Follow-up: Summa HCSM Talk

I'm sitting here in Cuyahoga Falls, Ohio which is my old stomping grounds here in medical school. I just left my presentation at the Summa Akron City Hospital Ob/Gyn Department and trying to process and absorb what just happened. Thanks again to @DoctorViv for extending the invite to talk at the hospital. There were about 50 people there, and not just from the Ob/Gyn department. I was also told that there were attorneys in the room and asking questions.

Right out of the gate, I said, "Does the hospital block facebook & twitter for employees?" A groan came from the crowd. But, that's ok. I mean bringing someone like me in is a good first step for a hospital culture. Actually, I was pleasantly surprised when I saw a negative comment on the hospital FB page, and instead of deleting it, the hospital commented for the patient to call the hospital to clarify the situation. Impressive.

@DoctorViv stated that it would be a beginner audience, but I found that there were some advanaced people there as well. I even got a question about Pinterest. I got to meet cool people like @farquharj and @oh_nikita to talk about geeky stuff. I tried the hashtag #akroncity which captured some tweets.

I have a new challenge that @DoctorViv has given me: How to change hospital culture to make social media more acceptable, not only with the grassroots folks, but with those "in the C-Suite" (not C-section suite, but those in administration - those that have decision making power and resources).

Very interesting thing for me to think about. I may need information from my friend Chris Boyer and his "Social Media = ROI" talk (meaning return on investment). The bean counters really like to see social media somehow convert to dollars. Hmmm....

Something really cool is that the hospital video taped my talk, in addition to me bringing all of my video equipment. So, hopefully, I'll be able to share some video with all of you on this site soon. Not only do I love doing Social Media & Medicine talks, but also I love meeting new people and making new connections. So much fun!

Summa Social Media Talk

I accepted an invitation in Akron, Ohio at Summa Akron City Hospital to speak on Friday, April 13, 2012. The invitation was from the Ob/Gyn Department there to talk about social media and medicine. They even wrote a nice post on their blog this week. Dr. Vivian von Gruenigen, also known as @DoctorViv on twitter, is the department chair of obstetrics and gynecology for Summa Akron City and St. Thomas Hospitals and medical director of women's health services for Summa Health System. I sent her some e-mail questions, and here is our chat....

1) How did you first become interested in social media?

@DoctorViv: I've done research in cancer survivorship "centering" for years and have been intrigued by the sociological aspect of patient groups. Two years ago, I became the medical director for the women's service line at the Summa Health System. Our communication and education budgets were not impressive so we needed to think outside the box. In addition, a member of the communications team, Julie Uehara, is a social media fanatic. She approached me to partner with her to start a women's blog. Since then, I listen attentively to all of her recommendations.

2) What do you tell colleagues about why social media is important for the physician/patient relationship?

@DoctorViv: I use two messages with my colleagues.

a) We are responsible to partner with our patients in their education: Social media is easy to use and it's

free. Not all patients have computers but everyone has a phone. Plus, it's environmentally green and

patients can learn outside a clinical office setting.

b) Social media is not going to go away: Embrace it now, your Mother has, and I bet she's on Facebook.

3) We met at the 2011 Mayo Clinic Social Media Summit. What were you hoping to get out of that conference, and what information did you bring back and share with your colleagues?

@DoctorViv: I am a researcher by training. My natural instincts is to become more educated in new pursuits. So, I went to the social media conference and read some of Clay Shirky's work. I brought back the conference materials and notes to all my colleagues. Most importantly, I brought the message that all speakers gave numerous examples of health care social media growth, cultural change and opportunity.

4) I see Summa Health System has a Women's Blog and even sends informational texts to your patients. What is the role of electronic and social media with patients in your program?

