Cast & Curious

Category: Self – Management

  • Debunking fake health news on social media

    Majority of adult Americans get their news from social media according to a recent 2016 Pew Research Center study. Roughly two thirds of Facebook users get their news on this social networking site, which translates to 44% of the US general population. Forty two percent of US consumers used social media to assist in their healthcare decision making decisions. The proliferation of fake news however has sowed confusion among 63% of adult population on social media. Health and health care wasn’t spared from fake news proliferation.

    In this discussion, we hope to raise your awareness on fake health news, learn how to spot fake health news online and advocate sharing of tips on spotting fake health news to the general population. Specifically,

    • to reflect on why (or why not) fake health news on social media is a problem
    • to enumerate ways on spotting fake health news on social media
    • to identify the ways in which social media companies combat fake health news
    • to enumerate way how healthcare professionals should address fake health news on social media.

    Fake news or post truths are “type of propaganda that consists of deliberate misinformation or hoaxes spread via traditional print and broadcast news media or online social media”. It is intentionally written and published to mislead people for financial or political gains. Fake news often have “sensationalist, exaggerated, or patently false headlines” to grab the reader’s attention.

    • Activity 1. Test your fake news knowledge by answering this BBC Quiz on spotting fake news. A number of quiz items refer to fake health information online.

    Social Media as a source of trustworthy news

    Approximately 62% of US adults get their news from social media sites such as Facebook and twitter.

    Percentage of US adults who get news from social media networking sites (Source: Pew Internet Research Group)

    This is a significant increase compared to a 2012 study, which says that 49% of US adults seek news on social media sites. Interestingly a 2012 pWC Health Research Institute study showed 42% of consumers have used social media to access health-related consumer reviews and assist in their healthcare making decisions.

    Not only are US adults getting their news on social media or that social media information influences their healthcare decision making but the trust ratings for health information on social networking sites are high. A 2016 architectural approach study revealed that users perception of health information on social media is high. This confirms an older 2012 pWC study that revealed 90% of respondents age 18-24 would trust information shared by others on social networking sites.

    Recently, the proliferation of fake news online has sowed confusion among social media users. About two-in-three U.S. adults (64%) say fabricated news stories cause a great deal of confusion about the basic facts of current issues and events. Fake news and the confusion it brings is even more dangerous and potentially damaging in healthcare. One of the most shared health news on Facebook is fake health information. Can you spot this popular health misinformation?

    Are fake health news on social media a problem?

    A recent Independent (UK) article stated “how dangerous fake health news has conquered Facebook” postulating that “misinformation published by conspiracy sites about serious health conditions is often shared more widely than evidence-based reports from reputable news organisations”. Half of the 20 most shared news bearing the word “cancer” in its headline seen by a combined total of millions in 2016 were discredited by health authorities and are considered myths or fake news. The worst part of this cancer fake health news is that it is dangerously misleading.

    In what ways could social media companies combat fake health news? 

    As to when will proliferate of this fake health news on social media end, nobody knows. Facebook CEO Mark Zuckerberg has pledged efforts to curb fake news on facebook and a group of scientist and science supporters have debunk some of the more popular cancer myths on social media. Some perpetuators of fake health news fought back by spreading information about “censorship on independent journalism” by social media sites or internet gatekeepers.

    How should healthcare professionals address fake health news on social media?

    There are a few health institutions and professionals who seek out and debunk fake health news on social media. Cancer Research UK and Sense About Science are two of these institutions but fake health news continues to proliferate online.  Admittedly, not many healthcare professionals debunk (or at least voicing out their concern) fake health news on social media. This is one of the reasons why fake health news still proliferate online.

    Activity 2. Using your twitter handle (eg. @bonedoc), join the #HealthXPh chat on twitter this Saturday September 30, 2017 9:00- 10:00 PM Manila time  and reflect on the following guide questions

    • T1: Is fake health news on social media a problem? Why or why not?
    • T2: In what ways could social media companies combat fake health news?
    • T3: How should healthcare professionals address fake health news on social media?

