As Don Perlgut’s previous post on the digital divide illustrates, there are many barriers to realising the full potential of the digital revolution, including lack of capacity amongst those groups with potentially the most to gain.
Other barriers include professional and organisational cultures, including suspicion of the challenging and sometimes confronting new ways of the online world.
In a timely example, The Medical Journal of Australia has recently published an online article, Social media and the medical profession, which takes a risk management perspective. It says:
- Inappropriate use of social media can result in harm to patients and the profession, including breaches of confidentiality, defamation of colleagues or employers, and violation of doctor–patient boundaries.
- The professional integrity of doctors and medical students can also be damaged through problematic interprofessional online relationships, and unintended exposure of personal information to the public, employers or universities.
- Doctors need to exercise extreme care in their use of social media to ensure they maintain professional standards.
But, as Dr Julie Leask, Senior Lecturer in the Sydney Medical School at the University of Sydney, reminds us, we shouldn’t forget the potential positives of online engagement.
One researcher’s experiences with social media
Julie Leask writes:
Too often the findings of important and relevant research are buried in specialist journals and locked behind paywalls. Meantime, public discussions can exist in a parallel universe.
In public health, we see media rhetoric blame individuals for problems and conceive of solutions on those terms – eg, more ‘education’ being the answer.
Tackling harmful drinking, obesity or low immunisation rates are examples where more upstream policies and programs with the greatest weight of evidence behind them can get sidelined. Then we can get frustrated by policies that bark up the wrong tree or end up chewing up needless resources which react merely to the loudest media voices.
Most of us want to see public health research have an impact on how debates take shape and which solutions are put on the agenda. These debates will influence what is done and even where research money is directed. People in research have a privileged overview of what is known and what needs to happen. They are the experts who should have a voice. So those who can, should speak out.
Why social media? Mainstream media is getting harder to get into. Reductions in newspaper revenue stream and the internet’s ability to compete for audiences means that public health advocates complete for mainstream media space more than ever. Images, for example, are taking greater prominence in newspapers. Our public health issue might not come with nice neat pictures.
More generally, researchers do not control what is published or broadcast, unless they do a live interview. They will often become mere actors, selectively quoted to give voice to an already written script that fits a compelling narrative.
In social media, researchers can control and disseminate their own content. They can directly link to other research, such as hyperlinks in a blog, and bring in the nuances. And people read these things – worldwide.
Social media is much more than adolescents sharing their new haircut or celebrities tweeting what they had for breakfast. There is a whole world out there that is conversing on matters related to public health, medicine and science.
The group Health Care Social Media Australia and New Zealand communicate mostly via the twitter hash tag #hcsmanz. Add this hashtag to a new development, article or idea that you tweet and it immediately goes to a group of interested and experienced professionals around Australia and beyond. They also meet for a weekly chat or “tweetup” to exchange ideas on a particular topic, like how social media can be used in public health practice.
Because social media is interactive, researchers can learn from a broader audience. Some researchers will blog early research ideas and get useful comments that help them shape their research question and direction. Others might seek feedback on a research proposal. (See here for example)
Reading real life accounts from patients might also generate new research ideas. For example, accounts from adults about the impact of whooping cough in their everyday lives via an ABC online discussion got me thinking about finding ways to better measure quality of life impact so evaluations of vaccines are informed by more sensitive and well-rounded measures of impact.
In social media, a researcher can control their content. Twitter, for example, allows a user to follow organisations or people who are directly relevant to their work. They get very frequent and short messages that direct them to an interesting new paper, podcast, or initiative. Researchers can engage as much or as little as they like.
Microblogs like Twitter are particularly good for time-poor professionals who might have only small portions of time available, like the train trip or waiting in a queue.
It’s not for everybody, but as a public health researcher keen to get messages out to a wider audience or keep up with interesting developments, it’s worth the small amount of time that it takes.
(Editor’s note: This article is a revised version of the one first posted)
PostScript from Croakey:
Some background to this piece. Last week, Mark Ragg and I gave a workshop at the University of Sydney aimed at encouraging researchers to communicate with the public and engage in broader public debates, including via social media.
Often there is some resistance to such notions, so I asked Julie Leask if she’d write a brief note reflecting on her experiences of engaging with social media in the wake of her recent article in Nature.
It was helpful to be able to show these tweets in the presentation….
• Stay tuned for more Croakey posts on palliative care and social media….
Agreed, “encouraging researchers to communicate with the public” needs more thought. Is there a risk of providing another avenue for direct marketing?
I mean, media corporations are the usual outlet for claims from the white-coat sector and when was the last time anyone asked about financial conflicts of interest.
Why would transparency be better on Twitter?
Why would any profit-based company pay out for public education that would decrease demand for their products?
Why would a researcher in vaccines for diarrheal diseases, dependent on a high profile for attracting funding, want to say a word in favour of soap and clean water?
I think you answer you own question Trevor. It’s much easier for undeclared conflicts of interest to be pointed out now, or for such general concerns to be raised in a public forum.
This is a good article, as it starts to drag the discussion in Australia into the reality of the growing but still very nascent, international “open source” medical research movement, where everything from going beyond traditional RCTs (e.g using crowd sourced data), through to crowd sourced commentary upon results, is utilized, often within particular vertical “disease” e-patient communities, where there is a strong element of trust.
One of the interesting features of such (mainly originally USA based) communities is that there are often significant number of Australian e-patient participators, but few Australian researchers.
Meanwhile back in Australia, most of the discussion is still about the one way propagation of whatever views are held by various lobby groups or researchers. All that has been updated is the use of a more diverse set of media, that are slightly more accessible.
I live and work in Darwin (which is pretty isolated for my standards) and during the last 1 year I’ve gotten more active on Twitter. I just returned from a Youth and PCEHR Forum organized by NEHTA and was honored to represent the Northern Territory.
A Tweeter known as Rachel De Dain (@rdesain) working with NEHTA had recommended me as a participant in the Forum.
I used my time after the Forum to meet other Tweeters who share the same passion for #hcsmanz (health care and social media), who work in varied settings i.e. Youth Wellbeing and Technology Cooperative Research Centre, the Burnett Institute, HealthyStartups and HelloMedical.
I would highly recommend researchers to experiment with social media and work out how it can work in their best interest.
All of this is good stuff. But it’s not an either/or situation. Having said that, in my view it does require education of doctors and all other health professionals about the advantages of the social media as summarised in the comments, whilst still being mindful that unfettered robust and enthusiastic exchange of ideas and information on social media outlets may indeed, albeit unwittingly, result in the potential breaching of confidentiality or professional standards and/or violation of patient-doctor boundaries, as the MJA points out. Therefore the challenge is to incorporate the educating of health professionals towards embracing social media and its potential, whilst also remaining savvy and alert to the pitfalls, rather than to decry their conservative reticence and resort to trying to drag them ” kicking and screaming” into the 21st century.