Dr. Kevin Pho is an internal medicine physician who practices primary care in New Hampshire and the founder of KevinMD.com, a leading digital hub for sharp, insightful commentary on pressing healthcare issues. Lauded and cited by numerous major media networks, KevinMD.com has been called a “punchy, prolific blog that chronicles America’s often dysfunctional health care system through the prism of a primary care provider,” by the Wall Street Journal, and a “must-read blog” by Forbes. Dr. Pho has also written opinion pieces for USA Today, CNN.com, and the New York Times. KevinMD.com was named the best medical blog of 2008 and has over 100,000 subscribers. 

Let’s start at the beginning… when and why did you decide to become a doctor?

I went to Boston University for their 7 year program. I decided to become a doctor early on in high school. I wanted to go into medicine because I wanted to go into a field that was constantly changing. But after I graduated and finished residency, I had no idea that social media would play such a huge role in what I do professionally. And I think that’s tremendously exciting. Being in a field where you can have technology that can really change what you do professionally. A lot of the training I got in medical school did not really prepare me for the digital world that doctors find themselves in today.

Why did you choose to do internal medicine?

The main reason was because I did not have a specific specialty that I was so interested in. IM gave me the most flexibility. If I wanted to sub-specialize later that always left that door open. When I graduated and started primary care, I liked the diversity and having the skills to manage patients in the hospital and in the clinic. You deal with a different issue every day – it can be a social or a medicine issue in any number of organ systems. The diversity and variety are what drew me most to internal medicine.

Can you talk a little bit about how you started KevinMD.com?

I started in 2004. At that time, there weren’t many physician bloggers at the time (less than 100). I wanted a way where physicians could provide commentary that accompanies the news that patients see on television or read in a newspaper. Whenever a story breaks – everyday there are new studies come out, drugs recalled, guidelines changed – patients have a lot of questions about these studies. They would say – Dr. Pho, what does this story mean to me? So I thought a blog was a good way to provide dynamic physician commentary that could keep up with the pace of breaking medical news. Patients can read what doctors think about a certain story and give them the meaning they need to better interpret it.

That was the start of it but it has evolved since then. Now I use it as a platform for my voice and the voices of other doctors and health professionals. I think it’s important for their voices to be heard. Now with healthcare reform and that healthcare is changing around them, it is important that doctors get heard and be part of that process. Having a platform like a blog is one of the best ways to do that.

 

Whenever I visit the website, it seems like there’s a lot of physicians who are discussing the changes in healthcare and I think it’s important for someone like myself who is training to work in healthcare to be aware of these burgeoning changes. As a medical student, I observe a lot of things but don’t yet understand the intricate details of being part of that workforce.

It is important. A lot of medical students have healthcare policy classes, which gives a foundation, but sometimes you need to hear real world experiences and that’s not always available in medical school.

Do you think there is any way that aspect of medical education can be improved? There is so little I understand about Medicare or healthcare insurance, I wonder why they don’t try to teach us more about that.

There are a lot of schools that do, but not enough do. I remember a time I went down to the Vanderbilt School of Medicine to give my social media talk. It gave me the opportunity to speak with medical students in small groups and they could ask these kinds of questions. Sometimes in medical school, you’re shielded from real world medicine so it’s nice to have practicing physicians to give that real world experience. I think that’s tremendously valuable to students. And that’s where blogs come in too. I get a lot of medical students commenting that they find the guest posts on my blog really eye opening. That’s where social media can fill that void.

Can you talk a little more about how you went about nurturing the expansion and growth of KevinMd.com? How and when did you start get guest bloggers?

The guest blogging didn’t start until 2008 or so. Logistically it was difficult for one person to write enough content to sustain a blog. Then you see other websites like Mashable, Huffingtonpost, TechCrunch, etc, and they employ a group blog concept. I thought that was a great idea to apply to my own. Sometimes people may not agree with what I say about health reform or how I interpret a news event. I think it’s important to get other voices as well. Those other voices don’t necessarily have to be physicians. I have patients, health policy experts, lawyers, physician assistants, and nurses guest blog. I think it’s important for all the healthcare players to hear each others’ voices and learn from different perspectives.  They are hearing voices that are liberal and conservative, they’re hearing voices from doctor and patient. When they hear these different voices they get a better understanding of the issues that we’re dealing with.

