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Ignoring social media is no longer possible if your practice wants to reach patients where they are.
Despite the explosion of social media over the past several years, most physicians have avoided using these channels to interact with patients. But pioneers say social media platforms such as Facebook, Twitter and blogs have helped them improve patient relationships and build their practices. Moreover, some observers say that practices that continue to eschew social media will pay a price down the line.
Jeffrey Livingston, MD, an OB/GYN in Irving, Texas, says his practice, MacArthur
Ob/Gyn, has been using Facebook and other social media for nearly a decade. This activity has helped attract new patients to the practice, he says.
“When we started this, we were a four-doctor group,” he notes. “Now we’re an 18-provider multispecialty group. I can’t say that it’s 100% because of our Internet strategy, but there is a correlation there.”
Medhavi Jogi, MD, an endocrinologist in Houston, Texas, says his six-doctor group also has benefited financially from its Facebook page. The practice’s website has a section where new patients must go to enroll and fill out forms, he explains. Using web analytics, he determined that Facebook had generated about 20% of the clicks in the new patient section.
Internist Kevin Pho, MD, coauthor of a book on social media in healthcare, also cites the practice-building potential of Facebook. “Facebook is a very shareable platform,” he says. “So if a particular story or picture on Facebook resonates with a particular patient, that patient may share it with his or her network. When that happens, it’s going to propagate word of mouth about that particular physician.”
Creating an online presence
In the short run, Pho says, the most compelling reason for physicians to get into social media is to counter misinformation on the web about them and their practices. All it takes to establish an online presence, he says, is to create a profile on a site like
LinkedIn or Doximity. That profile will likely show up higher on Google rankings than the physician’s review on HealthGrades or other rating sites, Pho says. That’s because sites such as LinkedIn, for example, are older and more authoritative in the eyes of Google.
Later, the physician might create a professional page on Facebook or Twitter, or might start writing a blog, he says. Engaging in multiple social media platforms enhances a doctor’s online presence and gives him or her more control over how they appear on the web.
Livingston agrees. “I always tell doctors, ‘You have an online reputation right now. And if you don’t know that, Google yourself. If you’re not engaging in social media, your online reputation is being created for you and about you without your participation. So I highly advise physicians to get involved in social media to help shape who they are online.”
Jogi says one goal of using Facebook and Twitter is to elevate his practice’s profile above the ratings sites on Google. But a Google search shows the practice’s website ranks first, followed by Yelp and Healthgrades reviews, and then its Facebook page.
In contrast, MacArthur Ob/Gyn’s Facebook page ranks higher than the review sites. To the extent that Google rankings are based on hits and links to a website, this contrast seems to indicate that more people are visiting and linking to MacArthur’s Facebook page than Jogi’s.
People looking for a physician may use Facebook as a research tool, notes Thomas Felch, MBA, a senior manager at ECG Management Consultants. If a doctor or a practice creates a positive impression on Facebook or other social media, that can be an advantage in wooing these patients.
But doctors can also generate a negative image by posting or tweeting something inappropriate-and that impression will linger on the web for a long time.
“Doctors need to be as professional on the web and on social media as they are in a room face to face with a patient,” Pho says. “Anything they post online needs to be as appropriate as if they were to say it out loud in a crowded hospital elevator. Doctors need to take that extra second before they hit ‘enter.’”
How to use facebook
To avoid any confusion between professional and personal uses of Facebook, physicians should have separate Facebook pages for each kind of activity, says Pho. Doctors should open their personal pages only to friends and family members. Moreover, physicians should not friend patients, even if they request it, Livingston says. In his experience, patients usually are not offended if you ignore their friend requests.
A physician can have his or her own professional page. But in most cases, when practices set up a Facebook page, that’s what their doctors will use, Pho says.
Jogi started a “fan” page on Facebook for his practice, a type of page that many other businesses use. Only the fan page’s sponsor can post content, although patients can comment on it and can “like” the page.