    Send your reflections with the hashtag “#HealthXPh” anywhere inside your 140 character length tweets. Multiple tweets allowed so long as it is within the one hour time frame set by the moderator. Expect retweets and tweet-discussion with global participants.

    FactCheck.org a US non profit consumer advocate, together with The International Federation of Library Associations and Institutions (IFLA) developed an easy checklist on how to spot fake news online. This is reflected on a shareable graphic below.

    Activity 3. Using this guide, retest your fake news knowledge by answering this BBC Quiz on spotting fake news. Share your experience on this discussion by appending your thoughts/ summary on the header of this image and posting it on your social media networks.

    Summary:

    In this learning discussion, we raised your awareness on fake health information on social media, did activities to spot and debunk fake health news on social media and shared your thoughts on combating the proliferation of fake health news via social media twitter and facebook. #HealthXPh hopes that healthcare professional would play an active role in combating fake health news online.

    References: 

        1. Gottfried, Jeffrey and Shearer, Elisa ; Pew Research Center, May, 2016, “News Use Across Social Media Platforms 2016” Retrieved Sept 30, 2017 http://assets.pewresearch.org/wp-content/uploads/sites/13/2016/05/PJ_2016.05.26_social-media-and-news_FINAL-1.pdf
        2. Health Research Institute April 2012; Social media “likes” healthcare From marketing to social business Retrieved Sept 30, 2017 http://www.pwc.com/us/en/health-industries/health-research-institute/publications/pdf/health-care-social-media-report.pdf
        3. Lopez, D.M., Blobel, B. & Gonzalez, C.; Information quality in healthcare social media – an architectural approach; Health Technol. (2016) 6: 17. Accessed Sept 30, 2017 https://doi.org/10.1007/s12553-016-0131-9
        4. Andrew Griffin, Rachel Roberts; Facebook’s plan to stop fake news revealed by Mark Zuckerberg, but site will continue to promote stories it knows to be fake. Independent (UK) ; 15 December 2016 18:59 GMT Accessed Sept 30, 2017 http://www.independent.co.uk/news/uk/politics/facebooks-plan-to-stop-fake-news-revealed-by-mark-zuckerberg-facebook-changes-what-are-they-fake-a7478071.html
        5. Childs, Oliver Don’t believe the hype – 10 persistent cancer myths debunked Science Blog in Cancer Research UK March 24, 2014 Accessed Sept 30, 2017 http://scienceblog.cancerresearchuk.org/2014/03/24/dont-believe-the-hype-10-persistent-cancer-myths-debunked/

  • Teaching the “right” attitude and values to would be doctors

    There are several methods of curriculum development in medical education. I’m familiar with Kern’s Six Step Approach to Curriculum Development which I discussed  briefly in this post. This approach is far from perfect but components of medical education ( knowledge, skills, attitudes and values) may be effectively taught using this approach.

    Kern's 6 Step Approach
    Kern’s 6 Step Approach to Curriculum Development

    On top of of this Six Step Approach is a well conducted general needs assessment of the community where health professionals are to be deployed. This needs assessment also determines the context that wrap health issues in that specific community. Implementing a health education program without prior contextual needs assessment is like running a car without a definite destination. Resources are spread thin across multiple objectives, draining resources and produce graduates who are “misfits”- physicians who just don’t fit the target community’s context of health issues. A misfit health professional so to speak.

    For years I believe, our goals for educating health professionals didn’t change much and remained true to the ideals of health profession. We still want to train ethical and moral health professionals serving our country in the most excellent and conscientious way. Our instruments in achieving these goals however have changed dramatically in todays digital age. Access to information greatly improved but processing these information lags behind. We have access to western health research but such data just don’t fit especially in the countryside where the context of health issues is radically different. We train our would be physicians that western medical knowledge and skills is the way to go in medicine but what is in the books and journals are vastly different from what we have here on the ground. The stark difference is even more palpable in the attitude and values being taught at healthcare academe. We have forgotten the socio cultural context of our health issues. We train highly skilled and knowledgeable physicians yet they don’t seem to fit the community they’re placed in. Most of them just gravitate towards the urban tertiary centers where western medicine, the context of how we train them, resides.

