COMMENTARY

Social Media Starter Kit and Managing Your Digital Reputation

Jeffrey B Geske, MD; Farris K Timimi, MD

Disclosures

March 23, 2015

Editorial Collaboration

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Arriving Late to the Social Media Conversation

Jeffrey B Geske, MD: This is Dr Jeffrey Geske, assistant professor of medicine and cardiology consultant at Mayo Clinic. In this episode of Mayo Clinic Talks we will discuss social media for healthcare providers. I am joined by Dr Farris Timimi, who is a consultant of cardiology and medical director of Mayo Clinic's Center for Social Media.

If we are going to have a discussion about social media for healthcare providers, it is important to define social media. What does that mean to you?

Farris K Timimi, MD: Social media are those that are designed to be shared. They are both archived and scalable. These media extend beyond geographic confines. That is the power and the risk associated with social media. Once something is placed online, it can't be deleted, but the reach is profound and the cost is negligible.

Dr Geske: That is a large umbrella, and I can imagine that it could have many different facets. What have you seen as emerging facets for healthcare providers?

Dr Timimi: The primary issue for healthcare providers is to be cognizant. We are late to the conversation. If you look at online activity in the United States, the third most common activity online is looking for healthcare information, and if you look at time spent in social media in the United States, 1 in 3 minutes is spent in the social network, which includes Facebook, Twitter, and YouTube.

Our patients, both past and present, as well as those from the future, are living in social networks and discussing healthcare. Our arrival to that conversation is relatively late, but our value added as healthcare providers can be quite profound.

Social Media: A Moral Obligation?

Dr Geske: Knowing that the impact from the participation of healthcare providers is potentially profound, would you say that it's important for physicians to dive into this if they haven't done so yet?

Dr Timimi: It borders on a moral obligation. Look at the impact of vaccine hesitancy in the United States, the impact on healthcare providers from a litigious standpoint who are often sued when their patients aren't vaccinated at their own request, and the impact on the efficiency of a practice. Think about the 60,000 members of the American Academy of Pediatrics. If each one this year produced one tweet, one blog post, or one YouTube video on vaccine hesitancy, we would be the moral authority on this issue, and we could change clinical outcomes and improve community dynamics. Our capacity to do so bespeaks our moral obligation to join our patients and journey with them where they spend their time, which is online.

Dr Geske: What would you say to a colleague who says, "I keep up with my print journals, I go to a journal club, I attend the national meetings. I feel that I am involved in where cardiology or medicine is going, and I don't think social media are for me"?

Dr Timimi: Frankly, if you don't think social media are for you, I'm not in a position to force you to explore that space. There are two things you need to focus on. The first is competence, and the second is being cognizant. I would like colleagues who are interested to be competent in using these tools. They are tools. They have rules. They have regulations. They have appropriate tool sets.

Those who don't want to participate should be aware of the opportunity, so that when the opportunity arises in clinical practice, research, or education to partner, to explore with clinical colleagues, peers, and patients, you can do so effectively or at least identify who in your practice can help you do so effectively.

Getting Your Feet Wet

Dr Geske: For someone who is thinking about taking that first step, who maybe hasn't yet stepped into the social-media arena, what would you offer as opening tips or tricks?

Dr Timimi: I would say don't lie, don't pry, don't cheat, you can't delete, don't steal, and don't reveal. By that I mean that everything you place online is archived and scalable. Don't misrepresent who you are or what you are. Be who you are in real life and let that extend to your online presence. Don't steal from someone else. Don't cheat. Don't reveal corporate information or enterprise information, and, fundamentally, use the same patient-information compliance that you use in the elevator when you are engaging online.

If you are new to such a platform as Twitter, spend some time lurking before you begin to communicate in that platform and then do so comfortably. The caveat we always use, just like a good marriage, is that you are judged by how you listen more than by what you say.

Dr Geske: That's great advice. I will take that when I go home to my wife tonight. What would be a good method for healthcare professionals to stay on the leading edge, to keep an eye on the pulse of the news that is coming out? Do you have methods or tools to aggregate and assimilate the information?

Dr Timimi: I use many platform tools such as Twitter for online information. I also spend some time on Reddit, which is a content aggregator. For Twitter, you have to understand that conversations on Twitter occur either around subjects, which are hashtags, or individuals, which are user names. Spend some time exploring, learn who the users are who are germane to your clinical practice, follow those users on Twitter, and identify the hashtags.

There is a site called Symplur, which is a healthcare hashtag repository that serves as the online registry for healthcare-related hashtags. It's a great resource if you need to understand which hashtags are relevant to interventional cardiology, structural disease, or valvular heart disease, and it can help guide you to the right conversations that occur online.

Dr Geske: Those are some high-yield tips and tricks that you have just outlined. For someone who may have just gone blank and doesn't know what a hashtag is, what first step would you recommend?

Dr Timimi: We offer training tools online at the Center for Social Media . You can set up a guest account and access most of those tools. There is a sense of community in social networks. If you have questions, reach out. Someone will help you. You are on Twitter. I'm on Twitter. We will be more than happy to address any issues or questions that may arise. There is a sense of small-town community that I find very attractive on social networks and social media in general.

