The Journal of Pediatrics
Volume 158, Issue 1 , Pages 1-2, January 2011

Social Networks and the Practice of Medicine: Harnessing Powerful Opportunities

  • Michael P. McKenna, MD

      Affiliations

    • Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
    • Corresponding Author InformationReprint requests: Michael P. McKenna, MD, Indiana University School of Medicine, Department of Pediatrics, 702 Barnhill Drive, Room 5867, Indianapolis, IN 46202.
    • ,
  • Donna D’Alessandro, MD

      Affiliations

    • Department of Pediatrics, University of Iowa School of Medicine, Iowa City, IA

Article Outline

COP, Community of Practice, SM, “Social media”

 

This instrument can teach, it can illuminate; yes, and it can even inspire. But it can do so only to the extent that humans are determined to use it to those ends. Otherwise it is merely wires and lights in a box.1

When uttering these words in a speech to the Radio Television News Directors Association, Edward R. Murrow was not railing against the newest Facebook fad. He was discussing broadcasting’s professional responsibility to use television not to just entertain the American people, but to instigate thoughtful debate and foster learning. He could as easily have been talking about today’s “social media” (SM) and its applications in medical practice.

SM is an Internet application in which users generate the material. Although a journal’s sponsoring society decides what to put on its own Web site, Facebook (www.facebook.com), Twitter (www.twitter.com), or YouTube (www.youtube.com), users determine what is published via blog posts, status updates, and videos. SM also helps users make connections by suggesting other users with whom one might want to be “friends.”

One potential pitfall regarding SM concerns medical professionalism. Unprofessional actions on SM have been well documented and recently summarized in The Journal.2 But SM is highly individual and expressive, and thus can be used as a self-reflective tool to help teach medical professionalism.3 Medical schools are actively developing policies to help guide learners in using SM.4, 5 These concerns should not detract from the powerful opportunities to use SM to teach the future generation of pediatricians, empower patients to become more involved in their medical care, foster connections among pediatricians, and improve public health.

The so-called “net generation” is now entering higher education. Born between 1982 and 1991, this future generation of medical professionals has been called “digital natives” due to the ubiquitousness of computers in their childhood environment.6 The net generation has a unique learning style highlighted by interactivity, multimedia, immediate response, and the use of technology.7 These are also the hallmarks of SM. Medical educators in the 21st century must accommodate this learning style.

Because of its connectivity, SM provides an excellent avenue for empowering patients in caring for themselves. In January 2009, Farmer et al8 found 290 000 Facebook members participating in 757 different Facebook groups related to such disorders as cancer, asthma, and Down syndrome. In an analysis of the posts for 17 concussion-related Facebook groups, Ahmed et al found that 65% of the posts were sharing personal experiences, 8% were seeking advice, and 2% were looking to advise others.9 PatientsLikeMe (www.patientslikeme.com) is a Web site with a goal of bringing together patients diagnosed with “life-changing diseases,” as well as “doctors, pharmaceutical and medical device companies, research organizations, and nonprofits,” to share knowledge and information.10 Patients are even using the Internet to help conduct their own drug studies.11 SM is providing a means to help patients control their care and collaborate with fellow patients and their physicians.

Today, the question is not if pediatricians will use SM, but rather how they will use it, and for what purpose. Increasingly, physicians are accessing medical information via mobile technology.12 In 2008, Harvard Medical School, Stanford University School of Medicine, University of California, Berkeley School of Public Heath, and University of Michigan Medical School founded Medpedia (www.medpedia.com), a medical wiki dedicated to “sharing and advancing knowledge about health, medicine and the body among medical professionals and the general public.”13 Patients can ask questions and seek information about topics related to health and medicine. Physicians answer patients’ questions and produce, edit, and review articles on medical topics. Although some are concerned about the veracity of information posted on wikis, Medpedia checks editors’ credentials against state physician license databases to ensure that information is written only by health care professionals. With entries being continuously added and edited by fellow physicians, Medpedia is the ultimate peer-reviewed Web site and can be a source of academic scholarship.

SM also can bring pediatricians together. With the current emphasis on interdisciplinary and multi-institutional research, such SM sites as Nature Network and Community of Science are bringing together researchers from across the globe. Medline Publications is a Facebook application that links researchers’ publications to their Facebook profile and suggests other researchers with whom to connect based on these profiles and publications.14 Gone are the days of cold-calling other researchers or nervously tracking down potential collaborators at national meetings. With SM to break the ice, pediatricians will find it much easier to make fruitful connections.

There is growing literature suggesting that membership in a community of practice (COP) is a key to professional development.15 A COP is a group of people “who share a concern, a set of problems, or a passion about a topic, and who deepen their understanding of this area by interacting on an ongoing basis.”16 COPs provide a means for learning from one another and sharing best practices. Because SM’s primary function is to bring people together and foster interaction, it can be an excellent platform for forming and sustaining COPs.