    Teaching medical knowledge and skills has evolved so much in recent decades.  Attitudes and values however remains the hardest, most elusive component teach and assess. Thus we hear of health professionals who’s attitudes and values are way off what’s expected of a health professional. Whispers of “lazy, easily discouraged, whiner, scum” health professionals  can sometimes be heard on performance evaluations.  The lack of a clear context and need assessments predisposes a program to produce such health professionals.  The lack of validated instruments to impart and assess our methods of teaching attitudes and values in our health education programs remains challenge to the medical academe. We’ve tried teaching methods like “fellowships” or paired didactic/clinical exposures, increasing patient exposures, community immersions  and other but we yet to figure out exactly how to teach and assess desirable attitudes and values to our health professionals.  We knew teaching methods are customised  on the context of the community and cannot be standardized across regional difference. Perhaps a basic framework to work on and modified regionally according to context would be a good way to start.

    So far, a standard method of evaluating attitudes of health professionals needs to be implemented and validated widely.  The closest we can get after going through the rigodon of trying to each time, is the multi peer assessment. This is an assessment method wherein everyone in the health professionals working environment gives an assessment as to the attitude of that health professional.   The assessment is quite comprehensive and is reflective  the working atmosphere of that health professionals. It is however tedious. Categorising components of this assessment tool and making sure everyone in the working environment uniformly understand its content requires training.

    In summary, our goals in teaching the “right” attitude for health professionals, hasn’t changed much in the past decades. The lack of clear context and needs assessment plus the scarcity of teaching and assessing ” attitudes and values ” among our health professionals is contributing much to “misfits” in the health community. A multi peer assessment is the closest tool we can use but is tedious and time consuming. A basic framework for training should be created on a national level but modified regionally according to the specific context of health issues present in that region.

  • Ten daily routines that help me balance my professional and personal lives

    “You don’t find time to do all these stuff outside of your physician’s life. You make time” as the cliche goes.

    Nowadays, I shy away from giving personal advices but instead “listen” until the advise seeker process his or her own personal thoughts and strategy. Knowing how different life circumstances are, my “personal” advices rarely work on everyone else on this planet.

    Yet there is a personal strategy I use everyday (or at least try to) in finding balance to the “tug of war” of my personal and professional life. Nothing in this strategy is original to me. I got most of it from people I look up to or books that I read.  The components of this personal strategy are mostly life tweaks, or hacks, a product of  daily hit and miss experimentations.  So if you are looking for a template to develop your own “personal” strategy, have at look at my daily routines. Pick the ones that would work for you or better yet, tweak to customize your own strategy. Enjoy!

    1. I meditate for 15-20 minutes daily. There’s evidence proving the benefits of mindfulness and meditation. My day would be a bit calmer, tasks and goals clearer and I react less to outside trivial triggers. The goal here is really not to create a state of mind and being but just to be self aware and mindful of everything that comes into mind. Consistency is key for me. The more I do it everyday, the greater is the benefit for me. I use a guided meditation app called Headspace.
    2. I journal everyday. Journalling makes my tasks and goal for the day clearer and simpler. My morning journal also centers on what not to do to weed out unnecessary stuff on my schedule. Journalling triggers a good portion of creative inspiration in me.  At night, journalling gives a sense of fulfillment for completing  small but meaningful tasks . My format is basically a tweaked 5 minute journalling although doodling sometimes eat another good 10 minutes of my time.