@DoctorViv: The goal of our social media platform is to build a community of women. Our original concept was to have a weekly blog written by physicians. It has now become much larger. I blog once a week and have guest bloggers 1-2 times a week. In addition, we have diverse bloggers including nursing, psychologists, cancer survivors, etc. Since it's inception in the fall of 2010, we have grown by about 10% each month. We have several physicians and researchers on Twitter, a Summa Facebook page, and a maternity texting program. We are presently crafting our first research paper on social media and women's health.

5) Finally, thanks so much for the invitation to speak to your department. What are you hoping that people get out of my talk?

@DoctorViv: The audience are beginners in social media. Framing social media from the past, present, and future is relevant. As a practicing Family Physician, we hope you will share some of your lessons learned, especially from your Doctor Anonymous era. If there is time you can give us a short "how to" course. If we can't get through it all we'll have to invite you back.

Autism Awareness Month

April is National Autism Awareness Month. In this short interview above, I briefly mention the new data from CDC which states that now, 1 in 88 children have been identified with Autism Spectrum Disorder. I did not get to mention this, but some parents are concerned about a possible redefinition of autism. In addition, just yesterday, there is a possible association with autism and maternal obesity.

If you found this video helpful, I encourage you to check out other TV interviews at MikeSevilla.com. Also check out my twitter feed and follow me on twitter. Did you know there is a facebook page for this website? "Like" our page, too. Finally, if you're daring, I invite you to check out the audio podcast for this website. Enjoy!

Autism Redefined?

April is Autism Awareness Month, and I'm going to be talking about this on local TV next week. As I was doing some background information on this topic, I found that experts are looking to redefine the diagnosis of Autism. One of the articles I read was "Parents Worry As Doctors Seek To Redefine Autism," from April 5, 2012 on MSNBC.com. (Also check out the news report above)

Familiar terms like "Asperger's Disorder" and "PDD-NOS" would be eliminated and lumped into a new category. The traditional term "Autism Spectrum Disorder" would be redefined to only encompass those with more serious symptoms now. "Social Communication Disorder" is a term that will be a new category.

Many parents are very concerned with the proposed definitions and re-definitions, mainly because they are concerned that their child will lose services. Frankly, I would be concerned as well. These new defintions are not permanent yet. So we'll have to see what happens...

Choosing (Un)Wisely

Watch Medical Groups Call on Doctors to Perform Fewer Tests on PBS. See more from PBS NewsHour.

"You see, Dr. Oz was right, you're ordering way too many tests for me," a patient told me today after seeing news reports of today's press conference in Washington DC by the Choosing Wisely campaign. This campaign, according to news reports (WSJ, PBS, ABC, NBC, NPR, AAFP, and others), points the finger directly at doctors for ordering "worthless" and unnecessary tests (that's why the press, like patient advocates, love this story, because another opportunity to blame doctors). While I believe this is a noble cause, here are some of the issues that I have with it...

Where's the Patient Responsibility?: So, if I get this right, there is also going to be educational campaigns directed toward patients with slogans like, "Don't expect that routine antibiotic for that cold," or "Don't expect routine testing if you're asymtomatic." There have been announced partnerships with consumer organizations like Consumer Reports Health, AARP, SEIU, and Wikipedia. Do you really think these groups will discourage patients from demanding unnecessary testing/treatments? Time will tell...

Thanks For Making My Job Is More Difficult: With these reports today, patients are challenging me even harder about the testing and treatments that I am recommending. I don't have a problem with this. However, I do have a problem how this story has been framed in that "I" am the reason why unnecessary tests are done, and my patients are more than happy to remind me of that.

Insurance Companies Must Love This: Sometimes I really wonder if all these physician organizations really know how medicine is practiced at the grassroots by physicians like me. Every day, our office have staff members sit "on hold" for hours at at time trying to walk through the maze of preauthorizations for tests and medications. I really think this announcement will further embolden insurance companies (including Medicare/Medicaid) to raise the bar and make testing and treatment more difficult for me to adequately treat my patients.

