Sunday, August 14, 2011

Health care and the Social (Media) Anxiety Syndrome - Do we need Baby Steps?

Let me state first off that there is no defined entity called "Social (Media) Anxiety Syndrome"*.  I am using it just as a metaphor. Social Media holds a lot of potential for the health care professionals.  Is fear of the medium inappropriately leading to professionals avoiding this "social situation"? Have we created a Social Media Anxiety syndrome?

We are aware of the social anxiety disorder or social phobia.  Among its many features are (this is a convenient list for the purpose of this post and not a strict definition):

  • Avoidance of interaction with others
  • Fear of being in a group, or being the center of attention
  • Fear that is made worse by a lack of social skills or experience in social situations
  • Possibly false beliefs about social situations
  • These factors lead to avoidance to of social situations.
Let us take a health care worker who has not used social media.  
  • It is possible that s/he would equate the term "Social Media" with Facebook and Twitter
  • Will likely be exposed to reports of unprofessional conduct on FB and Twitter and is afraid of getting in trouble
  • May be unaware of how one can have a closed Facebook account (so no patient can send you a friend request), how one can have protected tweets so only authorized people can see them.
  • Is quite unaware of useful applications of social media (e.g. RSS and feed readers to stay current with literature, use of Twitter to create a personal learning network, use of blogs to practice reflection etc.)
  • As a result avoids the entire medium. 
While there are clearly legitimate concerns about the use of Social Media by health care professionals, some of the potential problems can be averted by taking appropriate safeguards and some of the beliefs may be false.  It is possible that the voice of some experts is missing from the social media universe due to unfounded fears about this "social situation". 

Have we created a social media anxiety syndrome that prevents the voice of key people from being heard?  Do we need to develop some "baby steps" to help them?  Something like these:

Baby steps for Twitter:
  • Create a private account (Called protecting your tweets) and practice tweeting  - try adding a link to an online journal article and a short comment.  No one else can see this tweet unless you authorize it.  
  • Under “Whom to Follow” find someone whose ideas and writings you want to follow e.g.Atul Gawande.  His Twitter handle is Atul_Gawande.  You will now see their comments and links to articles and speeches.  
  • After you have added a few tweets, ask a friend or colleague who uses twitter to follow you.  You will need to authorize this.  They can give you feedback and show you some tips and tricks.
  • Create a private group twitter account - you can use GroupTweet for this.  This can be used to share informal learning objectives between residents on hospital service or longitudinal clinic)
  • Once you feel comfortable, you can unprotect your account and move towards creating a global learning network for yourself.
Do you believe that Social Media has some value for a health professional? If so would it be more valuable if more professionals were to participate in this medium? If so what is stopping them? Can we help remove some barriers? Should we even bother?

* [Since writing this I found that the term "Social Media Anxiety Disorder" has been used in 2010 by Phil Baumann for describing Pharma's Social Media Anxiety Disorder. The term "Social Network Anxiety Disorder was used in 2008 by Nicole Ferraro]


  1. Actually I coined it a while ago, referring to it as Social Media Anxiety Disorder :)

  2. Many people do see just FB and Twitter as social media... did you see this post by George Siemens?

    I feel a bit like a broken record saying this but there needs to be more teasing out of what the actual benefits are. What outcomes will social media help a health professional to achieve? Without being clear on that no-one is going to bother with the baby steps.

  3. I did see George Siemens post.
    I personally feel that the benefits of tools like RSS feeds, sharing and discussing articles, blogging for self- reflection are somewhat self evident. Every time I have done workshops on these, the feedback has been that people feel they would start using these. (whether they do is another matter).
    Do we need a study to prove benefits? The accommodators and convergers in Kolb's cycle would probably be willing to try it out if there is nothing to lose.
    Social media like twitter and G+ would benefit from the presence of more "experts" IMHO.

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  5. 'experts' in social media? in medicine? Are you saying we have a responsibility to be there? I'm really uncertain about that.

    Next, let's take blogging for self-reflection. How can or should a clinician (or a medical student) do this? If self-reflection then a private journal like 750 words might be more appropriate than a blog where one has to remember to keep the post private.

    Time is always something to lose. And there is more to lose than just time as you say. So we need to start saying what the benefits are. I'm trying to conduct this conversation with you in two different places, but I have to keep saying that as a clinician, as a family doctor, social media has quite limited utility for me. And I've been saying that for a few years! Your social media presence like mine is mainly related to being an academic/researcher/educator. But what of doctors who don't hold those roles. What is there is social media for them?

    How many people are talking about how to use RSS well now or what are the key sites that one should subscribe to? Personally, I don't see google reader as 'social media' which I consider a way of publishing to many. RSS is mainly about 'getting' getting content not sharing or producing content. Yes, google reader does have these features built in but I don't come across many people actually using them. Like social bookmarking the 'social' part can be quite hard to find.

    So I think that we should probably stop talking about social media for professional use and start talking about (and I can credit @astupple with this) 'digital media'. Even the media part might be off-putting to some people.

    Saying that the benefits are 'self-evident' isn't really going to work.

  6. In my opinion professionals in health care need to be life long learners even if they are not educators. (why do they attend conferences?) Can social media not take the place of conferences in some way? If we have the same subject matter experts (I did not mean social media experts) in social media, it would add to the richness of the content and the learning.
    Using social media tools we can create journal clubs, case discussions, reflective writing spaces all restricted to authorized groups. These are pedagogic tools used in real life by clinicians. I hope we would not have to prove their benefits just because the medium is different. I am not averse to doing this research but it will take time.
    Blogger allows your blog to be private or restricted by default without having to specify this for each post. Grouptweet allows closed tweeting within groups. Thus the tools are there.

  7. Can social media take the place of conferences? That's a good question. I'm going to a few this year and the main benefit seems to be having protected time to just talk to other people. Real-time communiction. Of course hangouts and skype do similar.

    But as a primary care doc I don't go to conferences. I do participate in CME- which is far. far too often delivered in a lecture format. What we really, really need to improve healthcare is much more messy, time-consuming talking at a local level. How can we make things better in our own areas. Of course we may be able to learn some from those in other areas- maybe because they've made a presentation about it or written a blog post or a journal article- but the main effort has to be put into making it work in a local context.
    Case discussions may lead to identifying organisational constraints, and individual constraints that need to be addressed. And I suppose a really well developed journal club might do the same.
    The kind of talk and learning I want to see isn't happening yet and it could be. I don't really see how social media gets over the current barriers to that kind of work. As Selwyn's editorial says we have to start seeing the world as it is rather than how we want it to be. I can do pessimism in spades:)