What Influences Physician Behavior?

As many reported today, the United States Preventative Services Task Force recommended against the use of the PSA screening test for prostate cancer. It was previously recommended against in men 75 or older. But now, the recommendation extends to all ages.

Which begs the question: Will this guideline influence physician behavior? Will physicians actually avoid ordering this test? In the past, many inside and outside of medicine have said that physicians listen to data and evidence. You see, the data on PSA testing has been known for YEARS, but physicians kept ordering the test.

Well, some say this: "Well, physicians will listen to other physicians. We just need to get their professional organizations to get on board. It's a peer to peer communication thing." That was the point behind the entire "Choosing Wisely" campaign, which I have written about on this blog in the past. Will Choosing Wisely campaign affect physician behavior? Read my opinion here (spoiler: Uh, no).

Some people have told me (some in a joking and some in a condesending way), "Hey Mike, since you're pushing social media so much, why not start a Facebook page called 'I'm Saying NO To Routine PSA Testing.'" Wouldn't that be an interesting social media experiment?

The point is that no one likes change (especially physicians) and no one likes to be told what to do (especially physicians). Physician behavior change is one of the most difficult to predict and no one single guideline, organization, medical study, or person is going to do it alone. However, as stubborn as we are, as we hear the drum beat getting louder (like in the well done video above), behavior change will occur, just not as quickly as some people would like...

2012 #hcsmNY conference: Day Two

Day Two of the Connecting Healthcare & Social Media conference in New York City (#hcsmNY on twitter) was much more relaxing for me - especially since I was not presenting. It was cool in that I got to sit in the "power tweeters" section, which is usually in the back of the room, with people like Wen Dombroski, Tiffany Peterson, and Wendy Blackburn. It takes a lot of focus and concentration to quote/summarize the speaker, find links, add hashtags to tweets, take/post photos, and the rest to make a quality tweet. And, I admit that it's a lot of fun!

First of all, I want to give a big shout out to Bunny Ellerin for inviting me to speak at this event and for the opportunity to share my story at #hcsmNY. I met her last year during the Mayo Clinic Social Media Summit. Kudos to her and to those organizations who sponsored and participated in the event. It was a great time!

Dr. Katie Malbon talked about her "Text In The City" project in which she is piloting a text messaging program for patients in her clinic. Her presentation slides are here. And you can also check out sections of her presentation previously recorded in 2011 here: Part 1 & Part 2. As she and many others have said, whatever the technology is, it is all about outcomes studies. If the technology improves outcomes, only then can you can seek a payment model for said technology.

Patients again showed a presence on Day Two with presentations by Jessie Gruman and Shelly Lowe. A fabulous mobile health presentation was made by Dr. Felasfa Wodajo. It was one of those talks where there was so much good information, it was difficult to keep up the twitter stream. If I have the time (less likely), I should write an entire separate blog post on this talk.

Following the completion of the conference, I had the opportunity to get some New York pizza with Chris Boyer and Ed Bennett. It's always a good time decompressing following a conference. I probably should have spent the weekend in NYC, but, alas, the reality of home is calling be back.

This is going to sound so egotistical, but, there were more than a few people that came up to me in the past day and a half and said, "I just wanted to say thank you for doing what you do. We need more physicians in the social media space." I'm always humbled by people who say they have appreciation of my passion for social media in medicine. What a fun conference, but now it's time to go home!

2012 #hcsmNY conference: Day One

What I can I say, day one ended with me being in a bow tie. How did that happen? If you didn't see the other fun pics from yesterday, check out my facebook page and the facebook page for this website.

I love coming to these conferences to learn more about social media, catch up with friends, and to make new connections. It's even better when I get the opportunity to talk about social media, especially when it comes to physicians and providers.

You'll see in the video above a short section from my presentation where I talk about how physicians & providers use social media through marketing, managing online reputation, storytelling, and finding community. (sorry for the low quality of the video, but couldn't upload a large MB file) And, thank you, thank you, thank you, to everyone who was tweeting out my presentation yesterday. I really appreciate it.

I also had the opportunity to be the moderator for a panel at the end of day one with Loring Day who is a patient using social media, Dr. Howard Luks, and Dr. Farris Timimi. It was really an engaging discussion including topics of how patients, how physicians/providers, and how hospitals utilize social media. There were even great questions from the audience. That session is still all a blur. So, hopefully, I'll be able to expand more on that session in a future blog post.

The other fun session was with Chris Boyer who did a great presentation about Social Media and ROI (yes really). Check out his great content and slides on his slideshare account. Of course, everyone was awaiting Chris playing the Uke at the end of his talk. And, in classic social media style, it was placed up on youtube within the hour after he was done talking. You can check it out here.

Following Day One activities, the group went to the Stone Rose Lounge at the Time Warner bulding to hang out before dinner. The best part of conferences like this are in a more relaxing atmosphere (ahem, bar) where we exchange business cards, and talk about a great variety of topics. Dinner was at Sambuca, and all I can say is that at the end of the evening, I was in a bow tie. Don't know how that happened.

