Editor’s Note: Matt Katz, M.D., is a member of the External Advisory Board for the Mayo Clinic Center for Social Media.
Finding the opportunities and risks of social media requires a willingness to question what we know. I find myself perplexed on how best to use social media effectively, and conversations online suggest that I am not alone. I would like to take a broad view and try to re-frame how we determine whether these technologies are good for our health.
To answer some of the questions I raised already, I have five themes that I propose can guide us:
1. Social media makes our interactions in healthcare more perplexing. Increasing patient empowerment, problems with medical professionalism and shifting relationships within healthcare create uncertainty. Social media has the potential to make our interactions more or less healthy but may differ for each disease, person, or online environment.
2. The concept of “Health 2.0” is too narrow. This is not the first transformation of medicine; adopting internet jargon has a catchy jingle but is inaccurate. A broader historical perspective can help us understand how our current situation is similar or different to past major changes in medicine.
3. Embracing uncertainty in medicine can improve our health. Medicine has relied on a positivist philosophy, assuming everything can be objectively known. This approach does not reflect our actual experience in healthcare. I plan to discuss how heuristics, communication and understanding risk can improve our relationships and decision-making about health. I believe it provides doctors an opportunity to redefine their role in the future of healthcare.
4. An ethics-based approach centered on the healer-wounded dyad can help us redefine health. There is a moral component to medicine that has been diminished for too long by the successes and limitations of the scientific method. I want to explore how social media both changes and fits into an ethical, humanistic model of health that places healing relationships at its core. And it’s not just about the patient, or the doctor, or any one person – it’s also about we interact in health decisions and experiences.
5. Social media should complement and enhance human interactions, not replace or degrade them. We may find areas where these technologies are not healthy. If so, then we have an opportunity to avoid harm both within medicine and society at large.
I may vary in how we discuss these subjects, based upon what crystallizes enough to write about, your comments and current topics that may arise. I don’t presume to think that my approximations will be entirely correct, only that with careful thought I can help improve upon our current state of uncertainty. I do think it will help lessen the risk of a negative Black Swan — that our connectedness online may hurt us in real life.
By appreciating how we interact best to heal in analog and digital milieux, I hope that together we can better guide ourselves, the perplexed, on a more perfect path to health and meaningful lives.
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Matthew:
Guidance that helps people use this medium for better health is certainly welcome. Any new technology can be perplexing, so finding the sweet spots will be different for every audience. You might approach patients and doctors from each therapeutic area to find what has worked best for them so far in this early era of social media. I know from my experience that while many providers have adapted to SoMe in sexual health, the opposite is not true for those engaged with other diseases.
I would invite anyone with clinical research on social media application in the health field to offer up their findings. Let’s share and condense what we learn for universal benefit.
An ethics-based approach as you advocate is important to consider, but it must be addressed in the context of our corporate-advantaged society. Health insurance companies have not traditionally acted in an ethical manner, as many class action suits and Attorneys’ General investigations attest. My point is that discussing a pro-patient approach is meaningless without real teeth. Without protections for patients who openly champion their treatment and risk insurance retaliations or without a sustained commitment to universal health care in light of political schisms, we are recklessly and naively discussing social media in a bubble. Ethics is not a one-way street.
Social media is a disruptive technology, so it will not always behave as we prefer. While we can show appropriate avenues for usage, I don’t think we’ll ever get to shepherding the entire flock from harm.
I look forward to your next installment.
Hi Carmen:
Thanks for your thoughtful response. I agree that the ‘best practices’ for using social media will vary, and I would suggest that it be examined on a disease-specific basis. What works for sexual health will not for cancer care or arrhythmias.
I also agree that social media are disruptive technologies. We can now get our health information and navigate through the healthcare system without complete reliance on paternalistic approach from doctors, other clinicians or others in healthcare.
As for the ethical aspect, that should be central if teeth are needed, so be it. I think the benefits of social media require that we re-evaluate medical ethics’s tenets, but I would suggest that instead of accepting a ‘Wild West’ culture online that it’s worth expecting more of ourselves and anyone else using social media online — including corporate entities.
Like you, I see great potential for research helping improve our health. But concerns come with conducting online research, and that will be the topic of my next post.
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