New media, new questions
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Utilizing social media for your practice

New media and social networking, relative to human history, have only existed for the blink of an eye. Yet their importance as entertainment, as business tools, and as facilitators of technological innovation can today be measured in the billions of dollars. New mobile phone hardware is released with the express purpose of allowing users to utilize all of their social networking tools absolutely anywhere. Tens of millions of Americans interact with businesses, friends, and an extended online social network while commuting, during downtime at work, or even while waiting in a physician’s office. Social media tools are ubiquitous, and only growing in popularity as broadband access grows more affordable and mobile phones become more Internet and application-oriented. To a busy physician, it may all seem a bit much to take on in addition to a packed work week. But for many physicians, social media has proven a potent gateway for connecting with patients and building their practices.

Starting out

According to Jeff Benabio, MD, a dermatologist with Kaiser Permanente in San Diego, author of The Dermatology Blog, and trusted physician voice to over 10,000 Twitter followers, the first step in jumping into social media is asking oneself what your goals are and recognizing the time commitment to come.

“There are a lot of reasons to connect with people — you should figure out going in what yours are. So you first have to define your reason for using any of these tools. I would imagine that for most, the aim is to build their practice or build their brand. Many times those are one in the same,” Dr. Benabio said. “Then you have to decide where your time is best spent. Fortunately, all of these tools are free. But in order to be done well, they all have a considerable time requirement. So unless you’ve identified what tool is best for you, you could end up wasting a lot of time. And that, even more than money, can be important for busy doctors.”

For physicians wishing to build their reputations, practice, or patient base, tools like Facebook and Twitter offer a massive worldwide community of diverse users with no cost and little set-up time. For those looking to network with colleagues, LinkedIn or a physician- only social network may offer a more manageable, if less popular, route. Blogging, while it offers the promise of both public and professional connections, requires the most time commitment, as the user must create and post articles and links on a regular basis to maintain consistent readership.

As a rule, Dr. Benabio said, it’s best to start with the basics.[pagebreak]

“Most practices should have a website, or at least a Web page up with information on the practice, if they don’t already. Facebook allows you to have a virtual space for your business on the site. Those two things are pretty mandatory,” Dr. Benabio said. “You have to at least have claimed your space and then decide how much or how little you want to do with that afterwards. It might be something as simple as my information, address, and phone number. From that point forward, it depends on how much effort you’re willing to put Into it, how much time you have, and how savvy you are with those tools.”

For physicians willing to dedicate more money than time to the prospect of creating a social media presence, there are a number of marketing and consulting firms that offer turnkey solutions to creating an online presence. The newness of that niche, however, can make finding and hiring the right firm a tricky proposition.

“It might make sense for a physician or practice to hand it off to people who do this for a living. They have so many things that demand their time already,” Arizona- based marketing consultant Wendy Kenney, who has worked on marketing with dermatology practices for more than 20 years, said. “The problem is, it can be easy to hire the wrong firm and end up with a social media presence that differs from what you thought you were buying. You need to find out what their capabilities are, and what kind of content they have put out in the past.” While the expense of outside hiring is affordable, it’s hardly insignificant. Prices vary depending on region and the level of content produced. Kenney said that the fees vary based on the level of social media management desired; both start-up and monthly fees start at $200 and increase depending on the client’s needs.

Finding a message

After finding one’s bearings in the social media landscape, it’s important to decide on a core message to communicate through your Facebook posts, Twitter updates, blog articles, and the like. Brian Ellis, a North Carolina practice marketing consultant, said that it is key to tailor a message to your goals and create a plan for disseminating that message over a set period.

“If you decide you’re looking to do social media, the question then becomes what message you’re giving. Do you want messages about sun exposure, before and after treatment photos, specials for the week? They all have different value to the reader,” Ellis said.[pagebreak]

Apart from message content, he said, it’s important to consider continuity and scheduling of social media updates. Irregularly updated social media presences will fail to connect with patients and potential patients.To assist with this issue, schedule management tools will do much of the work for a physician, Ellis suggested. Two of the more popular social media schedule management tools — HootSuite and TweetDeck Allow users to schedule tweets and updates ahead of time. As such, he said, “A physician or staff member can sit down and have a planning period to decide what the practice’s message is going to be, how it will be delivered, and when it will happen.”

In addition to scheduling updates, schedule management tools also allow the physician or practice manager to act as moderator. Many practices share Twitter, Facebook, or other social media responsibilities between a number of physicians or office employees And worry about inappropriate postings. These utilities allow the physician to approve or reject any outgoing message through either a computer or smartphone with a single click.

Dr. Benabio likens establishing a social media presence to community-building.

