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A doctor’s visit is not a social media situation

Abigail Schildcrout, MD
Social media
March 24, 2014
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I like a lot of things about Facebook. It allows me to see pictures and video of my nephews and niece and of friends’ children, it quickly lets me know when something big (either happy or sad) is going on in people’s lives, it lets me know what people are thinking about, and it gives me the opportunity to share my own news, thoughts, pictures, or occasional videos with others.

But as much as it allows glimpses into other people’s lives, Facebook doesn’t give complete pictures. Each of us has our own public persona, an image we project to others, which is only part of who we are. On social media that persona is even more deliberate and whittled down. We share the highlights, the good stuff, the proud moments, major life events, perhaps some political thoughts, and when we complain about something we often do so in a humorous light. In our reporting, a lot of us tend to skew positive.

I’ve noticed that people tend to do this in their doctors’ offices as well. Appointments are short. There’s frequently only time to cover a few highlights. People don’t want to be seen as complainers or don’t want to “bother” their doctors. So when coming into the office for a check-up or to address a specific issue, the answer to the doc’s “How are you?” is a smile and a friendly “Fine, thanks!” Not that there’s anything wrong with pleasantries, but if it stops there and concerns aren’t voiced, that can be a problem.

When we’re patients, we cannot assume that our doctor will notice a hesitation in our voice or a look on our face, or experience clairvoyance that will enable her to know that something is bugging us. If something worries us, we need to express it. We need to write down our concerns before our appointments so that we don’t forget them or decide that they’re not really that important.

When we’re doctors, we cannot assume that our patients’ friendly smiles and polite answers to “how are you” questions indicate that they have no concerns. We have to dig deeper. We have to read the review of systems questionnaires of 500 symptoms with check boxes that we made our patients fill out before their appointments and address what is checked off as “yes.” We need to specifically ask if there is anything else bothering our patients or if there is any other concern they have about their health. We need to remember the facade that people are used to maintaining.

A visit with a doctor requires, from both sides, more than a glance and a click on a “like” button. It requires human interaction. It requires communication. It requires connection. When a patient is in a doctor’s office, it is because that patient needs something beyond a Google search of a symptom. Even when someone healthy is in for “just a check-up,” that person cares enough about their health to be there, and deserves to be encouraged to share any medical concerns. And a doctor deserves information from his patients so that he can do his job as well as possible.

Appointment slots are brief. They can seem a bit like a Facebook encounter (or in some cases, even a Twitter encounter). But a doctor’s visit is not a social media situation. It needs to be deeper. It needs to address the person behind the post. Interact. Communicate. Connect. I “like” that.

Abigail Schildcrout is founder, Practical Medical Insights, and blogs at DocThoughts.

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