A Healthcare Answer For Some But Not All

The Internet Is Another Health Disparity That Must Be Addressed If you ask your friends, relatives and colleagues if they’ve used the Internet to find healthcare information, I’d be willing to bet the answer would be yes. There’s no question that the Internet is an ever more important healthcare tool. The ability to capture and consolidate information into electronic medical records; search and share health and wellness resources, and enhance communications between professionals and patients are among the many benefits of the web. It’s OK to cheer but just not too loudly.

The problem is that our friends, relatives and colleagues aren’t everyone – not by a long shot. According to Neilsen Online, there’s a whopping 277,636,000 Internet users in the U.S. The flip side of this seemingly good news is that it leaves about 30 million Americans disconnected from the world wide web and, thus, unable to access important healthcare tools and information.

The web is no panacea, of course. You may have read some of my previous articles where I pointed out the problems of web-based healthcare information. Because there’s so much junk science reported and repeated in cyberspace, it can be a case of information doing more harm than good. Still, there’s a growing list of important applications that will not be available to all who could benefit from them.

Take Keas, for example, the new company that boasts Google Health and Microsoft HealthVault as partners. Keas seeks to marry personal data and health information to produce personalized health plans for individuals. Delivered right to your desktop or smart phone might be diet and exercise advice, an explanation of lab results, different treatment options or reminders to take a medication.

During the healthcare reform debates, we heard repeatedly that a key to lowering costs is to have a healthier nation and that this goal will only be possible if individuals take more responsibility for their health. While we could achieve a lot if plain old common sense was applied more often, tools like those being developed by Keas could play an important role in both learning about and managing one’s health.

If experts are telling us that things like electronic medical records, on-line health information and personalized health plans are important to healthcare reform efforts and our own personal well being then we need to be thinking about two kinds of health disparities: insurance coverage and Internet access. Creative, cost-effective ways to distribute computers and expand broadband access must take on new urgency. The benefits would be manifold.

And, access should include more than the ability to go on-line. Access is meaningless if one can’t interpret what one has found. Even for those with Internet connections, there’s an enormous deficit in health literacy that threatens the public health, such as sensationalized claims that lead people to take potentially dangerous alternative medicines or parents to refuse vaccinations for their children other than for legitimate medical reasons. If there’s any hope in increasing coverage and quality while containing (or even lowering) costs, more attention must be placed on expanding access to and understanding of healthcare information.
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TV News is Taking Viewer Opinion to the Extreme

This article also appears in odwyerpr.com.

Sloppy Journalism Can Distort Public Sentiment
I have spoken out about the decline of journalism a number of times. Staff and budgets are shrinking, and the ability of the public to receive well researched news and information is suffering. How are news organizations coping?

One way has been to update and elevate the “man-on-the-street” interview. Used typically to gather some quick reactions from “average” citizens, television news has been devoting an increasing amount of air time to these spots at the expense of real reporting.

With an Internet connection, anyone can become an information source. And anyone can call him or herself a journalist. Some have heralded the arrival of the “citizen journalist” and the gigabytes of “consumer-generated content” as a way to fill the void. I am not one of them. As I’ve said before, citizen journalism is not journalism.

But that opinion doesn’t seem to be shared by television news. They are all eager to receive your emails, YouTube videos, “tweets” and Facebook postings in reaction to the issues of the day. In return, you will get your message posted and maybe even shown or read on the air.

I acknowledge that news and entertainment was converging before this big downturn in the business of journalism, and that this a clever way to engage the audience. Reaching out and obtaining feedback is smart. All businesses need to connect to their stakeholders. But you wouldn’t find a business pulling random customers off the street and putting them on the factory floor or on the phones.

Beyond this being a cheap and easy way to fill some time during a 24-hour day, there’s a more insidious element. Who chooses which comments to air? How are respondents vetted, if at all? Is a balance of opinion sought and, if so, how is it defned? Do the aired responses in any way reflect actual national, regional or local opinion? Does anyone understand how easily bias can be introduced to the news?

My fear is that expediency and a tilt toward showcasing intentionally provocative responses gives a warped portrayal of public opinion. More than just cutting corners or differentiating their broadcasts, this sloppy journalism can give the appearance of an actual poll. I’m all for sharing comments, and exchanging views and information but a more rigorous approach toward 21st century man-on-the-street interviews must be taken to ensure interesting but accurate reporting.

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Observations on the Social Media Landscape

This article also appears in odwyerpr.com

Web 2.0 is Like Being at Square 2.0
We can see some of the benefits of new media every day. Companies, associations and organizations are reaching out to engage, educate and sell to their publics. Information is finding new ways to bore through the firewalls of intolerant regimes. The lonely and the shut-ins have virtual life lines to the outside world. People are reconnecting, catching up and sharing news.

I’ve had some good experiences with new media, reaching "influencers" and gaining news placements. On the personal side, it’s been nice to reconnect with old friends and colleagues. Not long ago, I received a LinkedIn invitation from a friend who was in Cub Scout Pack 92 with me back in the fourth grade. Twitter is a different story, though. I'm still churning through sites in the hope that they can give me at least a 10 percent chance of reading something of actual interest.

