Can social media be hazardous to physicians’ (professional) health?

November 13, 2009 at 11:24 am | Posted in Communications strategy, Professional ethics, Regulation, Social media | Leave a comment

Ok, so the headline is intentionally provocative. But while the FDA decides how or whether to weigh in on the use of social media to promote regulated medical products (Reuters and many others covered the two-day event), a run of recent articles and blog postings posit the pluses and minuses of the use of social media by physicians.

This discussion is the latest and a logical extension of the ongoing debate about the benefits and potential risks of any new communications tools used by health and medical professionals. Clinicians, after all, regularly discuss sensitive patient information and are subject to all manner of legal oversight and professional ethics.

We saw a variation of this debate back when the profession mulled whether doctors should advertise, then over the rise of web, physician-patient e-mail, and now blogs, Facebook, Twitter and whatever the next new thing will be. (By the way, a related discussion on the blog Scholarly Kitchen looks at whether scientists are joining social networks and, to the extent that they haven’t, why that might be the case).

The clinician-focused discussion in a nutshell (Medscape has a nice overview on this) – social media tools can be useful ways for clinicians to seek out professional information and opinion, raise professional visibility and stay in touch with communities of interest. But like any technology, clinicians should be aware of possible risks.

Specific caveats (Medical Law Review hits this most explicitly)  — physicians should be mindful of patient confidentiality and not let the seeming informality of social media lull them into straying over professional boundaries – even on closed or “secure” sites. A couple of posts on the physician blog 33Charts nicely summarize some of the issues around doctor-patient interactions via social media. And you can monitor the Clinical Cases and Images blog for ongoing updates about this issue.

This all seems like common sense, certainly. And in many ways, it hearkens back to debates within professional circles about the early days of online communities, discussion boards and the like.

What may be different now is that both professionals and patients/consumers with access are using digital technology in far greater numbers, with far more sophistication, than a few years ago, and the adoption curve for social media tools is especially steep. We’ve also seen the ongoing rise of the “e-patient,” the term the late Tom Ferguson, MD, coined years ago to describe individuals “equipped, enabled, empowered and engaged” in their  health and health care decisions.  A federally sponsored summit earlier in November discussed this trend and its implications in depth.

My favorite take-away from this discussion? The Medscape review noting that, as far as the potential for clinician missteps on social media platforms is concerned, “physicians behaving badly is not a new concept, but for years, the risqué humor, alcohol-fueled hijinks, and derogatory slang in patient charts — think ‘CLL’ for ‘chronic low-life,’ ‘LOBNH’ for ‘lights on but nobody home’ and ‘grave dodger’ to describe a chronically ill elderly patient — have been hidden from view.”  Digital technology, the piece notes, makes it possible for all the world to see such potential bad behavior.

Will the pluses that social media tools present to transform professional and professional-patient/consumer communications outweigh the minuses, real or perceived? I  hope so. But stay tuned.


The more things change….

November 6, 2009 at 12:29 pm | Posted in Communications strategy, Digital strategy, Multimedia, Regulation, Social media | 4 Comments

Add the Food and Drug Administration to the list of those following how social media is transforming communications. In this case, the subject is the promotion of FDA-regulated medical products — including prescription drugs for humans and animals, prescription biologics, and medical devices – “using the Internet and social media tools.”

To gather comment from parties interested in this topic, the FDA has scheduled a public hearing November 12 and 13. There’s plenty of interest – registration for speakers and attendees is closed. You can follow the hearing via a free webcast . The agenda is here.

For those of us old enough to remember, this is especially interesting since we’ve been here before – on October 16 and 17, 1996, to be exact. That’s when FDA held a public hearing “to discuss issues related to the promotion of FDA-regulated medical products on the Internet.” Topics covered at that time included investigational product information, chatrooms and newsgroups (remember those?), and Web site links. The FDA has fired up its wayback machine and helpfully provided a transcript of that meeting.

