"Live the questions now. Perhaps then, without hardly noticing, you will live along some distant day into the answers.”With the tectonic shifts underway in America's health care delivery model, doctors influence in shaping the forces ahead seems to be dwindling.
- Rainer Maria Rilke
It started with the entire health care bill drafted by a team of some undisclosed, very influential academics, lawyers and policy wonks adept at social security and tax laws and was morphed by corporate and hospital interests with huge political and financial influence. Before the legislation was even read, the American Medical Association had stamped their seal of approval, worried that "they'd be eaten if they weren't at the table." As a result, a significant number, no, I'll stick my neck out here and say a majority of doctors, had little to do with shaping health care in America as we will come to know it.
But I would also bet that most of Americans want doctors with their best interests at heart to be integral participants in shaping our new health care system.
So now, as doctors align themselves with a single health system employer so they can beg for a portion of the government's soon-to-be-implemented "bundled" (bungled?) payment scheme to health care systems for episodes of care, how will doctors have any meaningful voice at improving health care for our patients and ourselves?
Enter social media.
I do not think social media, especially health care social media, is the best avenue to interact with patients. It's simply too risky on too many levels. But when interacting with colleagues on a professional level - it might be perfect.
It's fast. It's instantaneous. And most important:
It can influence.
But doctors must get used to creating influence not based on the scientific method as we know it. Doctors must get used to the influence imparted by lightning strikes.
As a simple analogy, Susan Boyle was a lightning strike (though not for medicine, per se). Her plain appearance meant little when it was contrasted with her powerful voice and its influence on the music scene at the time.
To administrators and regulators, doctors have a very plain employee-like appearance but carry powerful ties to their patients and are therefore uniquely situated to create their own lightning strikes in health care.
But doctors do not have time to sit in lengthy meetings planning strategies. Doctors (except a very few of us) have no interest in creating their own blogs. Doctors do not have time to endlessly perseverate on administrative and insurance issues as they try to repair a ruptured spleen.
But doctor are on line. Doctors do have cell phones. Increasingly, those cell phones are smart phones. And doctors can use social media to influence.
Of course, tons of websites are popping up all over promising to do just that for doctors. The New England Journal if Medicine, Sermo, iMedExchange, LinkedIn and a whole host of others - each with their registration process and promise of becoming the perfect Electronic Doctor's Lounge to interact (aka, waste time) with your peers. But these probably aren't going to influence health care policy and procedures in a meaningful way because there's just too many of them out there.
But I DO think doctors understand the need to know what's going on, but want a simple way to do it. Doctors want a simple way to connect and aire their concerns - irrespective of their employer. Doctors should participate in improving their care of patients.
And yes, right now, this minute, none of us has all the answers.
But here's the thought: we can all ask the questions. We can pose the problems we see today that influences our patients' care. We can collaborate and sign up for Twitter to follow our colleagues and maybe, just maybe, "without hardly noticing, we will live along some distant day into the answers."
Lightning strikes and all.