Thesis 1: Air was the original social medium

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Note: This post is part of the 35 Social Media Theses series, providing amplification and an opportunity for discussion of one of the theses originally posted on Reformation Day 2009.

SocialMediaEquation

In one sense, as I will argue in Thesis 4, the social media revolution is historic. But the fundamental issue to understand about social media is that, in their essence, they have been around from the beginning of human civilization. Or, as I put it in the first of my 35 Social Media Theses posted 492 years after Luther’s 95:

Social media are as old as human speech, with air being the medium through which sound waves propagated.

I have boiled that down further into the title of this post and in my presentation slides, in keeping with Seth Godin’s advice. I don’t completely agree with his arbitrary limit (never more than six words on a slide), but it’s good general guidance, so I try to comply when I can. And it’s nice to see that he relaxed the hard-and-fast limit with these helpful presentation tips.

For several millennia, “spreading the word” happened mainly by the propagation of sound waves through the mix of Nitrogen, Oxygen, Argon, water vapor, Carbon Dioxide (which is not a pollutant, by the way) and other chemicals that make up our atmosphere.

So whether it was news about a miraculous healer in the countryside of Judea or which merchant in the marketplace had the freshest produce, the way it was disseminated was almost entirely verbal, from one person to another (or a small group at a time), via the medium of air.

In other words, through a social medium.

I work at Mayo Clinic as manager of syndication and social media, but social media have been at work at Mayo long before I was even born. For more than a century, and even after the advent of mass media like TV and radio, word of mouth has been the most important source of information influencing preference for Mayo Clinic. It’s been all about people sharing their experiences as patients (or accompanying family members visiting Mayo) in a social context. In the equation above, S! stands for satisfaction, and as it is multiplied via sound waves through air, it leads to word-of-mouth. Putting it in a formula like that creates the illusion of scientific rigor, but it’s really pretty simple.

In considering the tools (as we will see in Thesis 2) social media are new, but in another sense they are just the way we as humans have always communicated.

YouTube, Facebook, Twitter and blogs are new.

Social media aren’t.

Thesis 9: Social Media Synergy with Mass Media

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This post is part of a series related to my 35 Social Media Theses, in which I will discuss and amplify upon each of the statements I believe define the social media revolution, particularly as they relate to healthcare. This relates to my example of Thesis 33, which is being demonstrated as I write this.

Even though I firmly believe in Thesis 4:

Social Media are the third millenium’s defining communications trend

…that in no way diminishes my appreciation for the power, influence and purpose of mass media. That’s why I have stated Thesis 9 as follows:

Mass media will remain powerful levers that move – and are moved by – social media buzz.

One example of this from my personal experience is, of course, the “Octogenarian Idols” story of Marlow and Frances Cowan, whose YouTube piano-playing video at Mayo Clinic has been seen 5 million times, and led to a story in the Des Moines Register and their appearance on Good Morning America and a spoof on The Tonight Show. These mass media features exposed at least another 5 million people to this special couple and their 62-year (so far) love affair.

I’m excited to be able to share another great story of social media synergy with mass media, and how it may help thousands of patients find relief for debilitating wrist pain. And it’s happening as I write this.

USAWerthSectionCover

USA Today has a story this morning about Philadelphia Phillies outfielder Jayson Werth and his comeback from a career-threatening wrist injury. You can read Jayson’s story as written by Mary Brophy Marcus (@BrophyMarcUSAT – it’s also in the print edition), and for more background on the injury you can see Jayson’s Sharing Mayo Clinic story and the post I wrote on our Mayo Clinic News Blog when he hit two home runs to help send the Phillies to the World Series for the second straight year.

A big part of being able to do those posts was the Flip video camera, which I used when I was in Philadelphia earlier this year, to interview Jayson about his experience. And with those posts and having Jayson on video, Mary (and her editors) saw both the significance of Jayson’s comeback and how this is an injury that affects not just elite athletes, but everyday people.