SM is also beginning to influence public health activities. Researchers are investigating the spread of medical misinformation via SM such as Twitter. Scanfield et al17 looked at ”tweets” related to antibiotics and the users’ belief that they helped resolve a recent viral illness. They found 302 posts to 850 000 people that spread the erroneous information that antibiotics can cure colds. It is unlikely that pediatricians can counteract this ocean of misinformation through one-on-one conversations with patients and families. Pediatricians either need to use SM to disseminate important health information messages or risk being marginalized.

One of the largest-scale SM public health interventions undertaken to date is Google Flu Trends.18, 19 Google engineers studied activity on search queries and found that by following the daily activity on 45 different search queries, they could create a model to replicate the Centers for Disease Control and Prevention data on physician visits for influenza-like illnesses, first in a retrospective manner and then in a prospective manner. Google now uses this model in real time to help track influenza, whereas the Centers for Disease Control and Prevention has a 2-week delay. Academic institutions are using Second Life, an online virtual universe, to simulate influenza outbreak planning and hospital evacuation.20

SM is an evolving field in which standards and norms are being developed in a continuous, organic, and social context. Although there are potential pitfalls, opportunities abound. We are confident that pediatricians can and will use these tools to promote the pediatric profession as a whole, as well as the health and well being of the children and families they serve.

Back to Article Outline

References 

  1. Radio Television Digital News Association. “Wires and Lights in a Box” speech to 1958 RTSNA Convention. Available from: www.rtdna.org/pages/media_items/edward-r.-murrow-speech998.php. Accessed August 15, 2010.
  2. Spector ND, Matz PS, Levine LJ, Gargiulo KA, McDonald MB, McGregor RS. e-professionalism: challenges in the age of information. J Pediatr. 2010;156:345–346
  3. Brown AD. Social media: a new frontier in reflective practice. Med Educ. 2010;44:744–745
  4. Chretien KC, Greysen SR, Chretien JP, Kind T. Online posting of unprofessional content by medical students. JAMA. 2009;302:1309–1315
  5. Indiana University School of Medicine. Online professionalism policy. Available from: http://msa.iusm.iu.edu/documents/OnlineProfessionalism.pdf. Accessed August 15, 2010.
  6. Sandars J, Morrison C. What is the net generation? The challenge for future medical education. Med Teach. 2007;29:85–88
  7. Oblinger DG, Oblinger JL. Educating the net generation. Available from: www.educause.edu/educatingthenetgen. Accessed September 10, 2010.
  8. Farmer AD, Bruckner Holt CE, Cook MJ, Hearing SD. Social networking sites: a novel portal for communication. Postgrad Med J. 2009;85:455–459
  9. Ahmed OH, Sullivan SJ, Schneiders AG, McCrory P. iSupport: do social networking sites have a role to play in concussion awareness?. Disabil Rehabil. 2010;32:1877–1883
  10. PatientsLikeMe. About us. Available from: www.patientslikeme.com/about. Accessed August 15, 2010.
  11. Johnson CA. Through website, patients creating own drug studies. Available from: www.boston.com/news/local/articles/2008/11/16/through_website_patients_creating_own_drug_studies/. Accessed August 17, 2010.
  12. O'Connor F. Smartphone, tablets seen boosting mobile health. Available from: http://www.pcworld.com/businesscenter/article/202224/smartphones_tablets_seen_boosting_mobile_health.html. Accessed September 10, 2010.
  13. Medpedia. Available from: www.medpedia.com/about. Accessed September 10, 2010.
  14. Bedrick SD, Sittig DF. A scientific collaboration tool built on the Facebook platform. AMIA Annu Symp Proc. 2008;6:41–45
  15. Parboosingh JT. Physician communities of practice: where learning and practice are inseparable. J Cont Educ Health Prof. 2002;22:230–236
  16. Wenger E, McDermott R, Snyder WM. Cultivating Communities of Practice. Boston: Harvard Business School Press; 2002;
  17. Scanfeld D, Scanfeld V, Larson EL. Dissemination of health information through social networks: twitter and antibiotics. Am J Infect Control. 2010;38:182–188
  18. Google. Google Flu Trends. http://www.google.org/flutrends/. Accessed October 14, 2010.
  19. Ginsberg J, Mohebbi MH, Patel RS, Brammer L, Smolinski MS, Brilliant L. Detecting influenza epidemics using search engine query data. Nature. 2009;457:1012–1014
  20. Stott D. Learning the second way. BMJ. 2007;335:1122–1123

PII: S0022-3476(10)00797-3

doi:10.1016/j.jpeds.2010.09.037

The Journal of Pediatrics
Volume 158, Issue 1 , Pages 1-2, January 2011

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