. At a minimum, you should post basic information about your practice such as the address, telephone number, and office hours. I highly suggest that you have at least a static website that offers this information, and definitely make it accessible on sites that people use to find locations such as Google Maps, Bing Maps, and Yelp.

However, this post is about 'social' media, and static information is not very social. Look into creating a presence on Facebook and Twitter. You will have to judge whether you want these channels to be more one-way, with patients sending information to you, versus two-way with you or your office actively responding. You also have to judge how 'medical' you want your communications to be, keeping confidentiality and liability issues in mind. Avoid discussing specific medical issues in these forums. However, they function great for communicating general health tips, answering general health questions, and providing specific office information such as hour changes or new medication / treatment options available. Images showing when preventative care should be performed, or basic management algorithms, can be very helpful for patients. If you are particularly intrepid, ask a patient with a 'success' story if you can share their story on your social site. Draw your patients into the conversation with you.

Social media is an uncharted territory for most physicians so don't fear - explore! Learn what kinds of pages and accounts work best on these sites. Try different types of comments and posts. Including engaging content that your patients/fans would want to share with each other. In the social media world, something being 'viral' is a good thing! Help your users catch the bug! Chart your own course in the social media waters. Your patients will benefit and sing your praises - online and off.

About: Jay Scrub blogs at http://www.ScrubNotes.com, a site for physican trainees of all levels discussing topics for success in medicine.

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The 3rd Paradigm Shift In Medicine

By Robert Keller MD

We are in the 3rd paradigm shift in medicine.

The first evolution occurred during the American Civil War when medicine developed standards for surgical procedures. The second shift occured during the early 1900 with the introduction of pharmaceauticals and the start of internal medicine. Both of these practices were reactive based medicine; in other words, after the fact medicine. The United States became the center of reactive medicine by developing empirically based evidence to support the treatments. Still, the model was reactive. Thus, we became adroit at treating disease after it had declared itself with symptomatology. The twenty First century now enters the 3 medical revolution: proactive medicine. We now have the ability to develop protocols that predict disease very early in the disase state or more excitingly before the disease expresses itself. Treatments such as stem cells, DNA and protienomonics, advanced labs such as telomer testing, virtual angiograghy are just a few of the prospective ways to prevent disease.

Yet, a challenge remains. How do we as physicians shift to the proactive revolution when the third party carriers reimburse for reactive treatments? Therein lies the rub. It is my contention that a cash based model for paying physicians for proactive services will evolve until the insurance data tables reflex proactive medicine is less expensive that reactive treatments. As we all know, this will take years. So, my advice: begin to incorporate a cash based element into your daily practice. It's good "insurance".

About: Robert Keller, MD is a world renown physician who specializes in cash based proactive medicine.

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Working In Jeans: Life Replaces Career

It’s been more than three months since stepping down from ACPE.  Like many of the readers of this site, I’m in a transitional period.  After nearly four years of big responsibility - 24/7, 365 - the change to part-time work in health care has been wonderful!  Our lives, careers, events, and people are interconnected, but sometimes we have to make an effort to see those connections in hindsight.

I’m taking an Improv class now that I have more time.  After hearing that two of my role models for presentation skills attributed their success to Improv classes, I decided to try it.  Just as my friends told me the secret of Improv, I’ll share it with you.  Two or three words: “Yes.....And”, or “Always say Yes”.  

The point of Improv is to always keep the conversation going, and to link improbable thoughts.  All too often in business and health care, that doesn’t happen.  People frequently try to stop conversations and ideas from moving forward.  “That won’t work”.  “We tried that before.”  “There’s no money in the budget for that.”  Or my favorite: dead silence.  If we can laugh as hard in business as we do in our novice attempts at Improv when an idea moves through its zig zag path from the absurd to the sublime, we will be better off.  We’ll also provoke new ways of thinking or seeing something differently.

Like most of you, my life since finishing medical school has been pretty much pedal to the metal in private practice, management roles, and family responsibilities.  Mix in regular periodic sleep deprivation to the physician’s life of self and family sacrifice for patients and the expectations of our profession, and it becomes very difficult to step back and assess who we are, and how we want to live our lives.  It seemed like I always knew what my life was about, but seldom had the proper time and circumstances to reflect on the more existential questions.