      An empty example of my daily journal.
    3. I talk to mentors as often as I could.  I have a set of personal and professional board of advisers I call to for advice. These are people who’s thoughts and advices on subjects add value to my my decision making process. Sometimes, “talking” means reading self help, life hack books to pick out skill sets or strategies and then customise it for my own purposes.
    4. I connect with my advocacies. I knew only a handful of lucky people who’s advocacy exactly coincides with a career that put food on the table. Mine is far from such although I strive daily to align my advocacies and work. An advocacy (like our at #HealthXPh) is self fulfilling while achievement is usually associated with “wins” in our professional lives. Advocacies also steer me directly to an aspirational self “who changes the world” for the better.
    5. I practice my hobby, everyday. Hobbies are not just a distraction but a life essential for me. It is my ultimate source for the creative juice for a life I designed for myself.  I love photography and hiking as well as blogging. So I invest time and money modestly in these to force myself into consistently practicing it. I have to or else my professional life will eat up more time of my daily schedule.
    6. I network with friends outside my professional circle. A nurturing community outside my professional circle is an essential for me. I found out that most of the personal “help” I had in the past was from people outside my professional circle. This network of friends are also a source of life hacks I listen to and emulate.
    7. I read books. Goes without saying that I consider books as mentors too. It is my gateway to new and exciting world beyond what my mind could possibly ponder alone. A good 15-30 minutes or even an hour is spent on reading pages of one or two books, then another 15 minutes for my “marginalia” or very short personal summaries of the pages I read. I also horde books. It’s a screaming bargain!

      Book hoarding for later read.
    8. I aggressively protect my personal and family time. Another very important non negotiable for me. I know this is very hard for most of us in the medical profession but I started out focusing on small day to day opportunities of saying “no” when my personal life requires me to. Key is being consistent on what constitute personal or family time. Sometimes industry will hate me for having such a immovable stance on this, but I felt somehow they’d respect me for doing so.
    9. I consciously build a productivity based and proactive professional practice rather than a reactive one. I can’t work effectively or productively for more than 4 hours each day, except while doing surgeries. I found this primarily beneficial to my patients, who deserved the best and most productive of my time. This translates to less income for me but greater non tangible benefits for my professional and personal life.
    10. I exercise 15 minutes each day. The benefits of regular, consistent exercise is well documented. Doesn’t matter what form of exercise is available to me so long as I move. I sometimes dance when no one else is looking. 🙂

    Well wait you might ask what the heck am I enumerating these for? First,  I specifically mentioned  “processes” or daily routines that help me “win” the balance to a  daily tug of war of personal and professional lives.  These routines help me make better choices or at least avoid the worst ones. Do I have proof that these work? On a personal level, yes or at least I felt it’s working for me. I think finding the balance in our life starts with the small, daily processes and decisions we make. So in this case, to win big, I start with the daily struggle and work from there.

    I hope you will find this useful. Feel free to comment below for your thoughts.

  • Mental Good: How healthcare professionals balance career and personal lives

    “To go beyond is as wrong as to fall short.”- Confucius

    About a month ago a colleague committed suicide just a day after her hospital duty . She was working 72 hours straight without sleep for weeks, but not even her family had an inkling she was about to take her own life.  Two days ago I talked to another friend who is disappointed with his medical career because of the so many challenges he is going through. He is beat up. Today, I talked to another healthcare professional and the same “tone of disillusionment”  is palpable as tears well in the corner of her eyes.

    “This is not what I signed up for medicine”  was the bottom line for this three healthcare professional.

    Disappointment, frustration or simply “burnt out”  is a well known but rarely verbalised, “not so secret” secret among colleagues in the healthcare profession. In fact, it is so common in the medical profession we’ve considered this part of the “normal challenges” of our career path and we expect every physician to survive it. Of course the sad reality is that not everyone survive this challenge.

    Some of them end up dead.

    While the cases of suicide among healthcare professionals maybe small and sporadic (an outlier) what surprises us the most is that nobody seem to have an inkling that physician or healthcare professional A is depressed and suicidal until he or she is actually dead or dying.  Are healthcare professionals good at hiding depression and frustrations or have the general public gotten used to the notion that healers ought to endure superhuman problems and heal themselves?

