Managing your online presence simply, economically

Blogs and social media platforms like Facebook, Twitter, LinkedIn, and YouTube may help physicians not only expand the reach of their practice but also influence online conversations with their own perspectives. It helps, though, to have clear goals in mind before you begin, said Kevin Pho, MD, ACP Member, an internist and founder of KevinMD, an influential health care blog and social media outlet online at KevinMD.com. He offered physicians a succinct piece of advice: “Don't just go on social media for the sake of using social media.”

Dr. Pho said that social media can empower physicians in three ways. “There's a lot of bad information online. You can go online and direct people to a reputable source, or you can be that source,” he said. “Second, if physicians don't define themselves, they will be defined by a physician ratings site, and they may not like what comes up. The third is to make their voices heard, especially when it comes to the ways in which health care is changing.”

The key to optimizing social media tools, in a nutshell, is determining what to say and how to say it, said Ira Nash, MD, FACP, senior vice president and executive director of Northwell Health Physician Partners in the New York City area and founder of “Auscultation,” a Northwell-hosted blog.

“Start by exploring what you are trying to accomplish, and those goals should drive what tools you use,” he said.

Audience is also an important consideration, Dr. Nash said, with the two primary choices for physicians being patients or other health care professionals.

“I think it could go either way [patient or physician], but it's hard to sustain both,” he said. “I got into online health because I wanted to start a new channel of communication among physicians in our medical group. … There [also] are people who are posting around a clinical area in hopes of burnishing their credentials and expanding their practice, and that's a different activity.”

Drawbacks, solutions

Social media takes time, a scarce and precious resource for physicians. But the number of hours spent is less important than sustaining a given channel or platform—on whatever schedule is feasible—after it launches.

Dr. Pho acknowledged that his part-time clinical practice and the 20 to 40 hours a week he spends on social media—not to mention his 3 million monthly blog pageviews—make him an outlier, but he said a one-time investment of a few hours can be more than enough to create a viable online presence.

“You need a certain amount of consistency,” Dr. Pho said. “A lot of people go gangbusters at first and then peter out after a few months. Create a schedule you can maintain for at least the first eight to 12 months. You do need some time, but it could be every day, every week, or every month.”

Starting a social media channel only to eventually neglect or abandon it can do more harm than never starting one in the first place. A 2016 report from Sprout Social, a social media management and advocacy firm, found that 89% of social messages go unanswered, which in turn can lead users to choose a competitor or even publicly shame the account.

“All of us hate to go to a site and see it's last been updated six months ago or a year ago,” Dr. Nash said. “Why would you go back there?”

Once you start an account or accounts, it's important to actively monitor them to continue to manage your reputation, said Thomas Savides, MD, chief experience officer for UC San Diego Health.

“You can respond to messages with a positive acknowledgement; ‘Thank you for your comment,’” he said. “Or you can say ‘I'm sorry for your experience. Let's find a time to talk offline.’”

Another concern is return on investment. Even as social media spending is expected to reach 20.9% of the average marketing budget by 2021, only 11.5% of businesses can demonstrate the impact of that spending, and only 3.4% of marketing leaders said social media contributes very highly to their firm's overall performance, according to the 2016 CMO Survey, a biannual survey of chief marketing officers across 13 industries cosponsored by the American Marketing Association, Deloitte, and Duke University's Fuqua School of Business.

At the same time, more patients now use the internet to “shop” for clinicians who fit their needs. A 2012 PricewaterhouseCoopers report found that 41% of 1,090 U.S. adults who responded to a consumer survey used social media to help them select a doctor, hospital, or medical facility.

As Dr. Nash's blog, Auscultations, gained prominence, the resulting visibility did not cause a noticeable uptick in patients, but he believes it did help establish him as a voice in the health care discourse.

“A number of my posts got picked up by people with a larger reach,” Dr. Nash said. “If your goal is to create some credentials as a thought leader, it's important to be using social media.”

The most widespread deterrent among physicians considering social media may be privacy concerns, particularly those related to potentially violating the Health Insurance Portability and Accountability Act.