It’s hard to know exactly how many people have a split tear of the UT ligament in their wrist, because most doctors don’t know about this type of injury. As Dr. Richard Berger, the Mayo Clinic orthopedic surgeon who discovered the injury type, has said, the MRI scans for these patients would typically be interpreted as normal because the ligament isn’t completely severed: it’s split lengthwise. So it may be as common as an ACL tear, but patients keep having to deal with wrist pain for which their doctors can’t find a cause.

That’s why getting this story in the mass media, in this USA Today article, is so important: it will alert many patients and doctors about a wrist pain cause they may not have considered. That’s why we scheduled a Twitter chat on #wristpain for Thursday, November 12 from 4-5 p.m. EST. Dr. Berger (@RABergerMD) will be available to answer questions and talk about the UT Split Tear injury and how it’s treated.

But this is where the real synergy comes in: Mary and her editors only had 30 column inches to devote to the story (believe me, we’re thankful for all the space they did find!) but they realized that people who think they might have a split tear will want much more in-depth information. And so they helped make it more likely that those people would be able to find the additional information, by adding this widget on the USAToday.com site:

Picture 4

For our part, we did this blog post about the Twitter chat that also includes a list of surgeons Dr. Berger has personally trained, so patients can come to a surgeon closer to their home. We also included a link to a scientific paper Dr. Berger has published on the subject, as well as a TV story about a bowler with the injury and an in-depth audio podcast with Dr. Berger.

The focused Twitter chat this afternoon will be great, but the other neat part about having the social media component is that it can continue long after the one-day run of the print story. People can continue to ask questions by tweeting @RABergerMD or using the #wristpain hashtag, or may leave longer questions on the wrist pain post on our Mayo Clinic News Blog.

I hope you will pass this information along to everyone you can (especially if you know of someone with wrist pain), via Twitter, Facebook or old-fashioned email. I will keep you posted on some of the results we’re seeing from this social media/mass media synergy.

Thesis 33: Decreasing Diffusion Time for Research, Innovations

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This post is part of a series related to my 35 Social Media Theses, in which I will discuss and amplify upon each of the statements I believe define the social media revolution, particularly as they relate to healthcare. I’m starting with Thesis 33 because it has particular application in an extremely exciting project I’m working on right now.

Social media will decrease diffusion time for medical research and healthcare innovations

One of the most frustrating parts of being involved in medical research is how long it takes for innovations and discoveries to spread. It’s generally understood within the medical community that it takes about 17 years for a discovery to work its way through the medical establishment, to really change everyday practice.

Social media will help revolutionize this diffusion process by making research information more accessible not only to physicians, but also to patients and consumers. And in a moment, I’m going to invite you to participate in an experiment to help prove this.

Here’s how the process has worked until this point (Because this thesis is about the dissemination of information and not about the discovery itself, we will start our discussion at the point of discovery):

  1. Dr. A’s research lab conducts a study and discovers a better treatment that could or should change medical practice.
  2. He submits an abstract, or research summary, to the annual meeting of physicians in his specialty. The abstract is reviewed by the program committee, and if they think it is interesting and valid they invite him to create a poster to be displayed at the meeting and to be discussed by other physicians and researchers. If they think it’s extra interesting, they may even ask him to do an oral presentation in one of the program tracks at the meeting. Those who attend the session or talk with Dr. A at the meeting may be stirred to change their practice, or may decide to conduct some related research of their own. News reporters covering the meeting may decide to do a story about the research findings, but perhaps one percent of abstracts submitted get news coverage.
  3. On another track, Dr. A will typically submit his research findings to a medical journal for publication. These papers are “peer reviewed” which means other physicians and researchers in the field look at the paper and decide whether they think the findings are valid and important enough to be published, and whether they’re something really new. This process of review and publication typically takes at least several months, although some of the journals are now publishing online before print, to help get the word out sooner.
  4. If the paper is published by the journal, the findings again may be the subject of news coverage, but for that to happen it requires a PR person (like me) to decide the research is likely to be interesting enough to reporters that they will be willing to develop a story. Then the reporters need to convince editors or producers that the story will be interesting enough to readers, viewers or listeners to be worthwhile. I would estimate that at best perhaps 10 percent of journal articles receive some news coverage. Of course, that varies by journal, as the the general ones like JAMA or New England Journal of Medicine or Mayo Clinic Proceedings may get one or two papers in the news, while the more specialized journals like Journal of Hand Surgery typically don’t get any mainstream news coverage.
  5. As Dr. A continues research related to the topic, this provides further opportunities for dissemination, and as other researchers in the field submit articles to journals they may cite his paper as a related resource upon which their research was based.
  6. Dr. A may be asked to visit other academic medical centers to discuss his treatment methods, which will help get more physicians personally familiar and hopefully even applying the results in their practices. He also may be asked to speak at continuing medical education (CME) courses, which help physicians get up-to-date on recent discoveries.

