The Orthopedic Posterous

When Americans go looking for information on health, they turn to the Internet as one of their first sources. According to a recent survey by the Pew Internet and American Life Project, 61 percent of adults say they look online for health information. There's a term for them: e-patients.

Most e-patients go online to read about a health condition. But that seems almost passive compared to the way a small group of Internet-savvy people are connecting to get their health information.

About 20 percent of e-patients go to Internet and social-networking sites where they can talk to medical experts and other patients, says Susannah Fox, with the Pew Internet and American Life Project.

Patients are going online, patients are engaged and collaborating in pursuit of *quality* health care information.

The physician community needs to engage WITH these patients...eyes wide open--- as a team leader. We need to engage to help filter the noise--- and aid in minimizing the risk of information overload or analysis paralysis.... and perhaps even the physician will learn a thing or two. Different patients have different needs --- different patients have differing abilities to synthesize the information and make the *right* choice.

How should the physician engage with these communities?

How can you help me to help you ??

The arrival of digital medicine promises to shake the medical establishment to its roots, not least because it will hand so much more information over to patients themselves. But the biggest savings will not come through exotic pills or “patient empowerment”, but from the application of basic economics. Realign the incentives in health care so that innovation focuses on making patients better and health care cheaper

We can't escape the fact that the cost of healthcare represents a significant portion of our GDP. Most "new" technology will only add to that burden. As the author discusses, most *technological* leaps involve a minor tweak to an older, cheaper platform ---and then patients as well as physicians are convinced that the newer version is necessary for various  (and often misleading) reasons.

True technological advancement, that incorporates a "smart grid" platform, on a large integrated and transparent network could potentially lead to true advances in care and cost containment. Now we just how to figure out how to align the incentives appropriately and figure out how to reimburse the various players accordingly... shouldn't be too hard :-)

"Traditional heart surgery has always been a mixed blessing," Murphy says. "Sure, it's life-saving, but it takes you two or three months to recover. The heart recovers in a couple of hours. But the body takes much longer. With robotic surgery, the patient is out of the hospital in less than half the time and recovered in three weeks. I'm talking back to playing golf or tennis."

Why isn't robotic cardiac surgery already the treatment of choice? Murphy estimates that it takes 100 cases to learn to perform it efficiently, and there's no immediate financial incentive to do that since the reimbursement is the same. That means few surgeons -- let alone other members of the surgical team -- can afford to travel and observe an expert in action.

Yet another example that makes you scratch your head. This guy can fix my heart valve through a few small stab wounds and have me on the tennis court in a month. Traditional surgery, which involves cutting open the sternum and exposing the heart, leaves me with the chance of returning to tennis in 6 mos, if at all. Hmmm... not a tough choice. Social media has the potential to improve the adoption of technologies in medicine by increasing patient awareness--- they will in turn seek out the appropriate expert who is skilled in the newer, less invasive, proven techniques. Physicians worry about the loss of income associated with the learning curve of adopting new technology. That won't matter in the *social* world... the patients will find another surgeon.

Physicians Use Copyright Infringement Threat to Block Patient Ratings on the Web—AIS Health

To date, 2,000 physicians have signed up for the Medical Justice program and, according to Segal, are asking their patients to sign MPAs. What makes the agreement unique is its use of copyright law. Segal says that Web sites are immune from accountability under Section 230 of the Communications Decency Act. But they aren’t immune from copyright infringement suits. So when a patient signs an MPA, the patient automatically assigns all intellectual property rights for anything the patient may write (and publish) about the physician to the physician. Should the patient post a rating on a Web site, the physician can then claim copyright infringement and issue a “take down” notice, forcing the Web site to remove the review pending further legal action.

One thing to be active against defamation, quite another to assert the automatic assignment of physician–patient relationship as an intellectual property right. This cuts directly to who owns the patient record. This needs to be challenged in court (and would be defeated). When you consider where ownership of PHRs may take us, the notion of automatic assignment of (intellectual) property rights to one party exclusively is very antithetical.

Bizarre argument... are physicians that afraid of being *rated* by the public? Many docs should embrace this. I receive numerous patients every week because they are tired of waiting weeks for an appointment at other providers offices, tired of waiting 2 hours in their waiting rooms, tired of waiting so long, seeing a PA or NP and getting only a cordial nod from the actual physician.

I have been able to run a very active practice and still find time to see each and every person myself, usually with no more than a 15 min wait. Are we as physicians afraid of the one or two folks who waited a bit too long or who were dissatisfied for another reason and went straight for the keyboard to berate us???? SocMedia is rating us now and will continue rating us. We need to be out in front of this. Physicians need to know what patients are saying about them and then we need to use that information to change our practice and improve the overall experience for the consumer. Failure to adapt could have significant negative consequences in the years to come....