Social Media

Jeff Benabio, MD

In this presentation at Maui Derm 2015, Dr Benabio reviews some important issues around social media and medicine. Dr Benabio reminds us that there’s a general feeling of malaise among physicians. Why do we suppose there is such angst in healthcare? One reason to consider is that doctors are uncomfortable with the idea that they are being rated on the Internet.

There are several factors that have contributed to the changes we see in healthcare; these include the digitalization of healthcare, consumerism and healthcare reform. Social media is one of the main digital aspects of medicine. When we think about social media, try not to think just “FaceBook.” Social media a lot more—it is all of the tools that allow us to connect and share with other people.

It is important to remember is that it’s not just about the numbers. What we need to understand is why the numbers [of views/hits] can be so astronomically high and why that can be important in healthcare. The numbers are high because a. the information has essentially become free; b. we are wired to connect; and c. smartphones are ubiquitous. When we put all of this together, we see very different behaviors. We can see this in business and in healthcare. Consumers/Patients are acting differently because information is free and everyone can connect to everyone.

Economists have discussed the idea that we are reaching a state whereby consumers, i.e., patients have what’s referred to as “perfect information.” Patients now have almost “perfect information” about their disease, their hospital, their health plan, their doctor, etc. They can choose what they do about it. For us, as healthcare providers, we need to understand that this is where our patients are going to get their information. We need to know the information that’s out there, particularly the information about our practices and ourselves.

There are whole fields of study around what’s called ‘behavioral economics.’ Studies are looking at how consumers behave in certain situations. This is the same thing in healthcare, i.e., how patients behave when they have information that they didn’t have before. Consumers used to choose products based on a. prior information; b. other opinions; and c. marketing. Today, things are fundamentally different. Prior experience is no longer perfect; in fact, consumers are nowhere near as loyal to brands as they used to be. Your prior experience is not nearly as informative as other people’s opinions. We can begin to question whether we know what’s right or whether the crowd knows what’s right. We, as consumers, truly believe that other people have good information. Marketing, today, is much easier to ignore.

If we consider healthcare, a recent study showed that 62% of consumers/patients have used online reviews to learn about doctors and this number is continuing to grow. There are websites, such as healthgrades, that provide very good information. The whole purpose of healthgrades is to provide accurate information to consumers about their healthcare choices. Healthgrades retrieves their information from quality metrics and national service metrics. In a few years, your data may be publicly reported as they are already doing that now with hospitals and consumers love it.

While consumers like healthgrades, they trust Yelp more than any other review site. As physicians, that may be a hard pill to swallow. Consumers use Yelp for other decisions with very good accuracy. A 2014 paper by Hanauer and colleagues surveyed patients regarding physician-rating sites. They found that 40% of patients say online reviews are very important and 35% of patients selected a physician based on a positive review. Additionally, 37% of patients avoided a physician with negative reviews.

Doctors are very concerned with how these reviews are filtered. Do you have to pay for advertising in order to obtain positive reviews? Dr Benabio has done some research on this question. A recent study, using regression analyses, looked at correlations between whether physicians had paid for advertising or not and whether that had any impact on if Yelp filtered the review. It turns out that the factors that were significant were having either a one-star or five-star review. Whether or not you were a Yelp advertiser or not did not make a difference.

For the most part, our patients love us. The average score for a doctor is 9.3 out of 10. Patients are interested in wait times, billing/payment, staff friendliness, ease of scheduling, and office environment/cleanliness.

Consumers of all types use Google. Eighty-six percent of patients Google their symptoms before they see a doctor. Google is running “pilot” physician consultations with patients when they search for healthcare-related topics. Consumers are realizing that they can get point-of-question care live from platforms like Google. HealthTap is another site that is aggressively recruiting physicians to participate in point-of-question care. HealthTap is connecting these questions with patients to enable them to do live video visits with a doctor. Doctors are now doing house calls again…they are meeting patients wherever they are. This is a normal expectation for consumers.

Another site, Iodine, allows patients to input their medications and then provides them with perfect information from other patients’ ratings on that prescription/product. Real Self is a similar platform for cosmetics. Today’s patients want transparency. A Deloitte study found three out of four consumers believe providers should publish quality of care information on the Internet. Two out of three patients believe that providers should publish their prices online.

Other Social Media Sites

Twitter is technically a microblog. It’s a way to say “what are you doing?” It’s a powerful tool to share information and report news. About one in four physicians use social media daily, mostly for keeping up with healthcare news. Plastic surgeons tend to lead with 50% of them using Twitter. Virtually all surveys of physicians who use social media say that it has a positive effect, i.e., it increases patient engagement, improves care delivery and patients are more satisfied. Doctors also feel more connected to patients and peers and it is a great tool for education.

Doximity is a social networking site for doctors. It allows you to take topics from a journal and engage in a conversation with your colleagues. Doximity also has very interesting crowd-source data.

What about Instagram? Instagram is a photo application that tends to be very much in the moment. There are 150 million active users and it’s the most popular social media site for teenagers.

How does social media affect healthcare usage? The American Academy of Facial Plastic and Reconstructive Surgery conducted a poll and found that one in three respondents in a survey pool of 2700 of its members said that they had seen an increase of procedure requests as a result of patients’ social media awareness.

In the last few years, FaceBook has gone public and as a result, they are now filtering posts. This is trying to drive you towards paying for advertising. As it turns out, people respond better to ads than they do random posts.

Summary

In conclusion, we need to recognize that the future of dermatology and healthcare is digital. As physicians, we needn’t use all of the existing social media sites but we must understand social media as it is changing what it means to be a patient. Sincerity and commitment to our patients is “always in.”

 

MauiDerm News Editor-Judy L. Seraphine, MSc