I gave a presentation on blogging at the Association of American Medical Conferences’ annual meeting earlier this month, and one of my co-panelists was Bryan Vartabedian, MD. I was struck by many of the comments that Vartabedian, a pediatric gastroenterologist who has written on 33 Charts since 2009, made about physician blogging, and I followed up with some questions that I thought would interest Scope readers. Our conversation is below.
You talked at the conference about the statistics on the number of physicians who use social media often being inaccurate. Can you explain – and does this mean we don’t have a true sense of the number of physicians who blog, tweet and use Facebook on a regular basis?
One of the difficulties that come with the interpretation of physician social media stats centers on the fact that social media ‘use’ is hard to define. When we say, for example, that 20 percent of surgeons use Twitter, what does that mean? Do they use it every four months or every three hours? Does a tweet three times a year constitute use? What’s equally important to know and perhaps more difficult to identify is how doctors are using these tools. Are doctors engaging with other doctors, patients or both? How are doctors interacting with other doctors and what are they discussing or sharing?
Beyond our own observations, we have little solid data on physician social habits. It is beginning to emerge, however.
In a study published this fall by McGowan et al in the Journal of Medical Internet Research, researchers surveyed 485 physicians and found that 24.1 percent use social media daily to scan new medical information and 14.1 percent contribute information daily. On a weekly basis, 61 percent scanned and 41 percent shared content. This study also demonstrated some differences between primary care physicians and oncologists and suggests that physicians perhaps shouldn’t be broadly characterized with respect to their online habits.
What do you consider the number one impediment to blogging for doctors?
This is difficult to answer since we don’t have objective data to explain the seemingly slow adoption seen by doctors. With that said, I have my own ideas about why doctors have been slow to adopt blogging and other new media:
- Naturally reservations: I think that doctors are naturally reserved with respect to their public opinions. Early on we are trained to maintain a ‘therapeutic distance’ between our patients and ourselves. This carries over to the social space where success is dependent upon our ability to narrate and share in an open way. Medicine also breeds what I call the ‘culture of permission.’ We are trained to offer an opinion only when invited. There’s a sense that we need permission in order to make ourselves heard.
- Time: Good content creation takes time. Successful connection on social platforms also requires some investment in relationship building. The time necessary to see a benefit to conversation or blogging is often too much for the average doctor.
- Morale: The most successful bloggers are those who are most passionate about what they do. I think it’s safe to say that medicine is in a period of transition right now and many doctors are working more for less. It’s hard to expect an internist after working a 10-hour day to spend her evening writing a creative post on hypertension.
- Liability: Many doctors cite liability as a roadblock to their public presence. Most of these concerns, however, are unfounded and can be countered with the adherence to some simple guidelines.
How much does concern about reputation affect a doctor’s decision to blog or tweet?
I think that concern over ‘saying something wrong’ plays into the decision of whether or not to participate in online dialog. I do remember when I began blogging having concerns over what my hospital or department chairman would think of me. It’s a reasonable concern. I also see it as a strong force in keeping me safe. Understanding that everyone’s watching forces me to adopt a civil, balanced tone in what I write and say.
I often argue that concern over reputation should actually drive doctors to blog and create digital content. Only you have control over what’s said about you. If you say nothing you’re online reputation is at the mercy of those writing and speaking about you.
Why did you start 33 charts and how do you have time to keep it up?
I began 33 charts in 2009 when doctors began using social media. I saw basic issues and questions begin to emerge and I thought we needed a place for dialog. I talk about the issues that doctors face at the intersection of medicine and technology. I’ve been fortunate to see the site emerge as something of a community surrounding these issues.
Since I don’t sell advertising and the site is just a place for my ‘public thinking,’ I’m not under pressure to create. I try to restrict my posts to issues that I’m really thinking about or struggling with. While I could do more, this approach lends to more genuine writing. My frequency can vary from 1-3 posts per week. I do most of my blog-related work late at night or early in the morning.
At the conference you talked about your most popular blog post – a personal story about a young patient who had died. Why do you think it resonated so much with readers?
This post reflected my experience at the funeral of a child I had cared for from early infancy to the time of his death. After three years of always having an answer for the family, I found myself oddly without words when I needed them most. Normally I don’t write much about my personal reflections on patient care but for some reason I felt compelled to share this experience.
As I mentioned at the conference, the traffic surrounding this post was tremendous. I think that readers love seeing a physician’s personal tensions and conflicts. It reflects our vulnerabilities and it creates a real connection with patients. This is perhaps one of the more difficult types of post to sincerely create but it clearly resonates.
Previously: Bryan Vartabedian: Physicians are public affairs professionals, A guide to the social web for physicians, Report shows rapid adoption of mobile devices driving increase in social media use among doctors and A conversation with 33 Charts’ Bryan Vartabedian about professionalism in social media
Photo by LaMenta3