Indiana AFP 2011 Wrap-up

Even though I got here 36 hours ago, it's time to head on home. I guess that's the life on the big time lecture circuit (hehe). I wanted to write this blog post before I left the grounds. With the 9 hour drive home, I'd forget everything I was going to write. One of the things I wish is that I had more time to explore the grounds here at the French Lick hotel and conference center. This is a beautiful facility that is kind of a resort area. Plus, it would be really cool to play a round of golf here - although not today, since it's again forecast to be around 100F with the humidity today.

Thanks again to the Indiana Academy of Family Physicians for the invitation to speak at the annual convention. I'm a little biased, but I think things went well with my two back-to-back talks yesterday. The topic was, of course, Family Medicine & Social Media. If you already haven't, I encourage you to check out my post from yesterday. Both of the talks were full, and there was very good discussion during the sessions. One of the questions that came up was about a social media policy for an office, a clinic, or hospital. I think I'll write a blog post about to follow-up on those questions.

Yesterday's talk was a kind of prep for the biggest lecture opportunity of my short presentation career - namely the American Academy of Family Physicians Annual Scientific Assembly in Orlando in September. Maybe I'm a little too hard on myself, but I think that the presentations could have gone a little smoother. And, if I'm able to, maybe change a few slides before Orlando. In addition, I did video record the talks, and, hopefully, I'll be able to post them up for you to check out.

The rest of the meeting was really fun. I learned a lot during the education sessions. I was also able to tweet out during the meeting. Hopefully, it's still there when you read this. But, you can check out the results of the meeting at the hashtag #IAFPac. Thanks to @QuiltingDoctor and to @MissyCLewis for tweeting out during the meeting. Congrats to @DeDe_Willis for being installed as the new President of the Indiana AFP. I also posted some stuff to my facebook page and to the academy facebook page.

Even though I love social media, there really isn't anything like catching up with old friends and meeting new people - In person. I don't know if it's good or bad that I have been involved with the academy for a long time, but you have long time acquaintances and friends that you're able to catch up with at meetings like this. In addition, I had the opportunity to tap the wisdom of some leaders and mentors that I have had in the past - to talk about some life coaching and career coaching for me. Mentorship doesn't stop when you graduate medical school.

Finally, I know I always say this, but I'm going to repeat it again. Coming to meetings like this really recharges me and energizes me. There is nothing like being around people who have similar thought processes - especially when it comes to Family Medicine advocacy. There is a kind of synergy that takes place where the best ideas come from. The next opportunity for this will be my own Ohio Academy of Family Physicians meeting in 2 weeks in Columbus. I will not be presenting there, but will be tweeting out and continuing to talk about social media. For now, time to go home feeling recharged....

I'm At The Indiana AFP Meeting

Good morning from French Lick, Indiana and the hotel, convention center, and casino that are here. What a beautiful location for the Indiana Academy of Family Physicians Annual Convention! I'm going to be speaking here later today on the topic of (what else) Social Media and Family Medicine. What they don't know yet is that I've changed some of my slides and I'm going to be trying out a presentation that will also be at the American Academy of Family Physicians (big) Scientific Assembly meeting in September. So, we'll see how that goes.

I'll also be tweeting out during the meeting using the #IAFPac hashtag. Don't forget to follow their twitter account as well @INFamDocs. According to their website, other topics today include the Patient Centered Medical Home, Accountable Care Organizations, and clinical topics as well. As with other state chapter organizations for FamMed, they also had a business session where potential resolutions were discussed and possibly forwarded to the national organization.

An interesting tweet that came out yesterday from our friend Dr. Kevin Bernstein which stated that "AAFP to implement updated AAFP Social Media Strategy. Stay tuned!" Additionally, our friend Dr. Russell Kohl not only tweeted out this, "interesting to watch twitter feeds of AAFP members while discussing if we should do twitter. Seems like an answered question," he also put together a creative you tube video below simply entitled "I Need A Family Doctor." Is this an effective way to use social media for advocacy? Leave your comment below....

