I do realize though that patients probably wanted a social media manifesto of their own, just like their physicians. This manifesto empowers patient to “own up” their health and bring health care conversations to their level.
To refresh, a manifesto as defined by Merriam-Webster.com, is :
a written statement that describes the policies, goals, and opinions of a person or group.
A social media manifesto self commits an individual- a patient or a healthcare professional, how he/she intends to behave on the different social media platforms. We at #HealthXPh believe a manifesto is different from a guideline. A guideline is enforced by a governing body based on existing laws and policies. In the Philippines, we don’t have healthcare social media laws or governing bodies yet. A manifesto is more powerful because it’s an expression of what an individual or group’s intends to do on social media.
If you are a patient and wanted to join the conversation on patient’s social media manifesto, join us this Saturday February 22, 2014 10:00 AM Philippine Standard Time (UTC + 8 ) on #HealthXPh tweet chat and Hangout On Air.
Philippines ranks first in the global social media penetration according to a February 2011 market survey by Global Web Index. In this survey, it was also pointed out that asian countries do more ‘content sharing‘ than sharing messages as in other countries (UK, Canada). What is the implication of this survey results to Philippines’ healthcare system?
Philippines tops social media usage globally! (Infograph from Mashable by Global Web Index)
For Filipino patients, the surge of content sharing and social media usage puts a huge stress on prevailing (or lack of) Philippine laws that govern patientinformation confidentiality. The lackluster enforcement of such laws, if there is/was, is/are sporadic. One does not need to look further. The gruesome photos (trauma, surgical, etc) that somehow lands on your Facebook wall is a testament to this breach. It’s also not uncommon to read patient blogs, tweets and comments on Facebook that cast doubts on healthcare professionals or or institution’s credibility. Some even lead to sensational malpractice suits.
To healthcare professionals (physicians, nurses, allied medical professionals) the responsibility is even greater. In first world countries, there are stringent rules of engagement for healthcare professionals on how they relate to their patients and to healthcare institutions on social media. Such policy govern healthcare professionals employed in healthcare institutions and who’s social media usage directly or indirectly affects that of his or her employer. In the Philippines , while majority of healthcare professional and institutions does not seem bothered yet, catastrophic consequences still hangs in the future . How many times have you encountered photos on Facebook that are in one way or another health patient or institution related? Too often?
For healthcare institutions, this surge is promisingly positive should they take advantage of social media usage. This study by the Global Web Index for example is a market survey for business entrepreneurs. This could be an area for healthcare institution to reach out, communicate to their clients and improve the institutions online visibility. This is what the Mayo Clinic, Mount Sinaihospital for example is doing crafting their own social media policy to enhance patient – institution communication.
Filipinos spend one fourth of a day on social media network.(Thanks to Dr. Iris Isip Tan for posting this infograph)
But without a policy to govern such social media practices by their employees (internal) or their patients (external), the healthcare institution risks running into so many potential negative social media issues aside from economic ones (employees using social media at the workplace).
As an afterthought, let me share another info graphic about use of health related IT technologies in US (source). Take a look at the social media usage. To think, Philippines is ‘ahead” of US in terms of per population social media usage. I don’t know if Philippines has have similar figures in terms of health related social IT. This should be an interesting research for healthcare markets.
Health related IT technologies usage in US (source)
So to answer this post title-question, I’m making an informal, non scientific survey here. This is open to all medical and allied medical professionals. Please answer the poll and please comment below if you need to explain your answer.
“Hello! And again!” I happily greeted this patient sitting on my clinic chair. He smiled back , albeit sheepishly and said “Sorry doc!” . “Don’t mention it, it is your right by the way”.
(Photo credits goes to http://blog.drfirst.com/eprescribing/florida-providers-beware-of-doctor-shoppers/)
I saw this patient about 2 months prior to this consult in one of my other clinic in another institution. He consulted me for a certain orthopedic problem, examined him, ordered the needed diagnostic procedures and appraised him carefully of my treatment recommendations. This including financial considerations and proximity of institutions where we can do the necessary procedures. Then I lost him to follow up.
Mr. X resurfaced 2 weeks after, in my other clinic, in another institution thinking he was seeing another surgeon. He was surprised as I am that we met for the second time in another clinic and in another institution. I don’t know if he was just plainly uninformed or he wasn’t very particular physician names, but I’m pretty sure my name was clearly printed on this clinic door. The guy was surgeon shopping and is surprised that so far, he window shopped the same surgeon in two different institution – me and myself.
That aside, I went on with my routine patient consult gave the same treatment recommendations as before. His surgical problems needed the same surgical treatment. Nothing changed. Went he stepped out of my clinic door, I had this inkling I won’t be seeing this patient again. Indeed, I lost him to follow up. Again!
Until this very moment, when he showed up (again) in one of my other clinic in another institution different from his previous consults with me. I greeted him “Hello, …again!” …He went pale. So the rest of the story goes.