“If you can have someone — yourself or someone in your office — dedicate time to regular posting on the top social networking sites, then it’s a great way to interact with patients. You can advertise deals or Specials that you’re offering, or just be part of the community. We’re here, we’re interested in your skin health. You can give some free advice, and patients will begin to recognize that and recognize your brand. They’ll come to your practice to see you and have you as their physician. Facebook is a place to do that under the business page side. A blog is a place to do that.Make sure to have regular posts that are informative or offer specials, but also allow for patients or potential patients to respond or comment. That’s where the social aspect comes in.”

As proof of the success of this model, Dr. Benabio said that since successfully establishing his social media presence, he has received inquiries for appointments from as far away as New York City.

In addition to building one’s reputation, Dr. Benabio said, social media also allows opportunities to address issues that patients may have had during visits.Even large corporations, he said, have recognized the value of this tactic, with Comcast notably receiving plaudits for devoting resources to monitoring and addressing issues brought up by customers on Twitter.Many large companies — including a handful of major airlines — have followed suit.

“Another thing you can do is interact with and address patients who may have been unhappy with something about their visit,” Dr. Benabio said. “You can contact them privately and try to solve the problem to the benefit of everyone involved.”

Doing so, Dr. Benabio said, will serve to protect and improve one’s online reputation, as well as create a reputation for customer service with that patient and everyone they tell. Positive word of mouth serves as the best marketing tool, he said.[pagebreak]

The role of marketing

While social media can be an excellent springboard for marketing messages, the first rule of social media participation is to keep a light hand with the marketing messages, according to Dr. Benabio. Creating a valued and respected presence, he said, must lead to marketing success in the social media sphere, not the other way around.

“Physicians tend to misuse Twitter a bit, only advertising and highlighting specials. There’s a small place for that, but if you understand the Twitter community, you understand that [advertising] doesn’t carry much weight as a strategy. Envision being in a room with a hundred people having conversations. If you just stand at one end of the room and shout out ‘I’ve got a Botox special coming this weekend!’ people eventually get annoyed with you,” Dr. Benabio said. “On the other hand, if you decide to start a conversation about melanoma awareness month or how to look for atypical moles, you may get a person coming over to listen to you. Then someone else notices and you get two people listening, then three. Eventually you have 15 people actually listening to what it is you have to say — you’re engaged in a relevant topic. It’s much better to have the 15 people actually engaging with you than having all 100 people aware but ignoring you.”

Ellis agreed, saying that the intrinsic educational aspect of medical information is the best enticement to potential patients.

“The building of community is why social media is viable. Getting someone to the dermatology office requires education and a little bit of changing the mindset of the potential customer,” he said. “By using an education model and consistently nurturing what your practice has to offer you’re engaging with the community — they’re learning something new and talking about your practice and what it has to offer.”

For physicians wishing to focus more on marketing and advertising, coupon of the day sites like Groupon and Living Social offer a great deal of exposure and increased foot traffic. On these sites, a business will offer a heavily discounted good or service — $50 for a $100 restaurant gift certificate, for example — for one day only that is only honored if a set number of people purchase the coupon for that day. The business benefits from being showcased on one of the Internet’s most popular sites, and the site gets a set percentage of that day’s sales.

“If your objective is to just build practice revenues and attract new patients, tools like Groupon are a great place to start, because you’ll get your highest return on investment from time spent,” Dr. Benabio said. “With Groupon, you don’t have any commitment at all aside from signing up and deciding a special to offer. That model is good for your practice, and in most practices it really depends on what the physician or the business manager decides you can handle in terms of cost and increased traffic. The cost only comes from the coupon itself and what you can afford.”[pagebreak]

Recruitment and hiring

In addition to reaching out to patients, social media can be utilized as a tool for the recruitment of new employees, according to health career columnist Andrea Santiago, who also manages social media campaigns for The Medicus Firm.

“It’s best to start with LinkedIn when recruiting with social media, because the site is specifically based around professional networking,” Santiago said. “People tend to gravitate to it when they’re looking for jobs, and they’ve recently made it even easier to network with people outside of your contacts list.”

One advantage of LinkedIn, she said, is the staggering number of professional associations represented on the site. Employers looking to hire a medical assistant, for example, can join the groups dedicated to professional medical assistants and publicly post their job description for a modest fee. In addition, users can customize their email notifications to send them a message when someone posts a job opening in their desired field. The effect, Santiago said, is that professionals looking to hire can attract the attention of both frequent users and more passive ones. Even if one chooses not to pay for the site’s job posting service, many users are still able to find numerous viable candidates through their personal connections, as users can forward a job posting to their personal connections. From there, Santiago said, those looking to hire begin with a wealth of information at their fingertips.

“When you get an interested candidate, you’re immediately able to see their professional continuity of experience and other qualifications,” Santiago said. “From there, it’s easy to search out more information about their previous practices and see whether you think they’ll be a good fit for the kind of work and volume your practice has.”[pagebreak]

Evaluating your successes

The problem with social media, for many, is that goals like community-building and word of mouth seem unquantifiable. Yet Ellis contends that many of the tools that accompany sites like Twitter and Facebook allow for much more sophisticated measurement of one’s reputation than previously available.

