How to make your doctor VERY happy!

15 02 2012

picture credit Jacob T_98

(For those who need to be told – yes, that was sarcasm.)

When I used to work in the health sector, we had a phenomena called the “heart-sink patient”. I am sure they still exist. Everyone working front-line knew what this phrase meant.

The heart-sink patient was the patient who, when the doctor went to the waiting room to call the next patient, literally made the doctor’s heart sink.

Them. Again.

Now there were a few sub-categories of heart-sink patient. There were those who had a genuine condition that defeated all attempts at diagnosis or treatment – frustrating and reminding the doctor of their own fallibility and limitations. There were those who had unrealistic expectations – either for instantaneous cures, or who medicalised the ageing process and wanted it stopped. There were those who had self-inflicted illnesses and refused to address the underlying cause – leaving the doctor to do ongoing patch-up medicine, knowing that the illness was only getting worse (for example uncontrolled diabetes). And of course there were the drug-seeking patients, many of whom were highly manipulative, disruptive and unpleasant.

I suspect there is now an additional category. The Google patient. When I left the health sector this was already quite prevalent – the patient who came in having looked up their symptoms on the internet and done a self-diagnosis. Sometimes they come in quite panicked, having diagnosed terminal illness. Sometimes they would come in demanding irrelevant and expensive tests for some highly improbably diagnosis, or requesting a prescription for a drug without having any form of examination or investigation (not going to happen). Either way, it made consultations longer – although, I am told – sometimes more interesting. And of course sometimes Google had managed to give them a correct diagnosis.

Given a list of symptoms, we are quite capable of generating those symptoms in ourselves. Remember when someone at work had a raging flu and you started to feel an itchy throat and snuffly sinuses – and it went away the next day? Let’s be nice and call it empathy taken to the next level. Well, reading about symptoms and illnesses can have the same effect. Author Jon Ronsson looked at the DSM IV – the diagnostic manual for psychiatric illnesses – for his book The Psychopath Test: A Journey Through the Madness Industry and diagnosed himself with twelve of the conditions. Now I don’t know the man, so I can’t be sure he doesn’t actually have any of these conditions, but I suspect he is just identifying with the symptoms listed. We human beings are so suggestible!

However Google is now helpfully taking this to a new level. Using search algorithms, if you type in symptoms – say “stomach pain on right side”, they will suggest a series of possible options – appendicitis, ovarian cyst, etc. Google is very clear that these lists are not compiled by medical practitioners and they are also not offering these as diagnoses. Just linked searches. They would not want to be getting involved in the convoluted world of medical liability.

So will Google’s new search function aid access to reasonable diagnostic options? Will they screen out the quackery the way Google Scholar (for the most part) screens out the opinion and focuses on peer-reviewed journals? Will this aid doctors, or by using search algorithms are they potentially funneling people and their diagnosis down the most common options – after all, someone has to have the bizarre and very rare illness.

The danger is, I suspect, if the patient having done a quick self-diagnosis on the web (and no matter whether Google says it’s a diagnosis or not, that is how patients will consider the information), then subconsciously edits or reframes their symptoms to fit their self-pre-determined diagnosis when they visit the doctor (because we all like to be right), then the doctor may also be funnelled into making an incorrect diagnosis based on the biased infromation s/he is presented with.

As they say, medicine is as much art as science.

Google’s Chief Health Strategist Dr Roni Zeiger’s blog post on this issue is here.


What’s your personal social media policy?

24 08 2011

Working through a social media policy for work is a good reminder of the issues social media can have for the individual.

We have all heard the horror stories – career-limiting photographs and postings that last forever. Employees facing disciplinary action, losing jobs or being screened out in interviews because of social media information. People being sued for defamation. Workplace bullying following employees home.

Here are some thoughts on defensive social media management.

1. Be clear about who each social media forum is for. For instance for me, Facebook is for friends, LinkedIn is for current and former work colleagues and Twitter is for anyone. I am very clear about this to avoid giving offense. I do not have work-related people on my Facebook site. It is too easy for an innocent comment to be misconstrued to relate to a specific work-related activity. On the other hand, I know people who do have work colleagues on their Facebook site. That’s fine too, but once you have made the decision you need to post appropriately. Remember who is there.

2. Make sure your privacy settings are high. This is basic common sense, but it never ceases to amaze the number of people who have low or no privacy settings. It’s a big world out there people, not everyone has good intentions!