I decided to continue doing health care related work no more than half-time after leaving  ACPE.  One part practical, another part passion for improving health care, the experiences from working at the bedside to the boardroom provide insight that I like to share with health system leaders - both clinical and non-clinical.  Now, as a free agent, I can be more provocative and take more risks in advocating for better leadership for health care.  For example, at the American College of Cardiology’s January leadership meeting in Las Vegas, the title of my topic was, “Venus and Mars: Why Can’t Hospital Administrators and Physicians Get Along?”  They chose the title, but I was excited about laying out the multiple reasons for conflict - and providing some ways to move beyond conflict to cooperation.  Judging by audience feedback, and the feeling of “flow” as I spoke, I hope to have more opportunities like that. 

Just before arriving in Las Vegas for the ACC meeting, I returned from my second visit to Saudi Arabia as an ACPE faculty member for a physician leadership development program at a major health system there.  The system’s determination to learn “American” principles of leadership, teamwork, and management was absolutely refreshing and motivating for me, and for Marty Martin, my fellow faculty member, and now frequent travel companion to the Middle East. 

In addition to being a witness to the profound changes happening in the world through international programs like this, I found myself enjoying even the unanticipated events associated with travel abroad: Missing a connecting flight in Amsterdam, and spending a night in that city; meeting Marty the next morning in the airline lounge for one of our usual discussions about insights into American health 

care (it feels like there’s ample time to listen when we’re far from home); and tagging along with Harry, the Dutch engineer with the gigantic handle bar mustache who was the only person in the Saudi customs lines that got smiles from the Saudi officials.  He sat next to Marty on the flight, and I’m sure our experience in customs would have been less cheery had Harry not given the impression that we were friends of his.

My attraction to international work continues.  I’ve also gotten involved in an interesting project based in China, with an American political connection.  Too early to tell if it will come to completion, I know it might never have come my way if I hadn’t traveled to China and Tibet in 2005.  On that trip I remember being drawn to the Tibetan symbol for interconnectedness, which was in all of the monasteries, including the Potala Palace, built in the 7th century, and home to several Dalai Lamas.  That symbol is prominently in my thoughts as I contemplate spending more time in the Himalaya doing something useful. 

Now the morning chill is gone, the snow is melting, and it’s time to resume my stonemasonry project that’s been on hold for too long.  Though my thoughts and activities are on a zig zag pattern, the stones are coming together in a beautiful, interconnected pattern that pleases my eye.

Floating Doctors + Humanitarian Medicine

The Floating Doctors Mission is to reduce the present and future burden of disease in the developing world, and to promote improvements in health care delivery worldwide.

• Providing free acute and preventative health care services and delivering donated medical supplies to isolated areas.
• Reducing child and maternal mortality through food safety/prenatal education, nutritional counseling and clean water solutions.
• Studying and documenting local systems of health care delivery and identifying what progress have been made, what challenges remain, and what solutions exist to improve health care delivery worldwide.
• Using the latest communications technologies to bring specialist medical knowledge to the developing world, and to share our experiences with the global community and promote cooperation in resolving world health care issues.

Sound like something that you might be intrested in helping out? (Freelance MD is already making a small monthly payment to help foot some of the bills.)

You can help Floating Doctors with a donation of any size.

Volunteer medical providers?

Doctors, nurses, PAs, NPs, dentists, optometrists, physiotherapists, occupational therapists, medical students, public health researchers, educators, engineers, and anyone with a pair of willing hands and the desire to help out in this world are welcome to participate in our project.

Everyone has some special talent or characteristic that can be used in the service of others. We pride ourselves on maximizing the experience of our volunteers to express their particular talent in a way that brings the most help to our patients.

We have no minimum or maximum length of stay and a reputation for working hard and being easy to work with. It is impossible to know exactly what kinds of cases we will see, or what situations we will encounter. All we know is that it will be an adventure of the heart—at some point, there will be a moment where your presence can mean a tremendous change in a person’s life.

Here is a typical experience for a volunteer…a surgeon from Austria vacationing in Panama decides to joining Floating Doctors for a one-day mobile clinic to a remote island indigenous village.

“Life is not about seeing what you want and how to get it but rather is about seeing what you have and how to give it.” Frank Baxter

Google +: A Refreshing Chapter In Social Media

While hesitant to try yet another Social Media platform, I have left thousands of Facebook fans behind for Google + (and so should you...)!