“Any kind of demographic information, whether it's age, sex, location, certainly name, should not be used,” said ACP Resident/Fellow Member Ravi Parikh, MD, MPP, a social media expert. “You'd want to stay away from a diagnosis if it was rare. Focus on the condition or the treatment rather than the patients themselves.”

Simply put, Dr. Pho advised, “Don't say anything you wouldn't say in a crowded hospital elevator.”

Hiring a firm vs. DIY

Many marketing firms cater to physicians and can execute full-service online marketing campaigns. Costs of such campaigns vary based on the size of the practice, the vendor selected for the job, and the desired components or objectives of a campaign (for example, some might include online ad buys or the creation of a website, while others might include only social media).

According to marketing data publicly posted online at the websites of online marketing providers, some vendor agreements can range from $1,000 to hundreds of thousands of dollars per month. (One-time setup costs for developing new items like websites may also apply.) Social media alone can range from $1,000 to $20,000 per month. Other vendors charge a percentage of a client's annual budget, which generally ranges from about 2% to 12%.

Evan Meyers, a business development representative with Docero, a New York-based physician marketing firm, said his firm not only helps design a campaign but provides metrics on its effectiveness. The campaigns are mainly geared toward physicians looking to bring new patients into a practice, he said.

Mr. Meyers said, “Proper campaign performance reporting tracks how many people have visited the physician's website, what brought the person to the website, and how many of those website visitors filled out an appointment form and became a new patient for the practice.”

At the same time, independently creating an effective online presence can defray the costs of or need for such a campaign. Tools like blogs and social media are free or very inexpensive to develop. “The technical side is pretty simple, unless you're [completely inexperienced],” Dr. Nash said. “It's very easy to go out and set up your own blog or social media account. The hard part is sustainability.”

“If [physicians] are not interested in doing it themselves, and they want to hire someone, that's fine,” Dr. Pho said. “But if you spend the time to figure out what you want to do, if you understand the different channels, that's what [firms] are going to do anyway. Plus, you lose voice and authenticity when you don't do the content yourself, and patients can see that.”

Navigating the space

Another benefit of a strong online presence is that it can help physicians compete with ratings sites in search engine results. Physicians are frequently frustrated by independent websites that allow users to critique or “grade” their doctor-patient experiences. Many reviews tend to fall on the extreme ends of the spectrum, presenting a misleading picture of a practice, experts said.

“The number of physician rating websites is high,” said Dr. Parikh. “When it comes to hospitals there are valid metrics, but with individual physicians there's not a good way to find out who's saying what and trust it. People who review either had a very good experience or a very bad experience. There's not a lot of volume or a good sample size.”

Although it is possible to dispute a rating or review, it can be challenging, experts said, with each site having different rules for amending or retracting user content. But if you cultivate your own online presence and offer details online about yourself and your practice, that information will compete with any negative reviews in search results, said Dr. Savides.

Dr. Pho recommends starting with LinkedIn, the all-purpose network for professionals, and Doximity, a similar network catering to health care professionals. After Dr. Nash writes a blog post, he shares it on Twitter and LinkedIn. And following others on social media is a big part of its value, said Dr. Parikh.

“It probably enables a greater amount of science and practical information being shared online,” he said. “Leading publications publish snippets of articles [on social media], and following them is a good way to stay up to date.”

It is no secret that arguments, sometimes heated, can break out online. Be prepared for the inevitable criticism, and be thoughtful about when and how to weigh in on specific topics, Dr. Pho said.

“Everyone understands the highly politicized nature of health care,” Dr. Pho said. “There are lots of opinions, and you'll get into arguments, especially on Twitter. Go in with your eyes open. Are you able to engage in healthy debate online?”

Ultimately, physicians who have successfully used social media argue, the benefits of building an online presence outweigh the risks, as long as there is a thoughtful approach.

“There's this tremendous power in social media and tremendous interest in using it—enhancing your public profile, branding yourself as a disease- or technique-specific expert,” Dr. Parikh said. “For all its downside, it has much more promise. Think about how social media could help your practice, rather than automatically straying away from it.”