In the health communications system today, most participants are trying to do what’s best, as they see it. But it still takes far too long for valuable discoveries to become mainstream practice, and as a result patients don’t get the best care they could.

Thesis #33 says social media can help accelerate this process of knowledge diffusion. Here are six reasons why:

  1. Social media don’t depend on reaching mass audiences for their economic viability. Mainstream media have scarce space and time and must be able to interest an audience sufficiently large to be attractive to advertisers. The social media space is practically infinite, so researchers with a story to tell or a message to spread have no real barriers to getting to the Web and reaching the group, however small, that might be interested.
  2. Even if a condition is rare – or especially if it’s rare – it’s worthwhile to shoot a Flip video describing the latest research, upload it to YouTube, and embed it in a blog. Rare conditions are less likely to have lots of material already published, so your post is more likely to reach the coveted first page of Google results for your keywords.
  3. Social media tools can tighten connections between researchers in the same field. Whether through Twitter, Facebook or physician-only sites like Sermo, social platforms take the friction out of maintaining relationships and sharing information.
  4. Social media tools make it easier than ever before for patients with a common disease or condition to find each other and to share resources. And they don’t have to live in the same community.
  5. Physicians and patients will increasingly interact in social networks. Patients will be able to form online networks for nothing, and as we have seen with Wikipedia, will be motivated to share the latest news and research findings with each other. Some physicians will also join these networks and will interact directly with patients.
  6. Patients will bring what they have learned online into office discussions with their own physicians. They will be motivated to spread the word about a discovery that could have implications for their own treatment.

I am pleased to announce that at Mayo Clinic we are conducting an experiment this week to see, among other things, how social media can help reduce this knowledge-diffusion time for an important discovery.

Dr. Richard Berger is a Mayo Clinic orthopedic surgeon who discovered an explanation for mysterious wrist pain in many patients whose MRI scans appear normal. In the video below, he explains the injury, called a split tear of the UT ligament, and how he discovered it:

Dr. Berger has developed a simple, non-invasive test for the UT split tear, which he describes and demonstrates below:

Here’s where the social media experiment in diffusion of medical research information comes in. Dr. Berger (@RABergerMD) will be participating in a live #wristpain Twitter chat about mysterious wrist pain and the UT ligament split tear on Thursday, Nov. 12, 2009 from 4-5 p.m. EST. The format for the chat and more background information about the injury are available on the Mayo Clinic News Blog, but I have embedded a widget for all tweets using the #wristpain tag below:


  1. If you personally are experiencing wrist pain, I hope you will join us for this #wristpain Twitter chat.
  2. If you know people who have complained of nagging wrist pain and haven’t been able to get answers, please forward the information about the #wristpain chat to them. They also may ask questions and engage in discussion directly on the Mayo Clinic News Blog. The Twitter chat also can obviously start before the Thursday afternoon appointed time, and can continue afterwards. But during that 4-5 p.m. EST time Dr. Berger will be online.
  3. If you don’t have wrist pain, and you’re not aware of anyone who does, you can still help spread the word, because who knows how many of your Twitter followers or Facebook friends might have a split tear? Dr. Berger thinks it may be as common as a tear of the ACL in the knee, but because it isn’t widely known it remains undiagnosed in countless patients, as it was in Philadelphia Phillies outfielder Jayson Werth…until he came to see Dr. Berger. So please post the link to this post on the News Blog, or to this post here on SMUG, to your Facebook profile, or send it out as a Tweet to your followers. If you’d like to be even more involved, you also could do a blog post about the Twitter chat and could embed the Twitter search widget you see above in your post or in your blog’s sidebar. Go here to get the code.