3. Be aware that no matter what your privacy settings, information gets out. A friend does a screen grab of a funny picture or posting you have put up, shares a comment you have posted, you comment on a friend’s site only to find that some of their friends know you as well.

4. Be careful which Facebook groups you join – despite your privacy settings your comments on someone else’s, or a group’s, page might show up on a google search. Just “liking” a page sometimes shows up.

5. Alcohol and social media do not mix if you want a career!

6. Be careful about what you find humourous, including the postings you repost. Just because it wasn’t your writing or your opinion, having it against your name for reposting may look bad.

7. Google yourself from time to time and see what pops up. Mine generally covers work related activities (quotes in media, reports presented, documents authored and conference presentations, etc) and some recreational activities including notice boards I have left comments on. I did once find an obituary in my name – I have an unusual double barrelled surname so this was slightly alarming. Turns out to be an 82 year old woman who died in Texas. I believe in coincidence!

8. Do you have a common (ie: popular) name? Is there some way you can differentiate yourself from others with similar names – particularly if they are in unsavoury businesses or making ill-advised comments you do not want associated with yourself. You need to be either clearly identified as to which comments are you (if your strategy is to make your profile stand out online), or be anonymous in the crowd of people with the same name.

9. If you find defamatory comments about yourself, request that the user remove them. If that doesn’t work, request that the site owner removes them. And remember, libel is libel, even if it happens in cyber-space.

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Who owns you?

20 08 2011

Two items of social media news have caught my attention this week.

1. Who owns you? A legal case where journalist, Laura Kuenssberg, amassed an enormous Twitter following, tweeting as part of her job. Her account even included her employer – @BBCLauraK. All sweet.

Until she changed jobs to ITV. Who owns the Twitter account?

Laura K's new Twitter feed - @ITVLauraK

Of course this instance is particularly complicated for the following reasons:

1. the account includes the identity of both the journo and her employer. Both have reputations at stake. Did people follow Laura, or were they following a BBC journalist? Or both – surely her credibility and newsworthiness related to her employment. Apparently some of the tweets were processed by BBC producers, and the twitter-feed was promoted on air.

2. The employer had asked her to tweet during work time and about work related matters. Therefore is it part of the product she produced for her employer in her paid time?

3. I am guessing here, but she probably tweeted in her own time as well. This complicates thngs a little.

4. She is a journalist, so she retains the copyright to her product under copyright law. However the product is not the same as the medium (Twitter).

Seems to me the only option is for the account to be abandoned after messages directing followers to both an alternate BBC feed and an alternate Laura K feed. That way everyone loses equally, and users get to chose which one – or both – they want to follow.

And that does appear to have happened. If you have a look at Laura’s new Twitter feed – @ITVLauraK- she is both thanking people for following her to the new feed, and referring them on to other BBC journalist Twitter accounts. Very graceful.

5/11/11 UPDATE : A court case in the UK has awarded an employee’s Linked-In contacts to the employer. Apparently this relates to the majority of the contacts being related to the employees’ work for the company (as they would be – given that LinkedIn is a professional networking site). See here for more details


2. Not Liked!
The data protection authority in Schleswig-Holstein, a state in Germany, has apparently outlawed the Facebook “like” button. I kid you not. (And no, it is not April 1 – I checked.)

This relates to the Facebook company collecting data such as our IP addresses when we click “Like” on the sites we visit. This information is then passed on to company servers in the US and saved for 90 days. It is this collection and retention of data that the data protection commissioner alleges contravenes German and European law.

Website owners in Schleswig-Holstein were ordered to immediately disable the *Like* buttons on their sites, and threatened with legal action if they failed to comply.

German Facebook Stats from

Users were urged not to set up Facebook sites and to avoid clicking *Like* buttons in order to prevent themselves being profiled.

Something about King Canute springs to mind, but this is not Germany’s first foray into the battle with internet giants over privacy laws. And they have won in the past.

Google has allowed German citizens to blur their houses in Streetview. Facebook has also put controls over its Friend Finder, which mines email address books to identify contacts.

So will Germany join China in banning Facebook entirely? It seems unlikely in a democratic country, whose citizens are currently heavy users of Facbeook and other social media. Over 20million germans have Facebook accounts, approximately 25% of the population.

Will the law-makers of Germany win over the corporates at Facebook? And on whose side are the private citizens of Germany?

And finally, the burning question for the day: is the term private citizen an oxymoron in this day and age?