Where's the Tort Reform?: Does anyone see that pink elephant in the room? Every time unnecessary tests are mentioned, physicians usually respond by saying things like "defensive medicine" and "fear of malpractice." There have been many studies, arguably conflcting, asking the question about whether today's medicolegal climate causes physicians to order tests that they maybe shouldn't. I was disappointed that all these physician organizations had nothing to say about malpractice attorneys and the need for liabiility (meaning malpractice or tort) reform in this country. Everyone knows that it's needed, but physician organizations are taking (in my opinion) the easy way out in blaming themselves and trying self reform first.

Here's the Dirty Little Secret: I'm a amateur pundit, but here's what I think is really going on. All these physician organizations are afraid of the government (whether it's Obamacare or other plan) ultimately deciding what tests should be done or not done. Private insurance companies are somewhat doing this now. So, if physicians can show that we can "police" ourselves, physician groups are hoping to score political points with those in Washington (that's why the press conference was in DC today). 

Now, don't get me wrong. I agree with everything that happened today. 30 billion dollars annually of unnecessary tests are a real problem. However, will this effort really change the behavior of physicians? Probably not. Will this effort really try to educate patients not to ask for unnecessary tests? Probably not. Will this campaign hope to score political points with Congress and the White House? Some believe yes....

Science Roll Interview

Thanks to my friend Dr. Berci Mesko for the opportunity to be interviewed on the very popular blog Science Roll. I invite you to check out the post entitled, "Social Media in Primary Care: Interview." If I remember right, he and I came on the blogging scene right around the same time in 2006, I believe when he was still a medical student.

Now, he runs one of the most popular worldwide blog, and the medical resource called Webicina which is a search engine for internet medical resources. There is even content specific for specialties like Family Medicine. Something that is very exciting is the introduction of a global social media course for medical professionals called "Social MEDia Course: Revolution in Medical Education NOW." Check out the video below...

AAFP President Tonight 9pET

Glen Stream, MD will be appearing tonight on Family Medicine Rocks Episode 248. Dr. Stream is the President of the American Academy of Family Physicians. One topic will be the recent announcement that the AAFP will be remaining in the RUC. Another topic will be the AAFP Primary Care Valuation Task Force.

On last night's show (Show 247), I shared some background information to help you get ready for tonight's show. This includes an article entitled, "What Every Physician Should Know About the RUC," which gives you a basic idea of what the RUC is and why it's important.

For a long time, the AAFP has stated that the RUC does not see the value of Family Physicians because Medicare payments are lower than subspecialists. Last summer, the AAFP sent an aggressive letter to the RUC asking for changes in the RUC's structure. RUC responded a couple of months ago and made only small changes.

In a post from Health Affairs blog, they encouraged AAFP to leave the RUC and many wondered if that would happen.  On March 13, 2012, AAFP announced that it would remain in the RUC which made some people very upset (check out the comment section of their press release)

On March 16, Dr. Stream wrote "We're Changing Our Approach To The RUC." The Academy then reached out to me to see if I was interested to talking with Dr. Stream about the Board's decision. And, that's how this interview was set up. In the video segment above, I share some of the comments that people have communicated with me in the past week leading up to this show. (Download the entire audio podcast for Ep247 here and below)

So, I hope you can join us on Tuesday, March 27, 2012 at 9pm Eastern Time/6pm Pacific Time for Family Medicine Rocks Episode 248 with my guest Glen Stream, MD who is President of the American Academy of Family Physicians. See you for the show!

Download Ep 247 (mp3)

AAFP President On FamMedRocks Podcast

On Tuesday, March 27, 2012 at 9pm Eastern Time, the President of the American Academy of Family Physicians, Glen Stream, MD, will be appearing on the Family Medicine Rocks podcast. The topic will be AAFP's recent decision regarding the RUC. 

According to an article on the AAFP website from March 13, 2012: "After much debate, the AAFP Board of Directors has decided that the Academy will continue to participate in the AMA/Specialty Society Relative Value Scale Update Committee (RUC) for now, while continuing to advocate that changes be made to the RUC from within."