There was widespread expectation that that hearing would yield specific guidance on using a then-new communications medium to promote, market or just plain discuss regulated medical products. As it turns out, FDA didn’t issue such formal direction, instead advising marketing/communications types to follow existing guidelines, which were developed with print and broadcast in mind. As I recall, the idea was that the net/web, while a new medium, did not necessitate a whole new set of regulations for proper use.

Thirteen years later — an eternity in Internet time — the digital media landscape has changed dramatically, of course, with an explosion of new technologies — particularly social media. But what about the core issues?

The FDA, in its Federal Register posting on the new hearing, has identified five areas to be explored in this latest hearing:

  • For what what online communications are manufacturers, packers or distributors accountable?
  • How can manufacturers, packers, or distributors fulfill regulatory requirements (e.g., fair balance, disclosure of indication and risk information, postmarketing submission requirements) in their Internet and social media promotion, particularly when using tools that are associated with space limitations and/or real-time communications?
  • What parameters should apply to the posting of corrective information on Web sites controlled by third parties?
  • When is the use of links appropriate?
  • Questions specific to Internet adverse event reporting.

All good questions, but when asked in the formalized setting of a public hearing by a regulatory agency, they underscore how policy can lag market/user demand and behavior when it comes to fast-moving developments in communications.

There are other instances of this, of course. For example, Susannah Fox of the Pew Internet and American Life project, one speaker at a meeting I’m attending on consumer health informatics, spoke today about security issues related to the broad adoption of electronic health records.  She noted that the federal law governing health information privacy dates from 1996, barely two years after the Web was born. Final regulations were issued in 2002, but even that date is years removed from the current explosion in the development and use of online medical and health information.

Will the latest FDA hearing on social media raise substantive new issues that prompt the agency to act in any way different than it did more than a decade ago? Stay tuned.

Focus, focus, focus

November 1, 2009 at 8:17 pm | Posted in Business Models, Digital strategy, Strategic planning | Leave a comment

The Harvard Business Review recently offered an interesting review of the challenges that philanthropic organizations face in critically analyzing what their strategic goals, how well they’re meeting them, and how to adjust priorities to improve their performance.

The article, entitled “Galvanizing Philanthropy,” is especially timely given the varying degree of organizational review and program juggling that’s been going on at many foundations as a result of the squeeze the recession has put on endowments and portfolios. Note, an HRB subscription is required to see more than an article summary.

Interestingly, say authors Susan Wolf Ditkoff and Susan J. Colby of the non-profit consultants The Bridgespan Group, the challenge to focus based on objective analysis is one that philanthropies face regardless of the economic climate. It’s just that hard times bring things into much sharper relief.

How to best assess foundation performance is something a number of visionary philanthropies and their executives have talked about for a while. When I was running the communications and publishing group at The Commonwealth Fund, for example, this was a favorite topic of EVP/COO John Craig, who spoke and wrote about it extensively. One good example is John’s 2006 essay on assessing a foundation’s performance. He also wrote earlier this year about private foundations’ response to the “new financial realities” the recession rained down upon them.

Philanthropies are in this delicate spot because of the double-edged sword that is the essence of nonprofit, mission-driven organizations, the Harvard Business Review piece notes. These entities, “exempt from the accountability imposed on business by markets or on government by voters, are free to experiment and take risks,” it says. “But they have little experience in objectively evaluating their own performance or figuring out how to improve it.”

To give a sense of how to attack this issue, the authors look at how the James Irvine, Bill & Melinda Gates, Annie E. Casey, David and Lucile Packard, and Edna McConnell Clark Foundations worked to “get real” by focusing on key strategic “anchors” to optimize their resources and outcomes.

Obviously, the more focused a foundation’s overarching strategy, the more focused and potentially high-impact its communications strategy will be.

Thanks to my good friend and former Medscape colleague Mike Squires, now a top-drawer health IT consultant, for drawing my attention to this HBR article.