I know, I know, another social media platform is about all you need to read about these days. From Facebook to Twitter to Pinterest to Instagram to Foursquare, it always seems as if there is another "latest" and "greatest" social media platform to pay attention to. But, trust me when I say this, I think Google + is THE one to pay attention to. And here are some reasons why:

1) Google is the largest search engine on the planet: from a networking aspect, using Google + only helps your efforts. Google is putting a lot of time and energy into building Google + into the very best social media platform. As such, they are giving a lot of weight to Google + from an SEO perspective. If you are looking to help your brand (whatever that is) than jump on board to Google +.

2) Facebook is CLOSED, while Google + is OPEN: Yes, you can certainly have many different Facebook accounts and manage all of those pages, but why not choose Google + and have just one account. Google + allows you to post information and messages to certain circles or even make anything you want public.

3) Google + Circles make managing ALL of your friends, family, colleagues and associates super easy: just choose one circle or multiple circles for anyone, the choice is yours. By utilizing the Circles approach, managing any and all of your “audience” becomes super easy and intuitive.

4) Follow people, like Twitter, but have more options for connecting: Twitter is fine to catch quick tidbits here and there, but with the restricted 140 character limit, you certainly are limited in how you connect. Why not choose Google + and follow just like you do on Twitter but also have as much room and space to post, reply and share!

5) Google + is very visual: much of the information shared on Google + are photos and videos and this makes sense given how well we communicate with YouTube and even Pinterest. We all get the sense that the future of online interactions is through videos and Google + makes sharing videos back and forth a cinch.

6) Google Hangouts are great for quick (or long) video chats: want to have a weekly discussion group with your patients or host a cooking class, utilize Google + Hangouts and you will see how easy it is to connect with whoever you want to by video.

7) You are likely using something on Google, so.....: most of us have Gmail accounts, search the internet through Google, use YouTube or some other Google app on a daily basis. By having a Google + account, you can easily and seamlessly share information, message and broadcast anything on the internet in the simplest of ways. Google + is intuitive and to me feels so much better than Facebook or Twitter ever did.

There are plenty of other reasons to start a Google + account. From what I can gather by who is active on Google + right now, this is the social media platform of the future.

A personal request: I am trying to form a physician’s Google + Circle--one where we can share back and forth and communicate with each other on this platform. I would love it if you Followed me and let me know that you are interested in joining. I am hoping to use Google + to host physician Hangouts where we can get to know each other better.

If interested, check out my Google + page: https://plus.google.com/u/0/105805860750647129686/about/p/pub

I would love to hear your feedback and comments about how you are utilizing social media and what you think about Google +!

What is your favorite social media platform and why?

What challenges do you face utilizing the plethora of Social Media Platforms?

The Top 10 Reasons You Should Go To Medical School... And The Single Best Reason Not To

By Jeremy Weaver, Medical Student and Editor of Uncommon Student MD

Whether you're a first year medical student or a practicing physican, there's a good chance you've asked yourself the quesion, "WHY the @#$% DID I GO TO MEDICAL SCHOOL?" Here are a few EXCELLENT reasons... and one bad one.

Just as the blisses of Christmas break was ending for most of us tortured souls who fly the banner of "medical student," and sail these uncertain scholarly seas, Uncommon Student MD got some serious traction with medical students around the world. I believe timing had a large part to do with the explosion in its popularity. Simply put, after christmas break a lot of medical people were thinking, “what am I doing here?!” - A case of mass buyers remorse.

It is an understandable and laudable question to be sure. If we spent half the time wrestling with the question of what to do with our lives that we spend OMGing and LOLing on Facebook, we would probably all be Nobel laureates (at the very least we wouldn’t use retarded abbreviations as much). There are a lot of bad reasons to go into medicine and there are a lot of good reasons not too… Conversely there are also many great reasons TO pursue medicine as well as a lot of bad reasons not too. Confused? Me too, but I do know that there are two sides to every pancake (perhaps three if you screwed the recipe up).

F. Scott Fitzgerald once said that, “The test of a first-rate intelligence is the ability to hold two opposed ideas in the mind at the same time, and still retain the ability to function.” So, even though I happened to agree with a few salient points made in the aforementioned article, I am trying to follow the advice of good old F. Scott and entertain the flip side of the coin. Maybe incite some wrath while I’m at it… one can only hope.