Pho recommends strongly that physicians not answer any personal medical questions on Facebook or any other social media platform. “Social media is a great way to educate many patients, but not to answer individual patient questions,” he says. He advises practices to create a standardized message telling patients who have medical questions to call 911, make an appointment with the office or send a secure message to a patient portal.
MacArthur Ob/Gyn warns patients not to post information about their medical conditions and is always on guard against it. The practice uses a Facebook app that allows Livingston and another staff member to see comments before they’re posted and weed out any inappropriate material.
While these precautions are warranted, Livingston says, patients rarely share information about their own medical conditions, partly because they know it will go into their public Facebook feed. “It’s an issue that creates fear among doctors and prevents them from engaging in social media, when in reality, it’s a rare issue,” he notes.
Education and blogging
Patients want access to valid information, Livingston says, and doctors can provide that.
Livingston says he realized the value of using social media for patient education many years ago, when he gave a lecture to high school students about teen pregnancy and sexually transmitted diseases. The night before the talk, his then-15-year-old daughter told him that if he really wanted to reach teens, he should go on MySpace. (This was before Facebook.) She helped him create a MySpace page, and he mentioned it in his talk. When he got home, he found numerous messages on the site from students who had attended his lecture.
Today, the McArthur Ob/Gyn Facebook page delivers educational messages in a fairly subtle way. It features videos, for example, about how men perceive their wives’ pregnancies, the story of one woman’s pregnancy, and caring for infants. It also posted a quiz related to the National Day to Prevent Teen Pregnancy.
The Facebook page of Jogi’s practice, Houston Thyroid & Endocrine Specialists, presents mainly two kinds of educational materials: links to newspaper articles and to posts on other sites about healthy lifestyles, disease symptoms, and medical news, and short explanations of various endocrine/thyroid disorders.
In addition to posting educational content on Facebook, a doctor can create a blog. Pho suggests housing that blog on the practice website, rather than Facebook, to retain control of the content as well as the blog’s look and feel. Then the physician can link to the blog from Facebook, Twitter and other platforms to increase the blog’s reach.
MacArthur Ob/Gyn has a blog on its practice website, linked to Facebook, and some of the physicians take turns posting on it, Livingston says. Where appropriate, the blog content is repurposed as additions to the educational section of the website. “One person can’t do it by themselves, but 18 of us can do a lot to create good, original content on our website,” he notes.
Nathan Pennell, MD, PhD, a lung cancer specialist at Cleveland Clinic, posts regularly on his blog that is housed on ASCO Connection, a professional site for oncologists that can be accessed by non-physicians. Some of his articles have been reposted by USA Today and other publications.
Pennell credits these blogs with helping to build his reputation among both fellow oncologists and patients.
Derek Kosiorek, CPEHR, CPHIT, a principal with the Medical Group Management Association Healthcare Consulting Group, says that blogging is “a great free way to establish credibility. But it’s a pain in the butt to keep posting.” To be current, he says, you have to blog at least twice a month.
Humanizing the practice
From a patient relations standpoint, the biggest opportunity in social media is to humanize a practice. “When a patient looks up their doctor or knows their doctor on a professional level, it can often be a fairly cold relationship,” Pho observes. “They don’t know much about him or her from a human side. And one of the strengths of social media is to humanize the physician.”
MacArthur Ob/Gyn’s Facebook page is designed to stimulate human interest, with features ranging from photos of staff and doctors to humorous posts. “Some of our practice’s Facebook posts are fun and funny, designed to make people smile or laugh,” Livingston says. “Others are personal, like getting to know the doctors better. And we try to sneak in education. Because if we can educate a patient on a health need accidentally, that makes taking care of them easier and more effective.”
Interaction with patients is key. Although practices should discourage patients from posting comments about their own medical conditions, patients can appropriately comment on the practice or the doctors and ask questions about practice services.
“If it’s just a loudspeaker of ‘here’s what we’re doing,’ nobody’s going to pay attention,” notes Jogi. “The more controversial things that are posted, within reason, the better. The more you allow patients to interact, the better. It takes more time, but it’s worth it in terms of engaging patients and making people realize you’re paying attention.”