Amazing web stats (no, not mine)

October 30, 2009 at 12:08 am | Posted in Digital strategy, Social media | Leave a comment

Thursday marked the 40th anniversary of the birth of what was to become the internet.  The day before, Harvard Business Publishing had a spiffy blog post with five “mind-blowing” statistics putting into dramatic perspective just how much that most ubiquitous of net applications – the web – has grown in the 15 years it’s been with us. Taking a look at these, compiled by blogger Anthony Tjan, it’s a wonder that anyone trying to implement an effective communications plan can get above the background noise.

Herewith, Tjan’s five fun facts guaranteed to make you the life of the next Communications Network cocktail party (see the complete post for references and additional resources):

1) The number of web sites has increased some 40,000-fold in 15 years, from an estimated 5,000 in 1994 to more than 200 million today.

2) Since its genesis in the late 1990s, blogging has grown exponentially, with an estimated 1 million-plus blog posts now uploaded daily.

3) Twitter has seen an estimated 5 billion-plus tweets since its launch (Tjan points to a “gigatweet” counter on the web that may or may not be accurate but is still cool).

4) Google owns the search market to the tune of an estimated 2 billion queries a day, while an estimated 700,000 new users are added daily to Facebook.

5) About half of the top 10 web sites, whether US-based or global, are no more than six years old (Twitter, born in 2006, is not yet in the top 10 but is only a few spots away, says Tjan).

Feel like your own online initiatives barely amount to a bill of beans in this vast digital communications stew? I do. But it’s fun to play with the run rate for these stats and figure out the date by which every human being on earth will have a Facebook page, blog, Twitter account, or all three (first one to figure that out  wins a prize to be named later).

Well before then, of course, at least a half-dozen new technologies will have come along and we’ll be sharing amazing stats about them. Stay tuned.

Social media — the “dark side”

October 26, 2009 at 11:38 am | Posted in Social media | Leave a comment

It should be no surprise that social media, like anything, can be very useful as a communications tool as well as an enormous waste of time. Now comes a report assessing just how much of a waste (it’s always fun when folks try to quantify these things).

According to a post on the Mashable blog, an IT services company has determined that workers in the UK are costing their employers some US $2.25 billion by using social media networks of various kinds. Call it frittering away by Twittering away, perhaps.

As this post notes, this sort of research isn’t new, nor is it limited to how social media can be just one more way for us to waste time and money at our desks. I recall the early days of the web when many studies put a price tag on productivity lost by workers surfing all manner of sites that had nothing to do with work (shopping, game sites, dating, etc.).

Indeed, as the post concludes, if you add up all this stuff, you have quantitative proof that workers spend their entire day at stuff other than work (well, maybe on some days). And it reminds us that before we had all these spiffy digital tools to help us waste time, we had the water cooler and the coffeemaker.

This just underscores what most of us already know. Social media channels, for all their real (and potential) transformative upside, aren’t magic or a strategy unto themselves, but just a means to specific ends, to be used appropriately.

What I’d love to see is a body of quantitative research on the ROI that social media do or can offer to those of us trying to adapt communications plans to the fast-changing digital landscape. Will those start to roll out any time soon?

Stay tuned.

Social? Try mobile too

October 22, 2009 at 6:00 pm | Posted in Mobile internet, Social media | Leave a comment

We heard a lot at the Communications Network conference about how we’re all testing the social media waters as part of our communications efforts — some dipping a toe, others wading in to the waist and a few (to torture the metaphor a bit more) diving in.

It was clear that the opportunities here go well beyond adding a simple content distribution channel , and equally clear that no one quite knows yet just useful — and cost-effective — these tools will be. Indeed, more than a few of us joked in hallway conversation that just as we figure out the basics of current Web 2.0 tools, we’ll have to contend with the next new thing coming down the pike.

So it was with great interest that I saw today’s post on the Society for Scholarly Publishing’s Scholarly Kitchen blog by my friend Kent Anderson, one of the chief drivers of the New England Journal of Medicine‘s highly innovative online publishing efforts. Kent reports on the latest economic and internet trends identified by Morgan Stanley’s Mary Meeker in her presentation at this month’s Web 2.0 Summit in San Francisco. Her take-home message this year — “Mobile Internet.”