For my readers who may not be familiar with this story (especially those who do not work in medicine), the RUC is a panel of experts who make recommendations to Medicare with regard to payment of certain services. Family Physicians, like those in the AAFP, have expressed concern that the RUC is biased toward specialists and non primary care physicians. Many believe this is one of the many reasons why specialists are paid more than primary care physicians.

Last summer, the AAFP sent a letter to RUC to make changes in the composition of the committee to try to lessen the bias toward specialists. Following the release of this letter, many AAFP members were urging the Academy to walk away from the RUC - especially if the requested changes were not met. Last month, the RUC did make some changes, but certainly not all the changes that were requested.

Some have called the RUC changes "Slight of Hand" and urged the AAFP to walk away from the RUC. On March 13, 2012, the AAFP announced that they were remaining in the RUC. I encourage you to check out the comment section of this article, of course, some favoring AAFP's decision and some questioning AAFP's decision. I imagine that this type of dialogue is taking place across the country.

Last week, I was contacted by AAFP to ask whether I would be interested in talking with Dr. Stream regarding AAFP's decision to remain in the RUC. Our schedules could not match this week, but we were able to agree upon March 27, 2012 at 9pm Eastern Time. You will be able to listen to our chat live at this link which is my podcast site.

I encourage readers of this blog post to submit questions and to leave feedback in the comment section below with regard to AAFP's decision to remain in the RUC and Dr. Stream's recent commentary called "We're Changing Our Approach to the RUC." I will choose the best questions and ask them on the air. I will not be taking any call in questions the night of the podcast.

I think this is a HUGE step for the American Academy of Family Physicians to utilize social media in a way that they have never done before. I'm honored that Dr. Stream, whom I have never met in real life (yet), and the AAFP, reached out to me for this opportunity to chat about a knowingly controversial Academy topic. Please submit questions and feedback below so, at least, I can get a sense of what people are thinking out there on this important health policy issue....

Why #FMRevolution Matters

Had a great show last night with Dr. Michelle Quiogue who talked about saving the Family Medicine Residency program in Bakersfield, California. I encourage you to download the entire audio podcast and listen more about Family Medicine Rocks Episode 246.

At the end of the show, I had the closing monologue in the video above. We need more positive stories like this one in the Family Medicine community. This #FMRevolution that you see out there on twitter is not only about a twitter hashtag.

To me, #FMRevolution is about spreading the word about Family Medicine. Social media has the power to bring together people from across this nation and around the world. Family Medicine has the data that we give high quality patient care at a lower cost. The Patient Centered Medical Home is the model by which we have this data.

For too long, Family Medicine has let other people tell our story. If Family Docs cannot be advocates for themselves, then who will? Ever since I started in social media (almost) 6 years ago, it has always been my goal to help spread the message of Family Medicine. If you are a Family Doc and have a story to tell that impacts your patients and your community, I'd love to hear about it. Have a great week everybody!

FamMedRocks Ep 246: Dr. Michelle Quiogue

Thanks again to Dr. Michelle Quiogue (follow her on twitter) for coming on the show last night. She shared her story about the saving of the Family Medicine Residency program in Bakersfield, California. She is not directly connected with the program, but through a Facebook update, she learned the news and then sprung into action.

Through her advocacy training from the California Academy of Family Physicians, she contacted the local politicians through letters and phone calls. She also helped coordinate the efforts of the Family Medicine community to help get the word out.

In the video above, she described the scene at the meeting where many people gave testimony to keep the program open. She stated that there was three hours of testimony given my many individuals. At the end of the meeting, the board ordered the hospital CEO to hire a new intern class for the program.

In the second portion of the video above, I asked her what she tells people who say they are too busy for Family Medicine advocacy efforts. I encourage you to download the entire audio podcast of Family Medicine Rocks Episode 246. Can download from the mp3 file from the link below, or here. I also encouage you to "Like" the facebook page for this site and to follow me on twitter. Thanks so much!

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Download Ep246