Patients find a lot of good -- and bad -- healthcare information online. That's why doctors need to be as digitally literate as their patients.
Mesko has also seen how social media can benefit the practice of medicine itself. When he was in medical school, his professor was stumped by the case of a 16-year-old boy suffering recurring bouts of pancreatitis, so Mesko tried tweeting an abbreviated description of the case and received hundreds of responses, including a possible diagnosis, within 24 hours. The suggestion was to check for a condition caused by tiny stones in the gallbladder -- difficult to spot in conventional radiology, but possible to find if you know what to look for.
While there are more exclusive online communities for doctors, such as Sermo, public social networks can also be useful, if employed with proper caution for what information is shared and how, Mesko says. In his experiment with crowdsourced diagnosis, the responses came from physician friends, as well as people like medical librarians and patients who had experienced something similar. "If I had these people all in one room, I wouldn't have used the Internet," he says, but it worked because "everyone did what they were best at," including the patients describing their own experiences.
Getting time for this topic in the medical education curriculum is a major challenge, says Warren Wiechmann, an emergency medicine doctor who is on faculty at the University of California Irvine medical school and teaches a course on Health 2.0 and Digital Literacy on campus and on iTunes U. "If you don't make the course mandatory, because students have so much else on their plate, it's hard to get full enrollment," he says, but if he were to propose making it anything other than optional, he'd be told "you mean we're not going to teach students about anatomy for 12 hours so you can teach them about Facebook?"
UC Irvine was one of the first medical schools to give every incoming student an iPad loaded with course materials, but Wiechmann says he still doesn't believe students are adequately prepared -- neither for the impact of social media, nor for working with hospital technologies like electronic health records (EHRs). For example, medical students are still trained to take notes with pen and paper, when that is not what they'll be expected to do as practicing physicians, he says, and they get little exposure to EHR software.
"It's not just Facebook and Twitter; it's what is the next face of medicine going to be?" Wiechmann says.
Yet the social media dimension really is important, he says, agreeing that physicians have a responsibility to "curate the Web" and distinguish between good and bad information. "We get hours and hours of training on how to read through a journal article and just tear it apart," Wiechmann says. "We need a similar rubric like we have for journals for websites and apps."
Fortunately, there are some efforts to help physicians sort through these resources. He pointed to Happtique, which offers certification for valid medical and nursing education apps. Mesko's company, Webicina, also offers a curated directory of apps, blogs and other resources.
Guidance is there, or at least starting to emerge, for those doctors who seek it out.