#SaveGME Podcasts

This is the third in a series of my discussions about funding for Family Medicine residency/training programs. I invite you to check out post #1 and post #2 in this series. In addition there was an entire twitter chat on this topic from #FamMedChat. Thanks to Pat Jonas and his Dr Synonymous podcast from Tuesday, July 12, 2011 in which he talks about #SaveGME as well.

In addiiton to #FamMedChat on Thursday, July 14, 2011, I also did a Family Medicine Rocks podcast in which I talked about #SaveGME, the post by another physician called "Why I Love Being A Family Physician," my initial thoughts about Google Plus. Thanks to those to were able to join the show live. You can download the show at the link below. Also check out the video segment above from the show. In addition, don't forget to go to the Facebook page and hit the big "Like" button at the top!

Left click here to download #SaveGME podcast

Family Medicine Social Media Advocacy #SaveGME

Yesterday was a unique experience for me. As usual, I was hanging out on twitter and monitoring things. What I was monitoring was spreading the word on an issue that is very important to Family Medicine. Read my post yesterday for more details. But, in brief, proposed federal cuts in Medicare may have significant effects on the number of Family Physicians in future years.

I called it a kind of social media experiment when I sent out an e-mail to some key advocates and FamMed/SoMe evangelists. For those with blogs, they were asked to write a blog post about it. For those only with twitter and facebook, they were asked to help spread the word on this issue using updates on their account. I believe I started posting at around 9am, Following this, I saw the other team members posting on twitter. They were even able to pull in other friends of Family Medicine.

It was really nice seeing more of the #SaveGME hashtag throughout the day. As you can see in the graphic above, the tweetreach free app was used to track the most recent 50 tweets for a reach of about 40,000 impressions. Now, did this experiment reach its objectives? Well, the ultimate goal was for Family Physicians to contact their Congress representative about these proposed federal cuts. I guess we'll never know if that action step was taken.

Overall, I'm happy how this quick project was pulled together. I only sent out the e-mail about 3-4 days ago. I'd like to thank everyone involved in yesterday's activites on twitter, facebook, blogs, and other platforms. I'm looking forward to trying this experiment on a higher scale with more people and more friends of Family Medicine. With the 2011 and 2012 election cycles, I hope that the Family Medicine establishment learns from this experiment and sees the potential power of social media when it comes to communication and advocacy.

What #SaveGME Means To Me

Every day in the news, you hear about the United States federal budget and the potential political complications if something is done or if nothing is done. And every day in the news you hear about possible cuts in Medicare. What you don't know is that some cuts in Medicare can significantly impact the training of future Family Physicians. What do I mean by this? Well, did you know that residency programs are paid Medicare funds (called Graduate Medical Education funds) going to hospitals? Check out this great article about how residency programs are funded. 

So, let's play this out with its potential complications for Family Medicine. If GME funds are cut as they are proposed, then many hospitals with only one residency program (usually a Family Medicine program), may be forced to close the program - thereby decreasing the number of Family Physicians being trained. In those hospitals with multispecialty programs (like large university hospitals), cuts in GME funding would force hospitals to cut their Family Medicine residency slots in favor or more specialty residency slots, which are more lucrative for hospitals. Again, this would decrease the number of Family Physicians being trained.

With GME funding being cut, there are two other disturbing possibilities that may happen. First, residency programs may need to actively seek out financial support from pharma to just keep the program open. Or, some Family Medicine residents may need to pay tuition to complete their training. If not, then those Family Medicine Programs would close as well.

Now, I'm not a part of a residency program. I'm a practicing physician in a community office and a community hospital. How will GME cuts affect me? Well, with less Family Residents being trained, recruiting efforts for our practice just got a lot more difficult - especially since the more veteran physicians will likely retire earlier with the proposed Medicare cuts for physician payment. In addition, with the lack of Family Physician workforce, practices like mine may be forced to look toward midlevel providers to pick up the slack. Now, don't get me wrong, there is nothing wrong with midlevel providers. It's just that it would be nice to be able to choose between a Family Physician and a midlevel provider when the time is right for our practice.

