Thursday, December 10, 2009

Randall Wong, MD: Authority - learn to use it

“Whatever you say, you’re the doc!” That was the old days.

Establishing trust between a patient and doctor is easy. How is it we gain our patients’ trust? How do we convince them so easily to follow our recommendations?

We have authority.

We earned our degrees. We earned the white coat. We earned the authority that comes with the territory of being a doctor. With the authority comes trust. People inherently trust authorities.

Let’s face it, most patients come to you naively. Usually through recommendation from someone they trust; be it their own doc or a friend or a neighbor. Do they really know the difference between doctors? How can they? They act on the word of someone they trust.

In the old days, we’d treat patients, patients got better, we’d gain respect. Appreciative patients tell others, you lecture periodically at the hospital, retirement homes, etc., and your practice grows.

Then the Internet ruined everything.
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Doctors don’t like the Internet. That’s nowadays.

Nowadays, it is pretty common that patients arrive at your office with lots of questions, usually off-target, printouts of articles and their own, preconceived, treatment plan. The “authorities” on the Internet have empowered our patients by providing them information — but usually wrong information.

How frustrating it is to “unteach” from the Internet. How difficult it is to be challenged due to the bogus information provided by these perceived authorities. How disappointing to be blind-sided by a “few more questions” only to witness pages of questions emanating from a manila envelope.

We can change this.

Alas, the Internet can build your practice; it can make you a better doctor. How to change this? Remember, we are the authority. With authority comes trust. On the Internet, there is no difference between authority and perceived authority. You and I are used to the concept of peer review (as in peer-reviewed journals). It validates our writings, publications and establishes true authority.

The Internet is about perceived authority. He who publishes becomes the authority. He who makes the effort, becomes the authority. This is the problem (and the opportunity). There are not enough (or any) authorities contributing to the Internet. At present, any “yahoo” (Ok, bad pun) can publish and become an authority. While this seems harmless for trying to fix the refrigerator or come-up with the best way to slow cook ribs, there is a problem when it comes to health information.

Does this invalidate the Internet? No.

This creates a tremendous opportunity for physicians to become active contributors to the Internet. Why not create sources of credible information on the health issues that you deal with everyday? Why not change the quality of the information on the Internet to benefit your patients, yourself and beyond?

Let’s pretend you are not the world’s expert on, say, colds, but you know a lot about colds and treat patients everyday with colds. You could say that you are an authority on the common cold. Now, let’s now pretend that you have a Web site. Everything you wrote about, just like everything you tell your own patients, would carry the same clout to your readers. You would write about everything you know about colds.

You don’t have to give medical advice (that’s kind of a grey, lawsuit area anyway). You just have to write down, preferably in the same manner in which you speak in the office, what you know about the common cold. The difference? Your Web site would be straight forward, contain useful information, and would be credible.

Get the idea? You’d be sharing the same knowledge with many over the Internet instead of one at a time as you do now. The same trust that is imparted to you in the office is imparted to you on the Internet. The only difference is you are not face to face — yet.

Remember that Clairol commercial? A woman told two friends about the shampoo, and they told two friends and so on … Let’s suppose that someone develops a cold. He uses Google, Yahoo, or Bing to search colds. Up comes your page on “Colds: Signs, Symptoms and Treatments” authored by you, Dr. Joe, MD. This person might decide to call you about his cold. He has read what you have written, understands what you have to say, and is impressed.

Not only does he call your office and keeps his appointment, but he comes in already informed about colds. He found a good source on the Web. You don’t have to “unteach” him. He has been taught properly the first time. He has no anxiety, he know what you are going to say. He asks good questions, he seems really appreciative.

Who wins? You both do. He has had a great experience and feels that he should share it through the world via social media. He’ll tells lots and they tell lots and so on and so on.

Perhaps it is an example using the extremes, but the potential is definitely there for us to reshape the healthcare information dispersed to our communities and farther on.More and more patients rely on the Internet. Why don’t we meet them there?

Randall Wong, MD, is a retinal specialist in private practice in Fairfax, Va. Wong has a strong interest in Web 2.0, the Internet, and social media, and will write regularly about how social media can help build your practice and even improve healthcare.

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