That aside, it’s exciting to see new ideas and experimentation taking place. Yet, with the deluge of offers I receive for webinars, courses and books, you would think the self-proclaimed gurus have Web 2.0 all figured out. Every time I turn around, my e-mail in box fills with “must attend” events like Social Media Crash Course, New Media Boot Camp, Social Media and New Media Boot Camp, New Media PR Master Class, Writing for Social Media, Social Media Best Practices, Social Media PR Power Guide, Social Media for Disaster Response and Recovery, and Social Media Strategies. (Note to gurus: it is not a strategy – it’s a tactic.)

While there are people who have better technical skills and know more than others about these media, we’re a long way from fully grasping its potential and its potential consequences. Along the evolutionary continuum of social media, we’ve just left knuckle walking to stand upright. Like the Neanderthals, we’re bound to see lots of offshoots that dead end into oblivion.

Oblivion is where many in and around the media business say newspapers (and books and magazines) are headed. They may be right… eventually. I do read a lot of material electronically but I don’t want to give up the ability to turn the page of my hard copy. (I take some comfort knowing that the crystal ball keepers who manage the Star Trek franchise have, on several occasions, made books the perfect gift in the 23rd and 24th centuries.) Indeed, when it comes to media consumption (according to Ketchum’s Media Myths & Realities Survey, 2008), social networking sites, blogs, videocasts and podcasts combined don’t come close to local newspapers (or network or local or cable TV news).

As social and electronic media gain ground, however, it seems to be pushing other forms of communication to the rear. A growing number of people -- practically everyone I know in generations Y and Z -- will use Facebook, AIM or send a text message before they’d ever make a telephone call. This leads me to question the actual use of the term “social” in social media. Certainly, it’s safer to write a message than to use one’s voice. Words can be chosen and rewritten before sending. Direct confrontation is avoided. But this is the opposite of social interaction. It’s remote, it’s disembodied. From the Random House dictionary (the 10 pounder on my bookshelf), social “pertains to, devoted to, or characterized by friendly companionship or relations.” Merriam-Webster (on-line) defines social as “marked by or passed in pleasant companionship with one's friends or associates.”

Like friends, music and art, a mix of the old and the new can make the picture complete.

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New Bedside Manners

Tell Me – Not the Internet – How You Feel
I haven’t conducted a formal survey but I’d be willing to pull some money out from under my mattress and bet that two of the most often-used words these days in the worlds of business and politics are transparency and accountability. There’s been little choice, if you think about it. The collision between out-of-control companies and politicians with public outrage and instant communication tools has sparked unprecedented demands for truth and openness.

The push to expand transparency and accountability has given rise to numerous rating sites on the internet – everything from food to teachers to virtually any product. This long list includes about 40 web sites where one can rate their healthcare provider.

In an AP story last week, “Docs seek gag orders to stop patients' reviews,” Lindsey Tanner reported how some physicians are coping with anonymous, negative patient commentaries on sites like RateMDs.com. Intrigued, I went to the web site and saw that over 185,000 “doctors” were rated, but this includes acupuncturists, chiropractors, podiatrists, psychologists and dentists. I clicked on the most reviewed doctors and found that the top four are ob/gyns and number five is a cosmetic/plastic surgeon. (Number six, I must note, is the fictitious Dr. Gregory House.)

It’s not a big surprise that women, the most influential healthcare decision makers in the family unit, are the most vocal. Randomly scrolling through, I found some posts to be reverential and others to be scathing. These comments are a one-way street, however. The doctor’s name is used but not the patient’s and, because of rules protecting patient confidentiality, there’s no way for the doctor to respond.

Here’s where a company called Medical Justice comes in. For a fee, they offer physicians a service that monitors the internet for patient comments and a contract (“mutual privacy agreements”) for their patients to sign where they “agree not to post about their doctor on the Web without the doctor's permission.” In addressing First Amendment rights, the site states that “Patients are free to discuss their care with other doctors, family, friends, licensing boards, attorneys, and any number of institutions. Mutual privacy agreements do not create a choice between healthcare and one's right to free speech (as some have erroneously claimed).”

So, on one hand we have sites that allow unfettered forums for blasting (or praising) health care providers. On the other hand, we have an effort to limit where patients can express their views. Here are a few thoughts:

Health care providers need to accept the reality of our information society. Telling someone they can’t do something is a sure-fire way to promote the opposite of what is intended.

Entering into a contractual arrangement with a patient over issues of speech may raise questions about the doctor’s motives, potentially damage the relationship and erect a barrier that decreases communication.

If women are using this medium most frequently, then some special attention needs to be paid to their concerns and communication preferences. There should be an office environment where concerns can be aired before they hit the internet. And, if face-to-face commentary is uncomfortable, perhaps an anonymous mail-in survey should be made available.

While both sides have legitimate positions, I think we require a third hand. What’s needed is a forum where patients can post justifiable comments, where those who read them can have some assurance that no axes are being grinded. Health care providers need assurance that inaccurate, reputation-killing commentary is kept off the web, where it’s so difficult to excise.

Patient advocates and organized medicine should collaborate on setting standards and policies – a code – for responsible, ethical rating sites. Both patients and their doctors need to get on the same side of the fence on this issue. When it comes to your health and wellness, I can’t think of an issue where it’s more important for all the parties to act as a team.