There's a stereotype that says doctors shun technology that might threaten patients' privacy and their own pocketbooks. But a new breed of physicians is texting health messages to patients, tracking disease trends on Twitter, identifying medical problems on Facebook pages and communicating with patients through email.
So far, those numbers are small. Many doctors still cling to pen and paper, and are most comfortable using e-technology to communicate with each other -- not with patients. But from the nation's top public health agency, to medical clinics in the heartland, some physicians realize patients want more than a 15-minute office visit and callback at the end of the day.
Kansas City pediatrician Natasha Burgert offers child-rearing tips on her blog, Facebook and Twitter pages, and answers patients' questions by email and text messages.
"These tools are embedded in my work day," Burgert said. "This is something I do in between checkups. It's much easier for me to shoot you an email and show you a blog post than it is to phone you back. That's what old-school physicians are going to be doing, spending an hour at the end of the day" returning patients' phone calls, she said.
She recently received a typical email -- from a mother wondering how to wean her 2-year-old from a pacifier. With a few thumb clicks, Burgert sent the mom a link to a blog post offering tips on that same topic.
Burgert, 36, doesn't charge for virtual communication, although some doctors do. She says it enhances but doesn't replace office visits or other personal contact with patients.
Dr. Steven Nissen is from an older generation, but has started to dabble in e-technology. A cardiologist at the Cleveland Clinic, Nissen is in his 60s and says he's hardly a member of "the Twitterati."
But with help from clinic staffers, he recently led a live Twitter chat about things like heart failure and cholesterol problems, and found the process "in some ways maybe a little exhilarating."
"This was an opportunity to use a different communication channel to find an audience to talk about heart health," Nissen said.
"The downside is that we dumb it down," he said. "It's very challenging for physicians, primarily because the messages that we have are not conducive to 14 characters. If you ask me a question, you're likely to get a five-minute answer."
But with so many young people facing obesity, which can contribute to heart problems, Nissen said Twitter can be an effective way to reach an important audience, and he plans to use it more.
The American Medical Association acknowledges benefits in using social media, but also warns doctors to protect patient privacy and "maintain appropriate boundaries" with patients.
Hard numbers are scarce on exactly how many of the nation's nearly 1 million doctors use virtual communication for patient care, but anecdotal evidence suggests the numbers are rising.
A survey last summer of 501 randomly selected doctors found that more than 20 percent engaged in emails with patients over secure networks, and similar numbers had websites allowing patients to schedule visits or download test results. Only 6 percent communicated with patients through social media; that translates to about 60,000 doctors nationwide.
A study published online in March found that 60 percent of state public health departments use Twitter or another social media site, mostly to distribute information rather than interact with patients.
The federal Centers for Disease Control and Prevention spreads its public health messages by Facebook, Twitter, YouTube and text-messaging. CDC scientists also monitor social media sites including Twitter for disease surveillance.
The famed Mayo Clinic holds "Tweet camps" to train its doctors how to use Twitter appropriately, said Lee Aase, director of Mayo's Center for Social Media in Rochester, Minn.
Says Aase, "If we can trust doctors with sharp instruments and narcotics, we can trust them with Twitter and Facebook."
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