What can be done? Great question. The first step is to educate our Family Physician friends and colleagues of this potential tragic situation. I admit that I didn't know much about this until some good friends alerted me of the situation. The next step is to contact Congress to let your federal legislator know about our concern and our need to #SaveGME. You may have noticed on twitter the hashtag #SaveGME. This is our way to raise awareness about this legislative issue and the future of Family Medicine. I encourage you not only to spread the word, but also to contact Congress via the AAFP Speak Out website. This is the easiest way to locate and to contact your specific legislator. Another way is to use this link for the House and to use this link for the Senate. 

Here are the key points that we need to convey to the legislators about #SaveGME: 

1. There needs to be an "unlinking" of GME funding from hospitals. GME funds need to go to the primary care residency program directly
2. GME funding for Family Medicine and other primary care training only
3. Do not fund (already profitable) procedural specialty residency programs

Finally, I would like to tip my hat to my Family Physician colleagues who have written blog posts on this issue. Please drop by the blogs below and leave a comment. We're also having our friends on twitter help spread the word about #SaveGME. Feel free to join us with your tweets and retweets. In addition, Dr Pat Jonas will be talking about this issue on his podcast on Tuesday night. And, there may be a twitter chat from #FamMedChat that could be taking place on Thursday night as well. We're trying to spread the word on this issue throughout the social media universe. Please help us do that! The future of Family Medicine could be at stake here. Let Your Voice Be Heard and Make A Difference Today!

Kevin Bernstein from the Future of Family Medicine Blog: GME Funding For Family Medicine Residencies Must Be Preserved Now!

Mark Ryan from the Live In Underserved Medicine Blog: Another Reason To Preserve Medicare Funding: We Need More Doctors

Ben Miller from the Collaborative Care Blog: His #SaveGME Post

Pat Jonas from the Dr Synonymous Blog: Family Physician Training - Save GME Funding For Primary Care

Jennifer Middleton from the Singing Pen of Doctor Jen Blog: Why Does GME Matter?

AmEdNews: Anonymous Posts: Liberating Or Unprofessional

About a week ago, I was interviewed by Kevin O'Reilly of American Medical News for the article "Anonymous Posts: Liberating Or Unprofessional" published today on their website. Kevin said that he hadn't heard of my Doctor Anonymous" work until after I re-branded myself as me. I mean, hey, how could you have not heard of me (hehe).

We had a great conversation where I even gave him a little history lesson of how it was "back in the day" in 2005-06 when the majority of physician bloggers were anonymous. Remember bloggers like Surgeonsblog? PandaBear? FatDoctor? And others? Here are my quotes from today's article.

When he started blogging as Doctor Anonymous in 2006, Mike Sevilla, MD, used the outlet to frequently express his frustrations with noncompliant patients and as a way to process his emotions. "If there was a case that was really on my mind here at the office or in the hospital, then I would write about it, then post it and be done with it," said Dr. Sevilla, a family physician in Salem, Ohio.

In March, Dr. Sevilla decided to start blogging and tweeting under his own name. He said he changed course, in part, because he realized that his anonymity was not secure. Dr. Sevilla no longer writes about specific patients and exercises more self-censorship. There was some value in writing anonymously, he said. "I miss being able to share some of those raw, core emotions," he said. "A lot of that stuff I'd write and not edit it. I would just send it out as one take, kind of release it and then move on."

Today's article opens with our good friend @BurbDoc, who is, at the moment, the most notorious anonymous physician tweeter (or at least we think she/he is a physician). I have talked to a lot of people about @BurbDoc in the past, but, as far as I know, this is the first written opinion I have seen. Even though it was not printed in the article, I told Kevin that I didn't think that those tweets were unprofessional, namely because that is what I was doing when I started my blogging life.

Now, do I do that now? No. The article then goes into the beginnings of my blogging life when I was talking about patient. What the article didn't say was that at some point in the past (probably around the Dr. Flea time), I deleted A LOT of those posts and I no longer talk about patients because I don't think talking about patients is a good idea. Some of you out there are probably saying that I'm a hypocrite now for saying that, but how I defend that is I have went through a social media evolution in the past few years.