So, today is Day Two, and I head home from New York this afternoon, back to Ohio and home. There is always the excitement of new connections and new possibilities when coming (and presenting) at a conference like this. Social media is great in that you can start to get to know someone. But there really is nothing like IRL (in real life). Gathering together with people with similar ideas and energy is just exciting! Stay tuned to twitter today with the hashtag #hcsmNY

2012 #hcsmNY Conference

I'm happy to be presenting at the Connecting HealthCare and Social Media Conference (#hcsmNY on twitter) which will take place May 17-18, 2012 in New York City at Roosevelt Hospital. The scheduled speakers are fabulous including Lee Aase, Ed Bennett, Chris Boyer, Margaret Fontana, Robbie Freeman, Jessie Gruman, Kathleen Kearns, Howard Luks, Katie Malbon, Farris Timimi, and Felasfa Wodajo. Check out the full schedule of the conference here.

I'm honored to be a part of two of the sessions. The first session, taking place on Day One, is entitled "Why Physicians and Healthcare Providers Need to be on Social Media." If you have read this blog in the past, or listened to the podcast in the past, you know how passionate I am about providers being on social media. For a little preview of what I'm going to be talking about, see the video above, which is from last week's podcast.

I'm also going to be the moderator for a session at the end of Day One entitled, "Using #HCSM to Bring Patients and Physicians Together." Loring Day is a patient who uses social media as a part of her health care system experience. Dr. Howard Luks is an orthopedic surgeon and uses his "social media presents to educate patients." Dr. Farris Timimi is the medical director for the Mayo Clinic Center for Social Media. Mayo Clinic is one of the leaders in utilizing social media in the hospital setting.

As I did a the AAFP NCSC/ALF conference, I have some ideas on meeting coverage for the conference. Of course, there will be twitter coverage using the #hcsmNY hashtag. I'm also going to bring my video camera, and hope that I won't have a technical malfunction to record my talk and to do some on site interviews. If I'm really feeling adventurous, I'll record a podcast during the conference to share with all of you what's going on. Should be a fun meeting!

Family Medicine Advocacy Mtg

The AAFP Family Medicine Congressional Conference (#FMCC or #aafpFMCC on twitter) will take place on May 13-14, 2012 in Washington, DC. During this conference, attendees will be updated on the legislative issues of highest importance to the AAFP. You can see a draft agenda of the conference here.

On day 2, this is the opportunity for meeting attendees to go up to Capitol Hill and talk with Congress representatives, Senators, and their staffs about the issues important to AAFP, Family Medicine, our patients, and our communities. I talk about this more in the video above.

The video segment is from Family Medicine Rocks podcast episode 257 from last week. You can download the episode here or below. You can even subscribe to the iTunes feed to the podcast, or listen in the player below. I also encourage you to follow me on twitter, "like" the facebook page for the site, and check out my you tube page. Enjoy! 

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Download Ep257 Here

Ep257 Wrap-up: Meetings Talk

Lots of talk on yesterday's podcast about last week's and next week's meetings on Family Medicine Rocks Episode 257. Last week was the AAFP ALF/NCSC meeting which I have a number of blog posts summarizing the meeting. In the video above, I encourage the Family Medicine social media community (also known as #FMRevolution community) to continue to turn their emotion into action.

Next week, in Washington DC, will be the AAFP Family Medicine Congressional Conference in which meeting attendees learn skills about lobbying Congress. In addition, there is an opportunity to talk with members of Congress during the conference.

Finally, about a week from now, I will be speaking at the Connecting Health Care & Social Media conference on the topic of Social Media and medicine. The title of my talk will be "Why Physicians & Healthcare Providers Need To Be On Social Media." I will also be moderating a panel entitled "Using #HCSM To Bring Patients and Physicians Together."

You can listen to the show in the player below. You can also download the show here or at the bottom of the page. If you didn't already know, you can also subscribe to the show on iTunes. I also encourage you to follow me on twitter, "Like" the facebook page for this website, and to check out my youtube page. Enjoy!

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Download Ep257 here

2012 AAFP ALF Report

By Sandra Hughes, MD - Written for Connecticut Academy of Family Physicians Newsletter

Social media, what does that term mean to you? I'm not sure it had much for me, I simply ignored it. After attending the Annual Leadership Forum in Kansas City, MO. Over the last 3 days, I have learned that it is a force that cannot be ignored in our profession. It is actually a crucial tool for our technology driven society where people check their email and Facebook before even getting out of bed in the morning. It is hard for me to believe I am saying this. I thought Facebook was for catching up with friends! Twitter, well, I never quite knew what that was for. And hashtag (#) clueless.

After attending two lectures on its importance, I am finally a believer. This conference had 6 (yes 6!) lectures on social media. Thanks, AAFP, I get it! As Dr. Mike Sevilla, social media guru at www.familymedicinerocks.com stated, we need family physicians out there teaching our patients. Why should we allow specialists like cardiothoracic specialist Dr. Oz to be the main spokesperson for medicine? We are in the front lines of medicine, that should be our job. In this day and age, our patients are turning to the Internet for advice. We as family physicians, should be giving it.

