A social media manager is becoming an imperative position for hospitals.

Medical institutions are waking up to the fact that they need to engage their patients and physicians online. No where is there more fertile growth than in the various social media platforms that are prevalent today — like Facebook, Twitter, and YouTube.

American Medical News recently profiled the phenomenon, highlighting the position of social media manager, which some institutions pay between $60,000 and $80,000 per year.

As it stands, many hospitals are tip-toeing into the world of social networks, guided by the able hands of select online mavens like the Mayo Clinic’s Lee Aase and Swedish Medical Center’s Dana Lewis. Convincing executives of the return on investment remains a challenge, however:

Part of the problem … is that there are little data to show hospital executives about the financial and quality-of-care effects of social media. However, one of Aase’s theses refers to social media’s relative small cost, given that programs generally are free: As investment approaches zero, return on investment approaches infinity.

At this point, Dana Lewis is talking to physicians at Swedish not so much about return on investment, but about tactics — how to use social media presence to your advantage while not putting yourself in legal and ethical jeopardy. “We have an Internet postings policy. We have guidelines whether you’re using social media at work, or personally. If you’re tweeting for a professional Swedish account, we have more hands-on coaching.”

Getting doctors to buy in requires several factors, outside of influence from an institution’s social media manager.

First, there needs to be physician leadership behind the push — rather than an outgrowth from the marketing department. The Mayo Clinic gets it right by having a MD-qualified medical advisor to their Center for Social Media.

And second, doctors need to see tangible benefits from their forays into Twitter and Facebook. They are time-pressed already, and they must see engaging colleagues and patients online as a value-added proposition, versus simply a chore. Seattle Children’s Hospital’s Wendy Sue Swanson is a good example of how a hospital is using physician-driven online visibility to improve patient care and enhance a doctor’s practice.

Hiring specialists is good first step to increase hospital’s online engagement. Getting doctors to buy in, however, is going to require a more physician-driven effort.

Kevin Pho is an internal medicine physician and on the Board of Contributors at USA Today.  He is founder and editor of KevinMD.com, also on Facebook, Twitter, and LinkedIn.