“There are tools that you can use to see the success of your message and marketing in general. With Twitter and Facebook and the like, you can start by using their built-in metrics,” Ellis said. “You can see which of your messages people respond to most and change strategy based upon that.”

For Dr. Benabio, the social media experience closely mirrors what people value as professionals, and as members of a society.

“How we think of social media now, it’s only four or five years old as an experience, but the numbers are ridiculous in terms of usage,” Dr. Benabio said. “And that’s because it encapsulates what we like to do as Humans. To share our experiences, ourselves, and to get responses from others who think the way we do. It gives us a way to do it online, instead of only face to face. That accessibility is why it’s so popular.”

Social media: the top tools

Facebook: The world’s top social networking site, founded in 2004. It boasts more than 600 million registered users and an estimated 2010 revenue of more than $2 billion. It allows users to create a public profile and interact with friends and colleagues. It also allows for the creation of business pages; Facebook users who choose to follow a business will receive all posts from that business in their news feed when they use the site.

Twitter: A service that allows users to broadcast 140-character messages (called Tweets) to other users. Allows for participation in multiple conversations with friends, colleagues, and interested parties. Posts can be given hashtags (#dermatology, for example) and sorted by discussion subject. Outside services allow for shortened URLs, which can be used to track user traffic to posts and links.

Tools like HootSuite or TweetDeck allow users to create messages and schedule them ahead of time, allowing users to create a content plan in an afternoon and automate it to disseminate for the upcoming week.

LinkedIn: A social network built around professional connections. Users upload their education, professional history, and skills and connect with colleagues, classmates, and professional acquaintances. Users can introduce like-minded connections and write recommendations for present or past colleagues.

Blogging (Blogger, Wordpress, etc.): Blogging allows users to create an online publication tailored to their specifications. There is no limit to word count or number of posts, but blogs require a fair amount of time to set up and maintain.

Deal-of-the-Day (Groupon, Living Social): These sites allow your practice a great deal of advertising and word of mouth by offering a one-day deal on a service or services of your choice. Aside from deciding on the deal and price, there is little work required by the businesses offered. The site keeps a percentage of each sale in exchange for the publicity and increased traffic. Businesses that make use of this model must be careful to ensure that they’re fully equipped to deal with a large group of new customers redeeming the discount voucher in a rapid time frame. Businesses that run into fulfillment issues often find themselves with far more headaches and complaints than new relationships with the public.

Check-in Applications (FourSquare, Facebook Places, Google Places): These services, accessed through a GPS-enabled smartphone, allow users to perform “check-ins” at registered businesses, noting the date and time of the user’s visit and keeping a record of each visitor’s check-ins. Businesses can keep track of their most frequent customers, and often offer incentives to the most frequent visitors.

Physician-only Networking (Sermo, SocialMD): These social-networking sites function much like Facebook, but restrict membership to licensed physicians. The tone of the dialogue, as a result, is more professionally-focused, though there are no content restrictions.

Drawing boundaries

While social media is a powerful tool with incredible potential upside, it’s important to set boundaries between yourself and both patients and potential patients. First and foremost, readers of your posts — be they blog posts, Twitter links, or Facebook notes — need to understand that the information you post is purely informational, and no substitute for medical advice. On The Dermatology Blog, Dr. Benabio devotes a tab at the top of the page to a disclaimer that reads, in part: “The information on this blog is for educational purposes only. This site does not intend to provide any medical advice and should not be considered medical advice or counsel. If you have questions about your health, then please consult your physician. This site should not be used as a substitute for medical help. Opinions provided here are my own and do not represent the opinions of my employer or the medical societies of which I am a member.”

In addition, it’s not advisable to interact with current patients through Facebook, Twitter, or other social media services on a physician-patient level, according to Kevin Smith, MD, who regularly speaks on social media and online reputation at the Academy’s Annual and Summer meetings. Interacting with patients in these arenas, he said, can be time-consuming and possibly risky if patients decide to try to replace regular office visits with online dialogues.

“There seems to be a growing body of opinion that it’s better not to get involved with patients directly on Facebook and Twitter. It can consume a lot of your time and potentially expose you to legal issues,” Dr. Smith said. “There’s an online forum that I visit where patients pose questions to the community and physicians can choose to respond. That’s about the only direct online method of interaction that I ever use.”

Social media in dermatology

The Academy has surveyed its members about their use of social media. While overall use was relatively low, residents and young physicians had significantly higher rates of usage, indicating that use by dermatologists will continue to grow in the future. Facebook remains the most popular destination for dermatologists, with the physician-only Sermo and professional network LinkedIn also proving popular options. 



Social media: the top tools
Drawing boundaries
Social media in dermatology