For Cardiologists: A Twitter Primer

With the explosion of social media, I am amazed at how many cardiologists I encounter who know little to nothing about blogs, Twitter, Facebook, Google Buzz and the like. "I'm too busy." "Who has time for that stuff?" "I wouldn't have time for anything else." "How can I possibly keep up?"

And yet today, as more and more patients reach out to the web to find medical information or, more importantly, their doctor, physician specialists of all types should probably be asking, "Can I afford to not be connected with social media in one way or another?"

Google yourself.

That's right. Type your name in Google's search box. What appears first? Your name or someone else's? Not there? How many pages down do you have to search to find something about yourself?

For me, I was surprised to find that my Facebook page and blog precedes my professional workplace's website, professional articles, and other sundry information. Hence, it's one small reason I have an online presence.

But for doctors, there are good reasons to be resistant. First, many do not want their details out there. Fair enough. Maybe you've been around enough to have enough references to do the Internet search heavy lifting. Also, there are important reasons, like patient privacy that need to be respected, and the Internet is the last place such conversations regarding patient care should occur. Realize this is not for those kinds of professional conversations. Finally, procedurally-heavy specialists have a hard time sitting behind a keyboard having near-real time conversations with comment streams on a blog. Also, while blogs create an important static chronological log of written works, they also take considerable discipline and time to get off the ground - whether one posts daily, weekly, or monthly. Simply put, if you want readership, you have to post often to your blog. Most cardiologists tell me they feel they are too busy to devote significant time to such an endeavor.

So is there something that can take less of a front-load?

Enter Twitter.

What is Twitter?

For lack of a better way to think about it, Twitter is to blogging as a person with ADHD is to an obsessive compulsive. Twitter is like a flight of ideas, streaming by very quickly, and if you miss the last few hours, you've probably missed the conversation. This is because Twitter only allows brief, 140-character text messages to be posted to the Internet as thoughts, ideas, or interesting web-based articles appear that the author wants to share with others. While it can be a powerful business or networking tool, it can also be a colossal waste of time if the content is unfocused or not used judiciously.

My Steps to Acceptance of Twitter

I was a Doubting Thomas when I first decided to register on Twitter. I was already an established physician blogger. Twitter seemed like a huge time sync. How the heck was I supposed to write a blog and send "tweets" out at the same time? Are you kidding? Seriously?

But then I realized that I can send my blog's RSS (Really Simple Syndication) feed over to Twitter using Feedburner or Twitterfeed. Instantly, another large group of people could be automatically notified that I placed a new post on my blog, expanding my blog's reach. Twitter suddenly became a huge networking amplifier above and beyond my current blog subscribers.

Alright, maybe Twitter had a purpose after all.

Later, I would attend a medical blogging conference in Las Vegas. Everyone there was on Twitter, or so it seemed. (I was the only cardiologist, at the time.) Want to send a message to the attendees? Send them a "tweet." It was instant messaging on your cell phone in near real-time. I found it useful to arrange a get-together or meet at a specific time with a specific group of individuals.

That was kind of cool.

Still later, I was watching one of the President's many talks on health care reform on TV. I decided to follow what others were saying about what the President was saying, so I searched Twitter using this thing called a "hash tag term" that always begins with a "#" character. A hash tag is nothing more than a labeled term that represents a topic for discussion. That night I searched on "#hcreform" on Twitter and could see everyone who was kind enough to place that text in their tweet about health care reform. As a result, I learned something and found some other like-minded souls who I could follow further.

Suddenly, Twitter had relevance to at least one cardiac electrophysiologist.

And so I have grown to appreciate Twitter with time. Not as a panacea to all that ailes medicine, cardiology, or my social life, but as a means to transmit information publicly VERY fast and keep up with the constant stream of ideas emanating from others with similar interests to me.

So What Do You Need to Know?

First to start, sign up on Twitter.com and use a short, descriptive name (it's easier to type) and put a good description of yourself under the "Bio" section so people will know your background and to differentiate yourself from marketing spammers (yes, they exist on Twitter, too). If you register as "drjoeblow", then your twitter name becomes @drjoeblow.

Second, you have to "follow" some people on Twitter. This is done by either typing "follow doctorwes" in the text box (without the @ sign), for instance, or clicking on some of the people's pictures of people I follow, reading about who they are, and deciding if you want to follow them too. If you want to send a public message to me, all you have to do is type "@doctorwes Here's my message." and it will come to me. If you want to privately message me (so the rest of the world can't see, I first must be following you on Twitter. Once I follow you, then you can send me a message privately using a "direct message" feature in Twitter by typing "d doctorwes This is my private message." The "d" or "D" at the beginning of the message tells Twitter to send that message to me privately. It also sends me an email telling me you've sent me a private message. (I like that.)

Third, realize people on Twitter as as diverse as there are personalities out there: some are the histrionics's "hyper-tweeting" every detail of their lives ("Heading to Starbucks") while others might be more schizoid and rarely ever tweet, but like to follow along conversations (we call them "lurkers.") Naturally, there are plenty of people in between. Read through what a few of them have "tweeted" and note how many tweets they transmit, then follow only those who appear to have relevance to you and whose frequency of tweets you can tolerate.

Fourth, when you see "RT" in the tweet, it means "re-tweet." This suggests that you like what they broadcast on twitter or wanted to restate their tweet and add come snarky commentary. Either way, the originating tweet gets mentioned so that others can follow that idea thread (or person) and also comment or follow the person.

Another common notation in a tweet you'll see on Fridays is "#FF". The Follow-Friday hash tag is a way to spread the word about your favorite people that you follow and you think might be worthwhile for others to follow. Perhaps one of the more popular #FF folks has been @ConanObrien lately.

Fifth, load a software program like Tweetdeck or HootSuite (available for free) on your computer and/or cell phone to help organize tweets. These software packages can also automatically shorten long URL's of interesting articles into smaller abbreviated URL's that are better to send along side a tweet.

Sixth, if you decide to try this, there are also things called "Lists." Lists can be either public or private. If you want to follow all the people I am that are part of my public ACC10 list, then type "follow @doctorwes/ACC10" and you'll be able to follow all the doctors, nurses and techs attending the American College of Cardiology's ACC10 conference in Atlanta this year that I am. You can also make your own very private lists for your own use.

Finally, some important suggestions:

1. Follow smart people doing work that is relevant to yours. Trash most others.

2. Post relevant, valuable content of interest to your followers.

3. Watch your time on Twitter. At most, I spend 20 minutes a day on Twitter, and I think it would take me far more time offline to gain and share the same information.

4. Do not EVER post patient information - Twitter is public and searchable on Google. 'nuf said.

So there you have it. A crash course on Twitter for Dummies.

Give it a try.

You should find Twitter can be immensely valuable tool to build a valuable professional network while simultaneously assuring an important and relevant online presence.

-Wes