Texts and tweets help an M.D. connect with her patients

How one physician maintains a professional bond through social media.

How one physician maintains a professional bond through social media

Physicians get bogged down, even discouraged, by a flood of paperwork, insurance claims and litigious ordeals.

But a pediatric endocrinologist at Nationwide Children’s Hospital says social media has brought the joy back to her practice. With texting, joining Facebook and using Twitter, she says she’s been able to make a difference and improve the quality of care she gives to patients.

“It feels good,” says Jennifer Shine Dyer, M.D., MPH. “You still have to deal with the medical, paperwork and insurance denials, but I can tell you that the cynicism decreased a lot. I don’t know how you can measure that.”

Health literacy is one of her biggest passions, and she’s using social media to keep people informed. Even though some doctors might avoid social media because of HIPAA concerns, she thinks it’s better to jump into the conversation, instead of staying out of it.

“We are responsible to our profession to keep a patient’s privacy safe,” Dyer says. “You do have to be extra careful about what you say, but sometimes, you have to be willing to take a little risk to be significant and relevant.”

Here’s how Dyer uses social media to connect with patients and the health-care community:

Innovative texting program for teens

Dyer noticed her teenage patients were having trouble adhering to their treatment schedules and would forget to take their boluses, an essential component to treating diabetes.

“Every time food is eaten, insulin is needed in order to push the glucose inside of the cell,” Dyer says. “Otherwise, the glucose stays in the blood and does not get inside the cells, where it is needed to make energy.”

In October 2009, she started a texting program and asked three 17-year-old high school seniors and their parents to get involved. They agreed.

Since then, Dyer has texted each teen every Thursday at 5 p.m. She begins with this introduction, “Hi, this is Dr. Dyer.” After they respond, she’ll ask them a personal question—such as, “How was lacrosse practice?” or “How were finals?”Once getting a response back, she asks: “How are you doing with your boluses? How are your blood sugars? Are they high or low?”

After three months, she says, the results have been successful. Before, the teens would usually miss taking about half of their boluses each week. Now, she says, teens miss only about three boluses each week.

“They were at a C-,” Dyer says. “Now, I’d give them a B+.”

The hospital’s communication team created a video about Dyer’s program. “Because diabetes is so complex, you have to think about every meal,” Dyer says. “Providing a little bit of personalized support is critical.”

She says her patients enjoy exchanging texts with her. One time when she was on vacation and had forgotten to text them, they texted her and asked, “Are you OK, Dr. Dyer?”

Now, she’s applying for a grant to create an iPhone app that will allow her to text up to 50 patients. With the app, she can store personalized information about the patient and send out personalized texts at regularly scheduled times.

Talking to patients on Facebook

Dyer reserves Facebook for more personal aspects of her life, but she is connected to a handful of patients that she’s worried about.

For example, one of her patients is a diabetic competitive power lifter. Before they were Facebook friends, she initiated weekly phone calls to monitor his blood sugar levels. Now, he will frequently ask her questions on Facebook about nutrition and diabetes.

After a recent shoulder injury, for example, fellow lifters recommended a growth hormone that’s available online without a prescription. After he sent her a Facebook message asking for her advice, Dyer advised against the regimen. Instead, she referred him to orthopedics for steroid treatments injections into his damaged shoulder.

Connecting with Twitter community

Dyer was inspired to join Twitter in April 2009, after a medical communications conference.

“I think all doctors have a civic responsibility to spread information,” Dyer says. “It’s the duty of doctors to be the voice of reason on the Internet and give people correction information. Whether doctors like it or not, people are talking about health and looking for health advice. You can choose to be involved or not, but it’s better to be involved—you can be a voice of truth and science.”

One time, she saw that a naturopathic doctor had said you could cure Type 1 Diabetes with a raw food diet. Type 1 Diabetes is an immune disease, however. Dyer says she didn’t have to spend too much time correcting the naturopathic doctor’s tweet.

“Well, let’s just say the diabetes community put him in his place,” Dyer says with a laugh. “That’s the good thing about social media. There’s a mob effect—when someone steps out of line, the community takes care of it and policies itself.”

As @EndoGoddess on Twitter, she doesn’t interact with her own patients, she says. Most of her 2,500 followers are health care advocates or people with diabetes. If someone with diabetes asks her a question, she says she has to give them general answers because they aren’t her patients or must encourage them to talk to their own doctor.

Dyer spends about two hours a day on Twitter. She checks her Twitter account in the morning, after lunch, before she leaves work and when she’s relaxing at home.

Here are some examples of her recent tweets:

@rlbates I agree, I think Michelle Obama childhood obesity campaign is AWESOME!! 🙂 Diabetes therapy should always be pt-specific.

A winning choice is whatever makes life with diabetes easier (and good glucoses of course).

I’m quite certain that fair food could cause a diabetic coma in ANYONE!


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