Social Media and Patient Education

I came across this interesting ABC News article on how patients are using social media (Social Media and Medicine: Sufferers Gather Together Online), and it really hit home for me.

Increasingly, social media is bringing patients together to exchange information, to provide support, to find solutions. However, over the past few months, I've had many conversations with surgeons and practices that aren't quite ready to embrace social media. Most understand the role that social media is playing in the patient community, but many healthcare providers are happy to leave it at that and not get involved. I can make many arguments about the benefits that social media can bring to a practice. Regardless, some surgeons are wary of having patients post on their Facebook walls, lest the comments be unflattering or inaccurate.  Many practices don't yet understand that social media can establish immediate provider-patient connections - intimate connections that breed patient confidence and satisfaction.

However, the ABC News article referenced earlier touches on one very compelling argument that focuses not on the benefits to the practice, rather on the benefits to the patient community. Unfortunately,  online patient communities can sometimes become a mess of misinformation. What surgeon hasn't had a patient walk into their clinic and ask for a certain procedure because the internet told them it was exactly what they needed? Now is the perfect time for reputable practices to get involved in social media and encourage the dissemination of accurate information. Not only is establishing a social media presence an opportunity to promote one's practice and establish great relationships with the patient community, but it is also an opportunity to do the right thing.

The value of a positive patient experience

A surgeon with whom I've worked for years (a mentor and good friend of mine) has a strong opinion on the matter of creating a positive patient experience. In his eyes, the role of a surgeon is to give patients the best medical treatment possible. Practice "amenities" are irrelevant - he is running a medical practice, not a spa. If a patient receives top-notch medical care and sees a significant improvement in his or her symptoms, that is the only "patient experience" that matters. I'm sure, to some degree, we all agree with this perspective.

However, research shows that a patient's satisfaction hinges on more than just clinical outcomes. A 2007 survey found that 41% of patients would consider switching hospitals for a better patient experience (“A Better Hospital Experience,” McKinsey Quarterly, November 2007). Patients aren't content unless their psychological needs are met along with their physical needs.

Moreover, to be blunt, surgeons aren't known for their high patient satisfaction marks. According to a 2010 Press Ganey survey of more than 3 million patients, neither orthopedic nor neurosurgical practices are among the top 10 medical practice specialties for patient satisfaction (see below). 

The Top 10 Rankings of Medical Practice Specialties for Patient Satisfaction
1. Medical Oncology  
2. Gynecological Oncology 
3. Interventional Cardiology 
4. Cardiovascular Disease 
5. Optometry 
6. Hematology 
7. Geriatric Internal Medicine 
8. Gynecology  
9. Nephrology 
10. Family Medicine

Patient satisfaction is important for a number of reasons. Happy patients drive referrals. Then, of course, there's the issue of malpractice claims. And lastly, we have to consider the possibility that patient satisfaction will, at some point, factor into reporting and pay-for-performance programs.

Tips and tricks for improving the patient experience are a dime a dozen - just Google it. You can go broke implementing all the changes the World Wide Web suggests. Improve facilities. Improve communication. Improve patient education. Hire a masseuse. Hire a counselor. Hire Mickey Mouse. See chronic patients more frequently. See chronic patients LESS frequently.

However, I argue that you can't set out to solve a problem without understanding the problem itself. The demographics of your patient population may differ greatly from that of the practice next door. Not every patient wants the same thing out of their surgical care and their relationship with their surgeon. I execute exhaustive market research, including patient surveys, for all my clients prior to spending a dime on new initiatives - and I recommend the same approach for any surgeon looking to improve the patient experience at his or her practice.

When it comes to the patient experience, work to truly understand your patients; ask their preferences and THEN work to accommodate them.

What they don't know can hurt you

In a recent discussion with a potential client, the need to educate local primary care physicians was a point of some contention. While I argue that it is of huge importance (indeed, one of the foundations on which my business is built), this particular orthopedic surgeon disagreed. He told me, "The less educated the better. I don't want family practitioners screening my patients. Send them all to me." In theory, this perspective makes sense. A patient presents with back pain, send 'em on to the orthopedic surgeon.

In practice, however, it's not quite so cut and dry.  In a 2009 study presented at the American Society of Plastic Surgeons Annual Meeting, researchers found that there is a great deal of variance among primary care physicians when it comes to their opinions on which specialists are best-suited to treat certain conditions. (A summary can be found here; please note that you may be required to complete a free registration for Medscape to view the article.)

While the referenced article focuses on plastic surgery, this translates to confusion about all referrals. Which patients to refer, to whom, and when? In reality, the scenario above in which a patient presents with back pain may play out differently for 10 different PCP's. Yes, one of the ten may go ahead and refer the patient to an orthopedic surgeon. Another may recommend a couple Advil and 6 weeks of rest. Yet another may refer to PT, or a chiropractor, or a neurosurgeon, get the point.

Anne Taylor, MD, professor of plastic surgery at the Ohio State University in Columbus, summed it up perfectly when she said of the study, "We need to get back to the hospitals and to educate our colleagues, starting with primary care physicians. They really are the gatekeepers."