Expert healthcare practitioners of the social web: Dr. Ronan Kavanagh

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Dr. Ronan Kavanagh (@RonanTKavanagh) is one of the leading voices in the rheumatology conversation on the social web.

Through his portfolio of social presences, Dr. Kavanagh maintains an admirable balance between approachable affability and informed professionalism, and I was delighted when he agreed to share some of his insights regarding healthcare professional use of social media with the Symplur community.

[AS:] Thank you for having agreed to take part in this interview, Ronan. I’d like to begin by asking what it was that prompted you to embark upon your personal healthcare social media journey?

[RK:] My pleasure, Andrew. My interest in social media stems from a love of technology, my sociability and a distinct tendency to become bored easily.

[AS:] In your opinion, what are the benefits to healthcare professionals in creating and maintaining a portfolio of presences on the social web?

[RK:] Without a doubt, the most important benefit for me has been the way in which it has supported my continuing medical education.

It has helped me learn more in the last year than I have through any other means since I completed my specialist training. In doing so, it has reignited the enthusiasm I had for medicine in my early days at medical school.

My digital presences have allowed me to build a community around my practice, help keep my patients well informed about their disease, interpret media comments about new research for them, and listen to their comments. I am thankfully at a stage in my career where I don’t have a need to actively market my practice, but there is no doubt that having an online presence generates new patient referrals to the practice.

If you are interested in innovation in medicine you will realize that most of what is exciting is happening at the interfaces between medicine and non-medical disciplines; wireless devices, apps, social networks, crowd sourcing, patient advocacy and the electronic health record.

Having an online social media presence affords healthcare professionals a direct connection to the people at the heart of these developments, and allows their own voices to be heard in turn.

[AS:] Which platforms do you use? Why did you choose them? What do you feel their particular characteristics are, and how do they support each other?

[RK:] I think it is useful to have a presence on different platforms as they serve different (but overlapping) purposes for me.

I use Twitter as my inbound source of information and the forum for most medical discussions. Although I have some interactions with patients on Twitter, most of my conversations there are with fellow medical professionals. The majority of my patients are not on Twitter (fewer than five percent in my practice).

I use a Facebook ‘fan page’ for patients in my practice through which I share disease information and blog posts, and where I run surveys. I consider the Facebook page to have the potential to serve as a community hub for the practice. Over 40 percent of online patients in my practice are on Facebook.

I also make limited use of LinkedIn as it presents me with a channel of communication to a wide network of professionals in areas outside medicine. LinkedIn facilitates seamless introductions to other professionals, whom you might otherwise struggle to access.

I use a number of video channels to educate my patients; I have used YouTube, and have recently recorded content for a new platform called Clear.md which I think has the potential to be the new ‘Khan Academy for patient information’. I also have been using Vsnap for video messaging.

I blog regularly on my own Website. I use Twitter and Facebook and LinkedIn to drive traffic to the blog and my Twitter and Facebook posts are also visible on my website. I embed the YouTube videos both on the Website and within blogs, and plan to provide links to the Clear.md content too.

[AS:] How much time do you spend within social environments? Do you publish updates routinely and as a matter of course, or only when you feel the urge to share something?

[RK:] Other than blogging (which can be time consuming, especially early on), it doesn’t take up that much time because its done ‘on the fly’ – e.g. checking updates or writing or sharing a short tweet in the few seconds of downtime between patients, over coffee, on taking a break from doing paperwork. On some days I might spend 5 minutes, on some (especially when writing or reading) 30 minutes. I’m online most days though.

I publish my blog whenever I have something to say and the time to write it; about every two weeks. The blog posts are automatically redistributed via my Twitter account, Facebook page, and my Linkedin profile as soon as they are published.

I have recently become much more disciplined about the time I spend on social media channels, though, as it is important to me to switch off. Twitter, in particular, is enormously addictive. I have removed Twitter, Foursquare and Facebook from my phone to avoid temptation!

[AS:] What are your favourite Twitter hashtags, facebook pages, online communities, and other digital hangouts from a professional and a patient-facing perspective?

[RK:] The #rheumedu hashtag is the one I find most useful for discussions with fellow clinicians in my own specialty of rheumatology and I dip into discussions on #hcsm and #hcsmeu for stuff on social media in healthcare. The ephemeral twitter hashtags from conferences can be really useful, allowing you to follow tweets and view discussions related to conferences in real time. While at a conference last year, I was able to view summaries of one session while I was attending another.

[AS:] Do you distinguish between the professional and personal use of social media, or is it more a question of your being mindful of professional requirements across all the social environments you participate in, regardless of the context?

[RK:] On Facebook it’s fairly straightforward. I have a personal Facebook profile for home use and another for professional use. I like to keep certain aspects of my personal life personal and I also don’t want to expose all of my ‘real’ friends on Facebook to content I might distribute to patients on my practice page.