This was Meeker’s 6th annual review of emerging trends in this space and Kent points out that she’s provided spot-on analysis every single time. So her overview is worth reviewing by anyone experimenting with Web 2.0 tools, no matter how sophisticated the effort.

In addition to walking through mobile internet trends, Meeker analyzes the revolutionary nature of social media networks like Facebook, then ties it all together. Kent offers a terrific synopsis and you can see Meeker’s slide deck on Scribd.

How will our communications efforts have to evolve to take full advantage of the mobile internet? Will we just be getting comfortable with that platform when something entirely new comes along (I keep predicting that it’ll be holograms, but what do I know)?

Stay tuned.

Dancing as fast as we can — takeaways from CommNet ’09

October 16, 2009 at 10:18 pm | Posted in Digital strategy, Multimedia, Social media, Storytelling, Strategic planning | Leave a comment

The Communications Network’s just-concluded annual conference provided equal installments of the cutting-edge — how to leverage social media — and the basic — how to craft and implement core communications strategies and overhaul your web site.

A squad of volunteers tweeted and blogged about the conference in real time. Rather than recount what other have already said far better than I, see the results of this useful and interesting experiment in using social media to discuss, among other things, how to best use social media, on the Network blog and archived Twitter stream.

My own thoughts, which I hope add some value to the ongoing conversation.

Social media. The biggest buzz. Keynoter Clay Shirky, an NYU professor and Web 2.0 big thinker, made me want to rush downtown to sign up for what must be a very entertaining and informative class. But I was also reminded that it’s important not to get too caught up in any evangelist’s fervor, even as they motivate you to a higher calling.

Shirky offered a series of compelling take-home messages about the revolutionary nature of the web in general and social media tools in particular, especially their ability to encourage unfettered information-sharing that can easily translate into calls to action. The good news – these tools offer those of us in strategic communications numerous opportunities to connect, monitor, listen and interact with audiences that not only are interested in what we do but can be helpful to advancing the goals of the institutions for which we work. The big challenge – getting past the notion that we can exert the same level of “message control” in this vigorous e-discourse that we might through more traditional one-way channels. As Shirky notes, “give it up” (you might want to use that in your next communications planning memo to the boss).

I fully buy into the potentially substantial upside and the argument that if you’re not part of the conversation, you’re letting others define you. After all, the train is moving, fast, and we’re be best advised to hop on in some appropriate and useful fashion while the thing figures out where it’s going. I actually would have liked a little more leavening discussion from Shirky of the “dark side” of this ride; Frank Rich did cover that, in spades, the night before, in the broader context of how the media have been ripe for manipulation for decades and now it’s just a lot easier. But Shirky did remind us of the need to be sure that we’re weighing the value of these tools as we would any others. Because at the end of the day, that’s what they are – tools, to be used strategically and carefully, like any other.

Story-telling has been a popular theme in non-profit communications for years, a mantra for many of us trying to get the word out and engage key audiences with more than just the latest white paper. And so it was at this conference. My main takeaway here was a useful discussion of the tricky business of getting top-level buy-in for the notion (“that’s just not what we do”); program-level buy-in for  identifying and vetting the stories we want to tell (“I’m just too busy helping grantees effect real change”) and a realistic process for the storytelling itself, regardless of the media formats we choose to use.

Digital strategies, from web site overhauls to more aggressive use of multimedia to jumping into the social media space, are critical to get right, as we all know. And they should be intelligently and firmly integrated into an overall communications strategy that is a solid extension of clearly defined institutional goals, aligned fully with grant-making. So it was a reassuring reality check to hear that no one – not even some of the big guys – has quite yet reached this strategic Nirvana. At the end of the day, we’re all just doing the very best we can to get it right. And while there were plenty of tips about what to do and scores of suggestions of tools with which to experiment, the bottom lines were familiar and worth repeating, maybe even reTweeting.