    The devil is in the small details.

    Most of the telltale signs of depression are what we see as “normal” in the day to day existence of a healthcare professional. Seventy Two hours straight duty? That’s normal. Most even brag about it. Felt bullied by a senior? “Oh thats just normal. That’s needed for you to harden up.” Sometimes, our health system exerts tons of pressure upon a healthcare professional, yet it doesn’t provide an outlet for overcoming stress, deprivation and disillusionment.

    When colleagues on rare occasions do come to me seeking advise on what to do with their career and personal life, I am tempted to answer drawing from my own experience. How do you balance professional and personal life really? I realized though that my experience might be an outlier too and would not be applicable to anyone else even if we thread the same career path.

    So i bring these dilemma for discussion here on our tweet chat.

    T1. As a healthcare professional, how do you balance professional and personal lives? Where do you draw the line of caring for others without harming your personal lives?

    I have seen obviously sick or sleep deprived physicians tending to patients, a dangerous situation for both patient and professional.  Where do you draw the line here?  If you are a patient, what would you suggest to your healthcare professional knowing he is sick or is sleep deprived?

    T2. What counsel would you give to a disillusioned, depressed colleague who seeks your advise,  besides seeking professional help? 

    We always give advise to disillusioned or depressed colleague but we rarely knew or had the chance to follow up if they really did.  What other advise can you give?

    T3. Can you give an example of the “lowest low” in your medical career and how were you able to overcome it?

    Join us this Saturday, May 20, 2017 9:00PM Manila time as we bring balancing life, depression and medical career into the discussions of health in the Philippines!

  • Correcting health misinformation on social media isn’t easy but not impossible

    I’ve seen  dubious health or medical information online in the past but what’s lamentable is that only a few health professionals took time to correct the misinformation.

    These are the possible explanations for this:

    1. We don’t care to do research on the health misinformation we see.
    2. We lack the necessary skills to distill  knowledge and communicate it to the general public
    3. We lack the skills to execute constructive criticisms  over social media.
    4. We lack networking skills to bring the conversation offline

    The common denominator to all of these is apathy. We don’t care that much because social media is nowhere our field of “expertise”.  We also assume that patients wouldn’t and shouldn’t believe these “fake” health information.

    Bad news is, we totally missed the train of opportunities on both instances, . Why? We assert that medical professionals should be the primary  source of medical information but failed miserably at putting our voice online.We make it hard for the general public to find credible healthcare voice online.  Majority of internet users do visit the Google search page before our clinics. Yet we somehow delude ourselves into thinking that the public will find our voice online without us doing our part.

    Why health professionals are not putting their voice online? Why are we so afraid of correcting health  information on social media?

    Most colleagues told me, they’d rather not talk or they might get into “trouble”. Things like online reputation being maligned or stepping on patient privacy rules are the biggest reason for not doing so. Second, most say they don’t have time for social media  in healthcare. Third, most lack the communication skills, that language over social media to connect well with the public. Fourth, which I think is the saddest, most healthcare professionals don’t correct misinformation until it is their reputation is at stake online.

    Most healthcare professionals are practically playing catch up with healthcare social media.

    There’s so much concentration on what physicians should not do on social media because of ethical concerns. That is a very valid reason for caution but it’s not enough. We also have to find creative strategies of using social media to provide a credible voice online and refute medical misinformation.

    Join #HealthXPh this Saturday April 8, 2017 9 PM Manila time as we discuss how credible health information can be placed online  and positively correct medical misinformation.

    • T1. As a healthcare professional, patient or patient advocate, how do you determine health/ medical misinformation online?
    • T2. Are healthcare professionals, patients or patient advocates allowed to refute fake health information online? Would you correct misinformation online? Why or why not?
    • T3. Give 3 tips on strategies you can take to correct medical misinformation on social media.

    Lets find creative ways of positively using social media to disseminate scientific, well researched health information online! Join this tweetchat!