I used to have two profiles on Twitter; one for personal use and one for professional use but now I have one. As in my professional life though, I found it exhausting and frustrating to adopt an exclusively professional Twitter persona.

It is actually much more liberating to Tweet as yourself. I comment on medicine, music and the arts, technology, and gardening using humour as I do in my professional life with patients. It has a humanizing effect and allows for deeper connections.

There are a few unspoken rules I keep for myself though; I don’t post pictures of my family, I tend not to Tweet with alcohol on board, I don’t swear, I avoid getting into arguments online and am meticulous about protecting the identity of patients online (although I crowdsource opinions all of the time).

In short: don’t discuss anything online about patients that you wouldn’t discuss in a lift.

[AS:] What tips would you give to healthcare professionals who are considering how best to enter social environments in order that they may present themselves and their professional practice optimally?

[RK:] In the first place, just be yourself. It’s much more satisfying and you will have better connections with people if you show more than your professional self. People are also much more likely to engage with a real person than a corporate identity in my experience.

Be polite, don’t be patronizing and treat everyone you engage with online as though you are likely to meet them face to face some time soon (if even if its blatantly clear you aren’t). Correct patient misconceptions but don’t be patronizing, rude, or dismissive of patient opinions online.

[AS:] What learning materials, how-to guides, resources and/or guidelines regarding healthcare social media usage would you direct healthcare professionals to?

[RK:] I’m not sure that there’s a single resource that will satisfy everyone’s needs but if there are three resources that I would direct colleagues to, they would be the Webicina portal run by Dr. Bertalan Meskó which features a free online healthcare social media course, the Symplur site (especially their Healthcare Hashtag project) and the Pew project overseen by Susannah Fox.

[AS:] What are the most frequently encountered hazards in social environments for healthcare professionals, and how may they be avoided?

[RK:] Information overload would be top of my list.

To help manage the flow of information, I use a Twitter management tool (Tweetdeck) where I have set up special interest lists eg. ‘Friends’, ‘Irish doctors’, ‘Rheumatologists’ etc.

It’s also a good idea to have a fresh look at the people you follow and do some weeding! Although it is tempting to follow back all of the people that follow you, it is not essential.

Although in my experience, the number of patients directly seeking medical advice is small, responding on social networks is risky and should be avoided at all costs. Although you are entitled to simply ignore a request, I think it’s better to take the discussion out of the public domain and politely explain why you can’t answer (Direct messaging can be useful in this regard).

Most will understand. I also tend to differentiate between direct requests for a medical opinion and general requests where I will sometimes answer if I have time.

For legal reasons you should ideally have a disclaimer on your website or blog so that there can be no misunderstanding about the rules of engagement.

[AS:] Which healthcare professionals do you believe to be exemplars of best practice in healthcare social media? Are there any particular facets of their individual activities that you would like to highlight as being ‘best in class’, in your opinion?

[RK:] In an area that’s changing very quickly, and which has the potential to fundamentally change the way in which we communicate with patients, we need medical leaders to show us the way.

Howard Luks, in my mind, is such a leader. He is an expert in the use of social media in clinical practice, a great communicator, a relentless innovator and above all a generous mentor and guide. Those who are interested in developing an online presence should have a look at his site and read his blog.

I’m also a big fan of Dr. Brian Vartabedian’s writing; Dr. Wendy Sue Swanson’s use of video technology in communicating messages; Dr. Wes Dimov’s immunology portal; Dr. John Mandrola’s site and Dr. Anne Marie Cunningham’s contribution to medical education.

[AS:] How do you anticipate healthcare professional use of social environments and digital communication evolving in the future? Can you envisage a tipping point subsequent to which the usage of the social web by healthcare professionals will be considered mainstream?

[RK:] As convinced as I am about the usefulness and enormous potential of social media in medicine, I have difficulty persuading my generation of clinicians (and even clinicians 10 years younger than me – I’m in my late 40’s) to get involved.

I believe the tipping point will be when the current generation of medical students, for whom social media is part and parcel of their every day life, qualify as doctors. Ninety percent of that age group are on Facebook so the idea of establishing an online professional presence will be second nature to them. Once they start doing it, I think the older generation will follow –orthose who want to remain relevant will, anyway

[AS:] Ronan, thank you for having taken the time to share these insights. It has been great to find out more about your personal perspectives on healthcare professionals’ use of social media.

[RK:] Thank you for having invited me, Andrew.

About Dr. Ronan Kavanagh

Ronan Kavanagh MD MRCP (@RonanTKavanagh) is a Galway based rheumatologist with expertise in musicians’ health, social media and the use of technology in healthcare.

Dr. Kavanagh works as part of the Western Rheumatology partnership, which is based in the Galway Clinic. Dr. Kavanagh’s maintains a socially-enabled, multi-media website at http://www.ronankavanagh.ie/

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