As Dr. Berger says, this is a relatively unusual case of an injury that is debilitating but is easy to diagnose with a highly sensitive and specific test and also can be easily treated, with 95 percent success. It all comes down to knowing what to look for, and that depends on spreading the word.

I hope you will join us in this experiment. It’s not about getting more patients for Mayo Clinic; if it really is as common as an ACL injury, there’s no way Mayo and Dr. Berger could treat everyone. And in fact, in our News Blog post about the Twitter chat we are planning to post a list of several surgeons at other hospitals that Dr. Berger has trained in the fovea sign and in treatment of the UT split tear.

It’s about helping to cut a few years off the typical diffusion time for medical innovations, so patients with this unexplained wrist pain can get the help they need to be restored to full, pain-free function.

We have another interesting element of this experiment I look forward to announcing tomorrow morning, so stay tuned….

Leadership Institute Presentation

I’m in Boca Raton, Florida this morning for a presentation to  the Founders group of the Leadership Institute, a group of top leaders from about 20 major hospital systems. I’m going to be speaking about my 35 Social Media Theses, and given the time allotted I’m going to get to directly address about 20 of them. Here are my slides:

Healthcare Internet Conference Presentation

Today I’m honored to be keynoting the 13th Annual Health Internet Conference at Caesars Palace in Las Vegas. So, as Mark Ragan said a couple of weeks ago, now I can tell people, “I’ve played Caesars.” 😉

Here’s how I planned to start my presentation, though I’m not sure it will come out quite like this.

I frequently have people ask me about the frequency of my travel and how I can do it, as they follow my tweets or blog posts. This is the 55th external presentation or Webcast I’ve delivered so far this year, and in October I was in Sun Valley, Scottsdale, Milwaukee, Nijmegen and Amsterdam in the Netherlands, St. Louis, Green Bay, Madison, Minneapolis, and Philadelphia.

This month looks almost as busy. So how and why do I do it?

First, the Web and related tools like the iPhone help me stay connected with the office when I’m traveling. So I can help keep things moving along at home, even when I’m not physically present.

But in another sense, I’m keeping faith with the founders of Mayo Clinic, to whom I will be introducing you shortly. They believed it was essential for them to reach out and learn from others, but that it also was their obligation to share what they had discovered in their practice so that others may benefit.

Social media will be used in health care; the only question is whether it will be led by responsible organizations or by the purveyors of herbal, all-natural Viagra substitutes.

Despite the diffuse nature of the Web in general and social media in particular, I believe it is not only possible for us (and by that I mean all of us in healthcare, not just Mayo Clinic) to lead: I believe it’s a moral imperative. We can do well for our organizations by doing good things in social media. More importantly, patients will do better by becoming more empowered and engaged in their own health and health care. They can learn from credible experts and from each other, and apply those learnings to improve their lives.

I’ve previously said it’s not my goal to convince begrudging skeptics that they should using social media. They won’t do it well, mainly because they will see social media as an extension of the mass media era, and as a former boss used to say, “A man convinced against his will is of the same opinion still.”

My goal is to encourage you, maybe even excite you. You’re most likely here because you sense the amazing potential of the Web and social media.

If you’ve been wanting to implement social media in your organization, I hope to provide you with some concrete examples of success and powerful arguments you can use to help launch your own programs. If our Mayo Clinic example helps you remove internal barriers or work up the nerve to just hurdle them, I will count this a success.

If you are using social media already, I hope to hear your story and what’s worked for you, so we can together help continue the momentum in growth of hospital social media that Ed Bennett has done so well in documenting.

I’ve also embedded the slides from the presentation, which are substantially different from anything you’ve seen from me before. It’s the first time I’ve discussed the 35 Social Media Theses in public. So I hope you will review them and share your thoughts, criticisms, suggested edits and additions.