Sharing and Privacy Concerns

Dr Geske: You have touched on this already, but I want to go back to it because when I have talked to people about social media, one of the hurdles is some fear related to privacy settings. People aren't sure what they will be sharing or how it will be shared. What are some basic principles with respect to privacy?

Dr Timimi: We have found that most violations that occur on social networks do not involve patient information. If we are talking about personal privacy, I treat Facebook differently from Twitter. My personal Facebook page, I tend to lock down. I reexamine the privacy settings every 3 months.

Twitter is a more public format. It's more like broadcast journalism, if you will, community-based, and doesn't have the same personal privacy risk that Facebook has. Those issues are covered in our Center for the Social Media training modules on privacy. I would encourage you to take a look at those. But in general, the benefits far outweigh the risks. I often use the following analogy. I have a 7-year-old and an 8-year-old at home. I would never give them a number 11 blade and say, "Go start using this tool correctly." That does not mean the blade is dangerous. But these tools require training, orientation, and guidelines, and without those, you put yourself and your enterprise at risk.

Importance of Digital Reputation

Dr Geske: One aspect of social media that we haven't touched on is the use of digital reputation management. Can you give our listeners a basic overview of what that is and whether you think it is something that physicians should be utilizing?

Dr Timimi: The third most common activity of patients in the United States with internet access is looking for healthcare information. They Google their doctors, their diagnoses, and their diseases.

An evolution in search-engine optimization has occurred in the past 10 years. If we go back 7 to 10 years ago — and this is an oversimplification — if you search for "dry cleaners," the results are driven by geolocalization, meaning that the dry cleaners are in your vicinity based on the computer that you have logged in on. They are also driven by relevance, meaning that you get a list of dry cleaners, not florists in your area, and finally, by popularity. Historically, popularity was driven by link to link, meaning that if a website linked to the dry-cleaner website, it was viewed as being more popular. Now, that can be gamed very effectively. What you cannot game effectively are the 500 million tweets a day or all the Facebook posts that occur on a daily basis.

We have seen a shift in search-engine optimization from link to link to driven by social media. The best marker I can give you is if I put content onto a web page right now, the bot crawlers that prioritize content would find it in about 4 hours. If I tweet a link to that content, they would find it in less than a second because the bot crawlers (Bing and Google bots that prioritize search) focus on social media.

For providers who are worried about their digital reputations, social tools can be a key element of managing their online reputational platform positions.

What I suggest to providers is to Google themselves and variations of their names. Look at the results you get, particularly the top four organic results you receive from Google and from Bing. If there is problematic content—commentary on Healthgrades, Rate My Doc on Yelp, or Foursquare—that reflects poorly on them, that is going to be in front of your potential patients.

The way you respond to that is not by challenging the veracity of the content online and the platform. You don't challenge Healthgrades. You focus on the positive aspects of your practice using dynamic and static social tools to move that content further down the page. If you move it below the top four, it's not going to be visualized by most patients who look online.

Managing Your Own Online Rep

Dr Timimi: You need to avoid challenging bad information. The solution to pollution is dilution. You dilute it with good information, reflecting the positive aspects of your practice. I would encourage you to self-reflect. If the comments have validity, address that. But many of these commentaries are not related to clinical practice at all. "Parking is problematic." "I waited too long in the waiting room." "The waiting room did not have recent magazines." Those can be the first things that your patients see. If that content is there, you need to focus on a platform of dynamic and static social information to move that content down.

To do that, you need to get on Doximity and build a full profile because that will have a significant impact on your social-engine results. You need to look at your LinkedIn profile, and at least build that profile. Open up a Twitter account with your appropriate name and the imagery associated with it. Think about some YouTube videos. This sounds like a lot of work. This should take less than an hour to do. That 1 to 2 hours of investment on your part can move your search results and let you control your digital avatar online.

Dr Geske: That is a great roadmap for how to start with digital reputation management. It outlines why that it is important. For someone like me who is a younger physician, I have found that it is important, and I have had patients come in and comment on that. They are out there Googling us. This affects our real-life practice.

Dr Timimi: It does. Roughly 25 companies offer healthcare providers digital online reputation management. Most of what they do is set up dashboards that do exactly what I have described, set up both dynamic and static content that you control, and you can do it yourself in 1 to 2 hours.

The last thing I will stress is the utility of Google alerts for individual providers. Once you have Googled yourself, identified any of your problems, created content to move those problems further down on the search result pages, set up an alert for your name and variations so that if any new searchable content appears online, you are notified of immediately so you can at least be aware of what is happening in your reputation online.

Dr Geske: Thanks so much. It would be helpful if we gave out our Twitter usernames. Mine is @jeffreygeske.

Dr Timimi: Mine is @FarrisTimimi, and I blog at the Mayo Clinic Center for Social Media. You can find me on YouTube and Facebook, as well.

Dr Geske: We can also provide the username @MayoClinicCV, which is a divisional account where you can get more cardiology news from Mayo Clinic.

Thanks so much for joining us. This has provided many great insights and a broad spectrum of information for those just beginning the journey into social media as well as those who are looking for tips and tweaks. Thanks to our listeners for tuning in to Mayo Clinic Talks at theheart.org on Medscape. We look forward to you joining us next time.

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