We need to be at the forefront of medical advice, not others. We can't expect people to be savvy enough to know good advice from bad. We need to show and teach them. It is time for us to change. Harrison Coerver in his lecture entitled, "The Race For Relevance," states that the majority of chapters still spend more money on postage then technology. In this age, it is time to change. We need to reach out to our patients and members.

While in Kansas City, I began updating the Connecticut Academy of Family Physicians Facebook page and started a twitter account @CTAFPDOC. Mark Schuman, Mary Yokose, our chapter executives, and I will be updating the CAFP twitter and facebook accounts. Now, we just need YOU to follow along.

Family Medicine Is Unstoppable Force

I finally got to meet AAFP President Dr. Glen Stream last week at the 2012 AAFP NCSC meeting. I know I have said publicly in the past, but I wanted to again praise the Academy for taking the proactive step of embracing social media with a leadership blog, an AAFP President twitter handle, an AAFP President facebook page, and more. 

In the video above, you'll see the end of his remarks a the opening session of the NCSC meeting. He announces new membership numbers, the social media efforts of the Academy (love when he says "tweep" above), and the overall goal of increased communication. Family Medicine is definitely an Unstoppable Force. Go #FMRevolution!

Give A Damn About Patients

Family Medicine Pioneer G. Gayle Stephens, MD spoke at the 2012 American Academy of Family Physicians National Conference of Special Constituencies on May 3, 2012 in Kansas City, MO. I have heard a lot about this icon in the past, especially an essay entitied, "Family Medicine As Counterculture."

Even though this gentleman has given many lectures in the past, I could see (especially since I was sitting in the front row) that he genuinely looked nervous as he climbed the steps to the stage. He poked fun at the start of his talk by calling himself "Moses" and asking rhetorically, "Where did they dig up this old guy?" as the crowd laughed awkwardly.

He read his entire speech. But, as usually happens, speakers find their stride in the last part of the talk. In this case, it was the last eight minutes, which is the video above. The opening quote below was the best of the whole thing and inspired this blog post.

The first job is to give a damn about everything that matters to patients and about what the patient chooses to do or not to do about their condition. I've seen it happen that when the patient refuses medical advice, for those of us who believe strongly in patient autonomy, lose interest in the patient and say the patient should go somewhere else.... 

If the patient refuses a treatment, like chemotherapy, Dr. Stephens says, "[This choice] is not an ending of the doctor's responsibility, but the beginning of a new phase of patient care." He continues with concept like "Being There," how to "Talk" to patients, "Don't make promises you can't keep," Don't make rotten referrals," and "Stop Whining and Start Resisting." He closed with this ominous quote which made a lot of people think during and after his presentation.

Your turn to become a patient is inevitable. We're all going to be abused by this terrible system eventually. The closer I get, the more scared I become...

Family Medicine cannot look forward without looking back. Not only do I hope we remember Dr. Stephen's story, I hope that we retell it to our friends, our colleagues, and anyone else who will listen. The fundamentals of Family Medicine have not changed, and we cannot forget the pioneers like Dr. Stephens. Without them, Family Medicine would not be where it is today. Thanks Dr. Stephens for continuing to challenge Family Medicine to be Counterculture.

2013 NCSC Convener: Kim Yu

Last week at the AAFP NCSC meeting, Kim Yu, MD was elected to be the 2013 Conference Chair/Convener. Something I already mentioned in a previous post was that the AAFP recorded videos during the meeting including many of the nominating speeches and business sessions. In the video above, Dr. Yu gives her fabulous speech describing her NCSC story and why she wanted to be elected the 2013 Conference Chair/Convener. 

• "NCSC has such a special place in my heart and has been pivotal in shaping my career since my first NCSC eleven years ago...."
• "As Family Physicians, we have the privilege of hearing people's stories. I'd like to tell you my story about how NCSC helped me find my voice, follow my dream, and discover how diverse Family Physicians really are..."
• "NCSC changed an inspired me to make the first step in living the life I dreamed of being the physician I dreamed of making a difference in my patient's lives, my community, and beyond. And that we as Family Physicians can affect change in the Academy and our whole country..."
• "This is the family that is NCSC. The family that not only allowed me to grow roots, but spread my wings and fly. I've been honored to be part of the history of NCSC..."
• "I know that you will make memories and friendships here that will last a lifetime. I have. I hope that you will too be inspired to dream big and take that enthusiasm back to the people that you serve..."
• "I challenge you to keep your eyes on the stars and your feet on the ground, to have radical ideas to lead the Academy and to inspire other Family Physicians. Enjoy the wild ride that you will take over the next few days...." 

I also encourage you to check out my exclusive interview with Dr. Yu that was recorded before the 2012 conference on my internet radio show where we talked about her quest to become the 2013 conference chair. You can download the podcast here or listen in the player below. Don't forget to follow me on twitter, "like" the facebook page, and subscribe to my podcast on itunes. Enjoy!

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