By Westby G. Fisher, MD, FACC

With the increased internet connectivity of doctors, nurses, medical residents and medical students, I find more and more health care people interested in taking the plunge into the social media world. Many of these same people wisely see the advantages and the potential disadvantages to entering this space, so they are appropriately reluctant to dive “all in.” Nowhere is there more caution than with the medical professions, especially physicians. While there is no one way to dabble in the world of social media, for those looking to embark cautiously on this course, I might be able to offer an approach that is not too dissimilar from a child learning to swim.

The Baby Pool

Where to start?

While many might attempt to enter social media through simple “micro-blogging” sites like Twitter, realize that this is (professionally) a bit like diving into the deep end of the social media pool before learning how to swim. That’s because Twitter is a two-way interactive medium; you can receive AND send out tweets there. For medical professionals constrained under HIPAA, it might be better to take a cautious approach to utilize a one-way (receiving) medium first by using a “feed reader” like Google Reader or BlogLines. A feed reader is a program that reads news feeds that are automatically sent out to the internet as a standardized “Really Simple Syndication (RSS) feed” anytime there is something new published. Feed readers allow you to “subscribe” to a site’s feed so that anything new published can be collected and categorized by the feed reader program on your computer. Almost all of today’s newspapers, scientific and popular media journals, and blogs provide “feeds” whenever things are published to the internet.

To help people locate the feed from a particular site, many post the standardized RSS feed symbol shown to the right. As a helpful tip, I have learned that most weekly medical journal and local newpaper health care section feeds are published to the internet either Monday evenings or early morning Tuesdays. Check your feed reader first thing each Tuesday morning and you’ll have tons of articles to review from the select journals to which you’ve decided to “subscribe.” The real beauty of a feed reader, though, is that you can then scan hundreds (I’m not kidding) of these article feeds in minutes to find the few that interest you. If they’re not of interest (and most aren’t) then they are marked as “read” and replaced with new articles when they come available. This system is fast, efficient, valuable for every doctor, nurse, or medical nerd out there. Once you master a feed reader, THEN I would consider moving to the more “social” aspect of social media and start to interact with others. This is when you’ll move from the shallow end to the deep end of the social media pool.

The Deep End

But why wait? What’s so bad about jumping in to the “deep end” of social media (a blog/Twitter/Facebook, etc.)?

Simply put: the deep end is where you can drown as a health care professional.

Caution, especially as a doctor on the internet, should be the rule. Also, despite how smart you may think you are and how much you want to say about your brilliance on a particular topic, you can bet your bippy that there is someone smarter out there. If you’re a smart as$, plan to be handed your butt. (Heck, humbling others is the most popular sport in the blog-o-sphere!) Save yourself plenty of angst: be humble and write respectfully. If you do, you’ll be rewarded with respect. Along the same line: if you make a mistake, admit it. Say something you shouldn’t have? Own up to it and correct the error. Upset someone? Decide if you should reconsider. Yes, public figures are easier to slam (and get away with it) than private ones since it comes with the territory. But the line between respectful disagreement and slander is a line you don’t want to explore in court. So choose your targets carefully and really consider playing nice (or at least nice enough). Don’t get me wrong, I think it’s important for passionate professionals to stand up for what they believe, but realize that there is likely to be others just as passionate about the counter argument you propose. As a rule of thumb, you’ll get more mileage if you make it a point to consider the counter-argument in your blog post or tweet. Remember that your words on the internet have permanence and unless there’s a real defensible reason to go there, you might want to tone that rant down a bit.

Better yet, sleep on it before you publish it.

Joining the Diving Team

Every developing physician blogger I know hits a few snags along the way. Suffice it to say there is no single right or wrong way to approach social media as a doctor. Learn from those that have passed before you. Write them a private note. Comment on a few blogs to get the feel of the pace and tenor of the interchange. Once you’re up and running you’ll soon be joining the team of advanced aquatics: the diving team. These are the people that multi-task using their feeder daily, their blog to make a point, and firing off posts to Twitter and Facebook (or Google +) via a feedburner, then making a video blog or internet radio show. Seriously, it’s whatever you have the time and passion for.

For me, I’ve chose to stick with a blog. I find it hard enough to keep updates to it on a regular basis while keeping my day job. And while I can’t always get to comments for instant replies (who can as a doctor?), I find them entertaining and informative. For the sake of a modicum of brevity, I won’t dwell on the specifics of how to write a blog. Many others have already covered this topic in depth. I would make a few important points, though. If you decide to make a blog (favorites seem to be Wordpress or Google’s Blogger as starting points), decide early if you want to accept comments on your blog or not. Those who accept comments on their blog can learn a great deal from others, but when you decide to accept comments, you also accept additional responsibilities. For this reason, I always recommend moderating your comments. Moderating allows you to review comments before posting them to your blog. Bloggers have been held legally responsible for comments made by others that appear on their blog and it’s the sad reality of the internet that there are sometimes wacko’s out there that latch on to a blog and won’t let go. Stay in control and moderate. Perhaps most important as a doctor-blogger, moderating comments permits better complicance with HIPAA standards in the event an inappropriate comment should appear. Also, make sure to use links liberally and reference your sources. This provides credibility to your argument(s). It’s also nice to acknowledge the work of fellow bloggers by offering “hat tips (or ‘h/t’)” containing a link to their work if appropriate. Finally, be sure to add a disclaimer to your blog. This isn’t the place to offer medical advice – ever.

In summary then, be careful, be respectful, be smart and soon you’ll be using the wide array of social media springboards, like Problogger.net, to launch your online presence to new heights and opportunities.

Oh yeah, and one more thing…

… most of all, have fun.

-Wes