  • Focus on a clear number of agreed-upon, critical goals.
  • Plan. Rinse. Repeat.
  • Work tirelessly for enterprise-wide buy-in, giving credit where it’s due.
  • Do your homework on technical issues (and get expert help if needed).
  • Establish performance baselines and realistic metrics for improvement.
  • Monitor progress over time and adjust as you go.
  • Don’t fall in love with gadgets.
  • Don’t kill good ideas with endless discussion.
  • Just try it.

How well will we have applied these lessons when we meet for next fall’s conference? And what will be the new new thing by then?

Stay tuned.

RIP Stanford Professional Publishing Course

October 13, 2009 at 10:29 pm | Posted in Business Models, Journalism, Media business | Leave a comment

Say a little prayer for the Stanford Professional Publishing Course, officially shut down at the end of September. It was 31. Cause of death was acute financial stress due to general economic upheaval and the acute insufficiencies affecting publishing in particular.

As a course alum, as both a student and lecturer, I join many colleagues and friends in mourning the demise of the SPPC.  I was lucky enough to attend in an era (not so long ago, really) when my employer not only was willing to allow me but actually encouraged me to take a little time to think strategically and come back to my desk refreshed and full of ideas. A few actually came to pass — like some of the web projects I helped to initiate at JAMA in the 1990s — and others had more appeal as ideas than as real-world businesses. No matter. There was a sweet appeal in being able to brainstorm with some of the great minds in publishing and be treated as their equals, if even for only a few days at a time.

The SPPC was where many of us first heard in any detail about the web; learned about an experimental venture called HighWire Press; listened to a largely unknown Jeff Bezos talk about a crazy little company he called “” (and complained years later about having not bought stock the next day); dictated headlines to the founding editor of People magazine; shared a beer with Brendan Gill as he talked about his days at the New Yorker and a half-dozen of the greats of American literature; and got to hear John F. Kennedy Jr. charmingly admit that he wouldn’t have been George‘s publisher but for his celebrity.

Marty Levin, one of SPPC’s deans, provides more details here.

Will a new SPPC rise up to serve today’s generation of media professionals?

Stay tuned.

Watch this space for updates from the Communications Network’s fall conference

October 13, 2009 at 1:17 pm | Posted in Uncategorized | Leave a comment

Bruce Trachtenberg, valiant exec of the Communications Network, the professional association of foundation communications officers, has put together a terrific lineup for this year’s event — so good, in fact, that the conference has been sold out for a while.  Fear not; I (and others, see below) will offer the occasional highlight.  Since I was shut out of last year’s meeting, I’m especially pleased to be attending this time around.

Keynote speakers include New York Times columnist op-ed columnist Frank Rich. But the concurrent sessions promise a wealth of insight from the front lines of foundation communications, from strategic discussions to practical reviews of new tools and tactics. One especially interesting feature should be the “Gorilla Engagement Squad,” a group of volunteers who will capture and share highlights of the meeting using tips for using social media tools.

Stay tuned.

In which your intrepid correspondent tries his hand at consulting

October 12, 2009 at 11:39 pm | Posted in Uncategorized | Leave a comment

After three decades (ouch) of full-time employment, I recently found myself restructured out of my job as Vice President for Publishing and Communications at the New York Academy of Sciences. Given the way the world is these days, I’m in good company. I wish the Academy and its terrific staff nothing but the greatest success.

I’ve chosen to take this little bump in the road as a sign that I should try something different. So I’m embarking on a midlife career change and taking up strategic publishing and communications consulting, something I’ve been doing in one form or another in my last four full-time jobs in the health, medical, policy and professional education arenas.

My goal is to do what I can to help non-profits — professional societies, associations, advocacy groups, foundations and the like — better harness their communications resources and “storytelling” capacity to more effectively reach key audiences. And, since I’ve been there since the beginning, applying online opportunities will be my focus.

I have a number of colleagues and friends who have been in this space for several years now, and they are wizards at it. Hopefully there will be a little room for me to join them in doing good work. Thankfully, a few brave souls have agreed to take me on, and perhaps more will follow.

But enough pitching. I plan to use this space to provide what I hope will be useful observations about developments and trends in strategic communications and publishing in the non-profit sector. I welcome all comments and advice.

Stay tuned.

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