You’ve had patients guest blog as well?

Most of my guest posts are physicians (80-90%) but I do have a proportion of patients in my guest blog rotation. They give a patient perspective and I think that’s very important for doctors to hear as well.

It’s very common for people to think that a team in medicine is the nurse, the doctor, the physician’s assistant, etc – it’s easy to forget that the patient is a part of the team as well.

Some may say that the patient is the most important part of the team.

Why do you think social media is important for physicians?

I think doctors can use social media to dispel myths because there is a lot of bad information on the web. There was a worldwide study earlier this year that showed that only a quarter of patients check the reliability of what they read online.

So information from people who are trying to sell you things or push an agenda can be tremendously harmful. Social media can be a way through which doctors can be a source of reputable information or help guide patients to reputable sources of information. Doctors can do it on blogs or share posts on Twitter or even have a page on Facebook.

In terms of online healthcare information, being a physician gives you credibility. It gives you a certain perspective. If you’re a doctor, you’ve gone through the training, so you have a perspective that I think is tremendously important. When you’re in the position of being a medical journalist and you’re responsible for disseminating and reporting on the news, I think it is important to have that medical background.

The actual practice of medicine is very different from the medical knowledge. It’s very easy to overlook certain factors when you’re just looking at a book versus when you’re looking at a patient. That’s just something I’ve discovered this year because applying what I know to a patient is very different.

How do you think we can encourage doctors to use social media more? As you said it’s a great way to doctors to communicate and dispel myths, but it seems like a lot of physicians are not inclined.

There are two ways. The first way is to emphasize that patients are not only looking for diagnoses and treatments online, they are looking for doctors online. Doctors need to be very cognizant of their online persona, what I call their digital footprint. I encourage all physicians in all my talks – and I say this in all seriousness – every doctor needs to Google their name once a week and see what comes up. Sometimes what they say in a media interview will come up but it will also be their social media presence: Twitter page, Facebook page, LinkedIn page. Because what if they didn’t have any of that? What if they weren’t involved with social media? For a lot of doctors, the first thing that will come up is a physician rating website. These sites are populated by subjective patient reviews and in some cases, they are inaccurate. Most importantly they don’t control that information.

One of the most important reasons to be involved in social media is because it can put that doctor in control of their online profile. Doctors don’t need to use social media to the extent that I do. For most doctors I recommend a simple LinkedIn page that’s static. They can write a few lines of their resume and they can talk a little about their practice. They don’t know need to go crazy blogging and tweeting. That simple act can get ranked high when their name is Googled and it will put them ahead of 90% of their peers. I think the most compelling reason for physicians to get involved in social media to put themselves in control of their online reputation.

The second reason is to really make it part of the job description. Right now doctors are busy enough. I see 20-30 patients a day, deal with paperwork, do charting. The last thing doctors want to hear is that they need to do social media, just another thing to do.  I talk to doctors and show them the value social media have. I think we need to speak with our physician leaders and show them the value of social media. Maybe give doctors the dedicated time to write a blog or to compensate them to make it part of their job description. I think it needs to come from the leadership.

There needs to be incentive. And if there’s no incentive, it will be difficult to convince many healthcare professionals to integrate it into their practices.

 

What do you think medical students, who were raised with the social media boom, can do to better communicate with their patients in the future?

There needs to be strong social media role models. There was a study in the Journal of the American Medical Association which polled medical students around the country and asked them how professional their tweets or social media presence was. 60% of them reported unprofessional behavior – intoxication, sexual innuendos, they disclosed patient information. I think the first thing is that medical schools need strong social media role models to teach them how to be professional online. I hear a lot of medical schools telling students not to go on social media and ban them. But I don’t think that’s a realistic position. A lot of medical students grew up with Facebook. They need to be educated on the terms of how to act professionally and the importance of patient privacy. Instead of banning it, it needs to be included as part of their curriculum on how to teach online professionalism.

As it stands, I definitely would air on the side of caution and be careful if you ever talk about patient cases online. Realize that whatever you post on the web, it’s on there forever. I think these points need to be emphasized early on in physician training.

One last point I want to give – if doctors lose our influence online, patients will go else where to look for health information. That simply cannot happen because the more we lose our online influence, we lose our standing as healthcare authorities.