When I tell the story of the Doctor Anonymous blog in my social media presentations (along with my conversation with Kevin), I started my blog with the idea of bringing my readers inside the exam room to tell the story of how it is to practice medicine in the United States health care system. There is some good and there is some bad.

I wrote some of those posts because I didn't know what else to do with all that emotion that was going through my mind on those tough days. Since then, I have found other outlets to express those emotions. But, back then, blogging was very therapeutic for me. In addition, in the social media enviroment at the time, the majority of popular physician bloggers were anonymous. So, the norm was being anonymous.

I wrote this post today to give some clarity to today's AmMedNews article and to fill in some gaps that I thought were lacking in the article. Don't get me wrong, I really appreciate Kevin talking with me and the other physicians in the article. If you have further questions for me on this topic, please feel free to contact me through the website here, and I'll be happy to try to address any of your questions.

Fireworks Safety

I was reminded by someone that this interview was recorded 2 years ago about Fireworks Safety. It was one of my earliest live TV interviews. You will be able to tell how nervous I was during this. In addition, a little behind the scenes note here is that the reason I didn't do any kind of hand gestures here is that I was caught off guard about when we were going live, and I still had my diet coke in my hands when they cut to me. So, not only am I trying to get through my material, I'm trying not to drop my drink in this segment. How funny is that? Enjoy and Happy Independence Day!

Medication Adherence: The Evolving Role Of Technology

If you are a member of Sermo, I invite you to join our discussion when it comes to medication adherence (comments will be closed on this post otherwise). To go directly to the sermo post and discussion, click here. Even if you are not a member of sermo, I invite you to check out our CME series over at CMECorner.com/ADHE. Here is some background information.

Medication adherence remains a persistent and pertinent issue in health care. Nonadherence poses challenges to adequate control of the target condition and often leads to further unnecessary complications.  Lapses in adherence can lead to more severe and expensive disease exacerbations, requiring additional treatment and hospitalization.  Rates and reasons for noncompliance vary based on numerous factors including health condition, type of medication, and patient characteristics.

Primary care physicians (PCPs) treat patients with chronic conditions, who often find it difficult to adhere to their medication regimens.  Many of the latest practice management and communication technologies afford clinicians the opportunity improve patient medication adherence. Functions within electronic health records (EHRs), such as medication alerts and eprescibing; via social media, including blogs and patient communities; and through mobile technology and digital communication, utilizing tools like HIPAA-compliant texts, can help physicians to improve their patients’ adherence to their course of therapy. Recent video roundtable discussions on CMECorner.com strived to educate PCPs about these technologies.

There are already a lot of comments over on the sermo post. And, I admit that I have not used that platform that much. But, I have been pleasantly surprised by the discussion and response that has already occurred. If you plan to comment over there, please do it sooner rather than later, in that comments will close over there in the next few days. Thanks for your feedback on this project!

Family Medicine Rocks Michigan

The Family Medicine Rocks Revolution is spreading to Michigan! Of course I had nothing to do with this video (watch out for the catchy music here), but I'm gonna try to ride their coattails on this one LOL. The Michigan Academy of Family Physicians (of whom I have many friends up there), put together this creative video which makes statements like "We [Family Medicine] specialize in you, for life."

Now, this is the kind of stuff that I hope more Family Medicine organizations so when it comes to social media. I have written in the past why I believe Family Medicine Needs Social Media. Kudos to the Michigan Academy of Family Physicians for putting this together. Are there other examples of creative social media by Family Medicine organizations? Let me know. I would love to highlight them here because, yes, Family Medicine Rocks!

NJAFP11: Social Media And Family Medicine

Above is a video with a portion of my presentation at the New Jersey Academy of Family Physicians meeting which is their Scientific Assembly & Summer Celebration. Thanks to the NJAFP for the opportunity to speak on a topic that I'm passionate about, and I hope that it shows through above. I also encourage you to check out some of the other videos that were recorded, including their House of Delegates session and their resolution to encourage AAFP to leave the RUC. I'll also try to talk about some other sessions in future blog posts.