Medicine in the Age of Twitter

When Rahul Parikh arrived at his office on Tuesday morning, the first thing he did was to tweet that the hospital finished construction of the front entrance.

"I thought it was useful information for the community," said the 38-year old Parikh.

Parikh is a pediatrician at Kaiser Permanente Medical Center in Walnut Creek. What makes Parikh different from some other doctors is that he fully embraces Web. 2.0.  He tweets about heath care news, in addition to writing medical-related blogs on Salon.com and contributing to the New York Times, the Los Angeles Times, and the San Francisco Chronicle. You can follow the doctor at @parikhmd.

"I think social media [like Twitter] is a quick and direct way of informing patients," said Parikh, who is also the father of a 2-year-old girl.

Web. 2.0 has changed the old world of medicine in which doctors seemingly had absolute authority. Today, the doctor-patient relationship has become more leveled. Patients can Google their symptoms before doctors' visits, prepped on questions to ask.

Not all doctors are comfortable with these changes, but Parikh is taking advantage of this shift to make basic medical information as accessible as possible to the general public.

A Southern California native,  Parikh has been monitoring the influence social media has had on the medical industry for several years. Tweeting was a natural consequence. A few days ago, Parikh tweeted an NPR story about tanning salons.

During last spring's H1N1 influenza flu outbreak, Parikh tweeted when he would be available at a special tent Kaiser set up to handle the influx of patients. His tweets—140 characters or fewer—saved patients time and let them know if they should be worried, or not. One mother brought her daughter, one of Parikh's long-time patients, without panicking because she knew the doctor who would be seeing her.

Kaiser doesn't discourage their doctors from using Twitter or other social media, but it wants doctors to be clear that their posts represent their own opinions, not the organization's.

"Younger parents are comfortable using these technologies," said Jim Caroompas, media relations specialist for Kaiser Permanente Northern California's regional offices. He added that there are at least six doctors at the Walnut Creek campus who tweet on a regular basis.

Doctors must also abide by a strict code of ethics; they must not disclose any private information about patients without their consent.

"It is about patient-doctor trust. I have followers in the community because they trust me," said Parikh who majored in molecular biology at UC Berkeley and traveled internationally before attending Tufts University School of Medicine in Boston.

In 2006, Kaiser introduced a $4 billion electronics medical record system called "Health Connect." The system allows patients to make appointments online and access their medical histories and gives doctors instant access to patients' medical records. It also asks doctors to respond to patients' non-emergency inquiries within 48 hours.

"At first, some doctors were reluctant," Parikh said.

Using e-mail is a win-win situation for both doctors and patients, said Parikh. He recalls when he had to inform one patient about test results. He phoned the patient, but he couldn't reach him. Rather than prolong the phone tag, Parikh e-mailed the patient, suggesting they get into contact that way. "It saves time and it's more efficient," said Parikh.

Kaiser is not only the local medical institution keeping up with the digital revolution.

John Muir Medical Center in Walnut Creek also has an electronic health record system. The Mayo Clinic in Arizona has more than 20,000 Facebook fans. Some hospitals go even further. At the Henry Ford Hospital in Detroit, surgeons tweet patients' families about the results of procedures.

Parikh admits that "e-patients" have plenty to be cautious about. In a column for Salon.com, he confessed that some e-patients do not trust a physician's virtual advice, but he emphasized that "this rarely happens."

Most of all, he believes that social media allows doctors to work with more well-informed patients. 

"It's a small test of change in physician's ability and tolerance, and building a new doctor-patients relationship," said Parikh.