Both Jogi and Livingston occasionally get critical comments such as, “your office manager is horrible” or “I had to wait a long time to see the doctor.” That kind of feedback is valuable, Livingston says, and it may prompt improvements in the practice.
Marketing the practice
Many large healthcare organizations use social media mainly for marketing, Felch points out. Independent practices, which usually don’t have a dedicated marketing staff, can use social media to “fill gaps” in marketing, he adds.
For example, Felch notes, if a practice doesn’t have a marketing firm to run major campaigns, Facebook and other social media platforms provide an interactive environment for potential and existing patients to learn more about its services and people.
Similarly, Kosiorek says, “Most people view it as a marketing tool. They want patients to like or become fans of the practice.”
In Livingston’s view, however, the marketing aspect of social media is “accidental and secondary. I see so many groups now using Facebook and other social networks as practice marketing tools. It’s inauthentic. Your underlying tool should be to engage with your patients and build trust, and do that in a way that’s fun, entertaining and educational. Then let the marketing happen naturally.”
Flavors of social media
While there are many social media platforms, Kosiorek thinks Facebook is the only one worth paying attention to. “For the vast majority of physicians, Twitter is a colossal waste of time,” he says. “For anyone who doesn’t have a lot of followers, you send tweets into the ether and then they’re gone. I don’t think any kind of social media other than Facebook is useful for physician practices.”
Felch disagrees. Noting that social media platforms have different strengths and weaknesses, he says practices should decide which social media will serve their purposes and what they have the resources for. For example, he says, Facebook is effective for general information, opinion sharing and promotional campaigns. For promotions, Twitter can also be effective.
“But if I want a patient to see that the practice is promoting healthy lifestyles, and I want to explain how patients would do that, that might be a 90-second YouTube video, which you can’t throw out in a 140 character tweet,” he says.
Jogi follows certain people on Twitter for his own education and to keep up with trends in his field. In addition, he has an application that lets him post identical messages on multiple social media platforms, including Facebook, Twitter, Google Plus and LinkedIn. The messages include links to his blog, random observations, and things he’s read on various platforms that he wants to share. A number of his patients follow him on Twitter, he adds.
Pennell uses Twitter both to follow medical conferences around the world and to tweet on professional topics. Some of his patients-especially younger ones-follow him on Twitter and comment on his blog posts both there and on Facebook. Some of his posts have prompted patients to enroll in clinical trials and to seek care from him, he says.
Livingston and his colleagues are starting to focus on Instagram and Pinterest because they attract a younger demographic than Facebook or Twitter. Livingston’s interest in Pinterest faded soon after he created a page and realized he didn’t have the foggiest idea what the site was about. But one of his colleagues was a Pinterest fan and now carries the practice’s banner on the platform.
Instagram is growing quickly, Livingston notes, and its appeal to young women in particular is perfect for an OB/GYN practice. “It’s a platform that in the next six months we plan to really grow on,” he says.
Don’t get left behind
Although doctors’ use of social media is growing slowly, many experts predict it will eventually become mainstream because most patients use it. Doctors who ignore social media may find that it will hurt their practices in the long run.
This is especially true for practices that want to attract millennials and the families they’re now starting, says Felch. Many of these people will notice physicians who promote what they do on social media. “They’re going to pass right by Dr. Jones, a dermatologist who has been in practice for 30 years, and they’re going to go down the road to another clinic that has an online presence.”
Moreover, Felch adds, that clinic might well belong to a hospital system that devotes considerable attention and resources to social media. So getting onto Facebook and other social media is critical for independent practices that want to stay in business.
As mentioned earlier, physicians should never have professional interactions with patients on social media. But these platforms can help doctors engage patients in ways they could never do in brief office visits, Livingston says.
“Patient engagement is bigger than just connecting through likes and comments,” Livingston observes. “It’s about relationship building. The fundamental nature of a doctor-patient relationship is trust. So however we can build trust, we should do that. And social media is one more tool to do that.”