I am not sure, but I am of the opinion that there are as many good reasons TO go to med school as there are NOT to go (we should do a prospective cohort study to find out). At the very least I know there ARE more reasons than the sole example our friend Dr. Ali Binazir espoused. And so without further hemming and hawing… The top 10 reasons you SHOULD go to medical and 1 reason you should RUN WHILE YOU STILL CAN… in no particular order.

1. You will have a HUGE range of options at the end of your medical education.

To me flexibility and possibility in a career are of FAR greater importance than money, girls, fame, cars, illicit drugs, horses, blue suede shoes, kittens, my high score on angry birds, tickle-me-Elmos, or just any other temptation under the sun. Medicine opens up a WORLD of...

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Who Is Your Ideal Client (and Why Should You Care?)

I’ve spent a lot of time over the past year trying to identify who my “Ideal Client” is. 

The ideal client is that person, or group of people, you are most likely and able to help with your business’s product or service.  It’s a marketing term.  Knowing who your ideal client is also helps you identify who you most enjoy working with.  It doesn’t make much sense to serve a particular group of people if you don’t really like working with them or having them as customers.

The exercises that have helped me hone in on my ideal client have also added much to my understanding of what I actually do in my business, how I do it and why I do it.  I learned these exercises from one of my mentors, the creator of Conscious Marketing, Lisa Cherney http://consciousmarketing.com.  The first sentence of her website reads, “We specialize in identify your passions and helping you articulate it through your marketing communications.”

It becomes much easier to create a marketing message when you figure out what you are really passionate about doing, whom it is that you are meant to do it for, and whom you most enjoy serving.

I’ve determined over the course of my career that I’m passionate about helping many people see their own potential for living life fully and on their own terms, and then helping them move in a positive direction to achieve that.  It's not hard to see how being an ER doctor wasn't completely fulfilling that vision for myself.

Fast forward to 2011 when I began my coaching practice.  I initially decided to offer my services to doctors, because I know how many doctors would benefit from what I offer and I know how powerful it can be for doctors to find their true path and get re-inspired.  Everyone wins when that happens.

But as I was doing my exercises and soul-searching to hone in on my ideal client, I wasn’t visualizing a doctor. In fact, my ideal client didn’t have one specific job, or a specific age range, gender or skin color.  They might be married or single, have pets or not, drive a sports car or a pickup truck.

After more than a year of ongoing work in this critical element of my business, I'm happy to say that I have finally been able to identify three characteristics that every single one of my ideal clients shares:

1. They are at a transition point in their life and are trying to figure out how to best go forward
2. They are ready to do things differently than they have before- they are open to a new way
3. They want to have a positive impact on the world

Many doctors fall into this category, but so do many writers, teachers, lawyers, artists, entrepreneurs, students, retirees, gardeners and coaches.  My ideal client is actually me, a few years back.  Not the “me” that was a doctor—the “me” that was a human being passionate about creating an amazing life of freedom, joy and abundance, and committed to serving humanity in a meaningful way.

The ideal client exercise is a great way to help you get clarity on who you are best able to and interested in serving.  Doctors should spend whatever time and money necessary to figure out who their ideal clients are.

If a doctor determines that they are especially passionate about working with people who share a certain set of characteristics (perhaps working with people trying to become more physically fit, or people trying to lose weight, or young parents) they can focus their marketing energy and dollars on reaching out to these groups and will ultimately develop a niche in that area. People will want to come to that doctor because the doctor wants to serve them. The doctor will surround themself with the people they most enjoy working with- a clear win-win.  It may not happen this way overnight, but it will happen if they're committed to it happening.

The ideal client exercise spreads out to other areas of life too.  As we start thinking about whom we most want to serve in our businesses, we can’t help but consider the characteristics and qualities of the people we want to spend time with in the rest of our lives.  We start to “weed out” those relationships that don’t add value and focus on surrounding ourselves with people of higher quality and substance with whom we are more aligned.

I hope this has stimulated some thoughts for you.  I would enjoy hearing from you about the ideal client concept and how you think it could apply to your life and career.

Wishing you health, happiness, peace and prosperity.