The Inspire Q&A: Inspire talks with Howard Luks, MD

Dear Inspire Community Members,

We at Inspire are pleased to bring you the latest in a series of Q&A interviews with people we feel are making contributions to helping patients worldwide. We are posting these interviews in a Q&A format in my Journal as a news feature for members of all communities on Inspire.

I recently interviewed Howard Luks, MD, who writes and speaks frequently on topics related to patient empowerment, improving physician/patient communication, and healthcare social media. Luks is a board-certified orthopedic surgeon, an associate professor of orthopedic surgery at New York Medical College, and also chief of sports medicine and arthroscopy serve at University Orthopedics, PC and Westchester Medical Center in New York. He blogs at http://www.howardluksmd.com/. One of his recent columns, written for physicians, was titled, The Risks of Not Participating in Healthcare and Social Media.

Inspire: How do you think patients can best communicate what they’ve learned from online research to their clinicians?

Luks: What I fully support and recommend is that my patients either email me any relevant information that they find that they think pertains to their case, and most certainly, to print out any interesting articles or data they may find, or any discussion threads they believe are relevant, and bring them to the office, so we can sit there and review them. I have two chairs sitting next to the computer screen in my office. One of for me, and one is for the patient. I believe that’s probably very rare.

Inspire: How about for patients of physicians who only have one chair in front of the computer, and who are disinclined to have those kinds of discussions with their patients?

Luks: While there are a number of physicians who choose to engage in this manner and are recognizing and appreciating the value proposition of digital media engagement, there are still a lot of physicians who are resisting this. So, patients have the opportunity to walk. Patients have the opportunity to seek out a physician who is willing to engage them, who is willing offer them a means of communicating with them digitally once the patient leaves the four walls of the physician’s office, so it extends the physician’s reach and availability well beyond the realm of their office space.

Inspire: Patients do have choices, but wouldn’t you agree that making that kind of change can be scary and difficult, especially for patients who are seriously ill, or who have rare diseases?

Luks: It can be difficult, absolutely. But if you’ve had a well-established and long relationship with your physician, then I think your physician will feel that too. And that patient has a much better chance of convincing that physician to engage, either with simply a Web site that is full of actionable and meaningful content, or to engage in social media, or through means of digital communications. So, the better your relationship, the better chance you have of convincing your physician to engage with you. Patients drive physician behavior. It’s well known in the medical device world, and I imagine that will transcend to the digital world as well in terms of communications, outreach and education.

Inspire: You’re considered an evangelist among physicians on the topic of healthcare social media, and you interact with fellow physicians at medical meetings and in online forums. How have you answered criticisms by physicians of patient empowerment through social networks and online research?

Luks: As recently as a year ago, they were different conversations than I have now. You’d get a lot of eyes rolling into the back of their heads, and a lot of skeptical looks, and they just didn’t believe you or understand you. They didn’t truly understand the world of social media, digital media, and most still don’t. Now, while many don’t understand the space, they do understand their relevance going forward is certainly at risk if they do not at least start their due diligence process.

Inspire: And what is the nature of those conversations now with physicians?

Luks: Now what I talk with physicians is that this is about relationships. I tell them that this is about stories. We treat patients. We don’t treat x-rays or MRI findings. So, I want to know as much about my patients, their disease and how it affects their quality of life, as I possibly can. And sometimes, the office environment for them is quite scary, and imposing, and they don’t remember what they wanted to ask, and it’s not until they are on their way home before they remember. And it’s very well known that patients forget about 75% or 80% of what they were told when they leave their physician’s office. So, first, I have cards and pads so they can write things down. Physicians are starting to realize that it helps us regain or recapture those relationships that older physicians had with their patients. They knew their patients. They knew their patients had a recent baby, or that they just bought a new house, that they moved, or they got a new job, or got a puppy, or whatever. Having a relationship with your patient in that respect for some is special and meaningful. And I talk all the time about non-verbal cues and non-verbal communication. And that’s very important. I can tell a lot about how someone feels just by looking at them. But I can also learn a lot about them by what they have to say on either my Web site as part of a comment or testimonial, or on my Facebook or Twitter pages as well.

Inspire: Even so, many physicians are reluctant to become engaged in this manner, even a little bit.

Luks: True, a lot of them are fearful of the exposure and legal risk and also the time commitment, and thus, a perceived cost. The cost argument can be thrown out because patients are researching online. They’re researching and diagnosing themselves through WebMD and then they’re searching for physicians who have expertise in that particular area. If you choose not to engage, then I feel that is to ignore your own relevance as a healthcare practitioner.

Inspire: What you’re saying is that patients are online anyway, with or without your direction or consent?

Luks: Exactly. A lot of physicians believe that digital media is a passing fad. And during my talks now I frequently quote that whether you agree with this trend is not particularly relevant. It is occurring. It’s gaining an enormous amount of traction. It is growing by leaps and bounds. So, I’m not telling a physician to share with patients where he’s eating or what movie he’s at, or if he’s at a birthday party and eating chocolate cake. That’s what a lot of physicians think of the world of social media. And a little education goes a long way.

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