Just how he ‘window shopped for the same surgeon, three times, without him knowing” is mind boggling. But he obviously wasn’t very particular with names. He was shopping for the “surgeon” who will give him the treatment he liked. It’s unfortunate he ended up with the same specialist three times, in the process.
In a small city where “specialists” is as scarce as physician, “surgeon-shopping” may just be actually “healthcare facility shopping’. So patients, pay particular attention to your physicians names…
This question was thrown on me recently by a newbie colleague who was agonizing on whether or not to charge patients for an additional procedure he did to address a complication. I instantly went blank thinking what to say.
when surgery goes wrong…will you charge mr. bean?
In the field of medicine or at least here in the Philippines, there’s really no hard and fast rules on charging professional fees for services rendered to patients. This service for fee setup of our healthcare system is somewhat messy and often embarrassing to patients and doctors alike. The price haggling is totally unnerving. Sadly, this is what plague the professional practice of most physicians here in the Philippines.
Such charging “grey” is even more embarrassing in cases where patients entailed additional services outside of their routine or planned operative procedure. While explaining and appraising procedure risks and complications to patients is a requisite of any informed consent, most patients still think that additional procedures, should be an additional work for the physician and the healthcare providers alone. Patients or their financiers are not obliged to pay the healthcare providers for the services rendered for these additional procedures. Wherever, that notion came from, the stress on the attending physician(aside from that of managing the complication) is enormous, working on a very limited logistics to address complications. Besides, Docs have mouths to feed too.
This situation is akin to the “heroic” services rendered by physicians to dying patients. Just because the patient dies (despite the doctors valiant efforts to revive the patient), the fees for the physician’s services (resuscitation) does not “die” with the patient too. Services rendered have to be paid even if the service given did not achieve its original goal (that of reviving the patient). Can this situation be applied to procedures done to address morbidities?
Patients with a bantay or 'counsel' photo taken from this site (http://www.umc.org)
It’s not uncommon to see a patient or a patient’s relative bringing along some unrelated individual as “counsel” in your clinic. This counsel is unique among my Filipino patients and such counsel’s role has baffled me ever since I started my medical career. Roles, that to my knowledge broadly range from just plain ambulatory assistant or worst, to a nagging and combative counsel to the patient. I have tolerated such roles before because at times they can be very helpful in educating patients and relatives who haven’t had any time to convene a family meeting on their health issues at hand. But a recent bad experience with a ‘counsel’ pushed me to institute a policy of “no non related guardians allowed” inside my clinic.
My patient was a 10 year old girl who sustained a supracondylar fracture from falling over a park statue where she was playing with her cousins. The kid was brought to my clinic after 3 days, on a makeshift splint and after 3 sessions with a known bone setter in the area. The elbow is already grayish blue in color and is still swollen. The kid is wrenching in pain but I can still feel the pulses and there are no signs of compartment syndrome. The mom brought with her a “counsel” after the bone setter allegedly ordered an xray. In my setting here, even if we’re already an urbanize city with a tertiary level hospital at that , bone setters are primarily the first one being sought by patients or their relatives when dealing with fractures. It’s even very common to hear bone setters manipulating fractures and ordering x-rays! Anyway, what bugged me that time was the way this ‘counsel’ is disrupting my talk with the patient’s mom.
I was explaining the diagnosis and the treatment options to the mom, baring that a surgery is already needed in her daughters case. I could employ a conservative treatment (if cost is prohibitive to the parents) but the results, which I explained carefully to the mom, would be unacceptable and costly in the end. The ‘counsel” is impolite in drawing attention of the mom, and whispering barely audibles that as I can figure out was a urging the mom not to have the surgery done and bring back the patient to the bone setter. The mother was very much bothered and was in fact becoming inattentive to me because of the constant nudging of this counsel. As it grew frustrating to me, I looked straight to the counsel’s eye but politely asked the mom what is this counsel’s relation to the patient or the mom. She was a neighbor, the mom told me. She was also the one who brought the kid to the bone setter for manipulation twice! I asked the mom again politely of course, to ask the counsel to leave the clinic now and just wait outside. I also urged the mother to call a family meeting and talk with her husband the treatment options I laidout for the patient.
Well, that didn’t happen. The counsel refused to leave and worst, she kept on annoyingly nagging the patient’s mom. This prompted me to talk directly at the counsel, ask her that if she doesn’t stop disrupting our conversation, she’d answer for all the complications her constant nagging has brought to the patient’s condition. And she’d be thrown off the clinic’s premises for good!
Then there was this an uneasy silence. Everyone in the clinic knew that my usual cool composure got blown by this annoying ‘counsel’. Everyone was silent for at least 3 minutes. When the counsel was escorted out of the clinic, I apologized to the patient’s mom, not for throwing out the counsel, but for the disruption in our conversation. She just smiled and from that moment on. I know I won another loyal patron.
