Starting Health Care from Scratch – MDchat

Grandiose question: If we could build health care (medical and nursing education, payment/indemnification structures, diagnostic and treatment research, etc.) how would you build it?

That’s the subject of #MDchat tonight – Tuesday, May 31, 2011. We’ll break up this grandiose topic into a few small chunks. [Chat took place and the transcript is embedded below. Link.]

The idea is this: Every system has as its basis the technological, cultural, economic, sociological, and other conditions of the times it was created.

But all systems evolve – or should evolve – to ensure it works properly.

Healthcare has multiple historic origins – and much of those origins extend to a decidedly military flavor. “Doctor’s Orders!” – on the battlefield, a physician’s orders carried the weight of an officer. We still use that phrase today. A legacy element of a legacy system.

So, if one wants to know how to ‘re-form’ a system with which we’re all frustrated, a basic way to navigate and orient is to ask: If we built this thing right now with what we know and have, what would it look like? Call that Vision.

Then you look back at the way things are and their origins. Call that Legacy.

The changes we need to make – and this is admittedly highly simplistic – are equal to Vision – Legacy.

So we’ll discuss (Vision – Legacy) in Health Care in these three areas:

  • T1 Medical Education: What legacies in Med Ed need to be ditched and what aught to replace them?
  • T2 Patient-Provider-Pharmaceutical-Complex: from research to marketing, what needs to change?
  • T3 Incentives: How would we structure funding/payments? What fixes to current state are a must?
Follow the conversation tonight here – or read the transcript, embedded below:

A Suggestion for Vendors Using Hashtags

The use of hashtags on Twitter for chats and for marking tweets has exploded in the recent past. If used in moderation, they can be a valuable enhancement to Twitter.

The flip side, however, is that overuse of hashtags can create so much noise as to lessen their value or even render them unusable.

Vendors have especially seen hashtags as a way to promote their services. Is this evil? No. Twitter’s an open platform and anyone can provide value in their own ways.

Still, there are respectful ways to market ideas and products and services. And when vendors usurp hashtags in ways that lessen their value, the process eventually becomes counter-productive: for if everybody uses a hashtag or Twitter chat to promote their wares, nobody can pay attention to anything, and so the marketers lose in the long-run.

I’ve had a few conversations with vendors who I felt were abusing Twitter – needless to say, some were very angry with me. In fact, I feel as if one of them has basically threatened my reputation – I’m not completely certain it constituted a threat in the eyes of law, but it’s sad to see that kind of response.

Anyhoo, here’s a suggestion for vendors who seek to market their stuff via Twitter: create your own hashtag and/or Twitter chat. Here’s why:

  • It’s “your” platform (not technically, since Twitter’s an open space, but you get credit for building up the community).
  • You don’t run into the problem of appearing like a spammer on the work of others. For instance, Dana Lewis has done a wonderful job of leading #hcsm. It’s become a popular place for people in healthcare to connect. But it’s also becoming a place for vendors to overuse the tag to promote themselves. She does have some right in being respected for her work. If you’re in healthcare, you aught to be especially respectful of the community which people work to build.
  • If you use the hashtag to run Twitter chats, you get to lead them and use them in whatever way you want.
  • Your use of a hashtag can be a deeper and broader extension of your brand. If you build it right and provide valuable ideas, tips, etc. you position yourself as a leader, not a spammer and abuser of others’ work.

There are other justifications for branded hashtags but these should be enough to get a trend going.

Twitter has a role in marketing. But so does kindness, respect and appreciation for ideals.

We all use these hashtags to promote something – an idea, a blog post, a charity, a service. That’s OK. It’s just a matter of relevance, contribution and respect.

If you believe strongly in an idea or your brand, go build something that you can look upon with healthy pride.



First FDA Approved Diagnostic Radiological Mobile App and IOM Report On Expanding Nursing

On tonight’s MDchat (February 8, 2011), we’ll discuss these topics:

  1. The first FDA approved diagnostic radiological mobile application
  2. IOM’s report on expanding nurses’ role in Healthcare

Here’s the transcript:


Transcript of MDchat on Younger-onset Alzheimer’s

Below is the transcript from tonight’s MDchat on Younger-onset Alzheimers. For more on the backstory, please read this.

Here’s the transcript:

We’ll post more thoughts on the chat soon, but I wanted to get the transcript out to regular readers.

In the meantime, if you attended the chat, please feel free to continue the conversation here.


Alzheimer’s MDchat with Gwen Richards and Libby Embry

On Tuesday, January 25, 2011 MDchat, in conjunction with Albert Einstein College of Medicine of Yeshiva University (@EinsteinMed) and Alzheimer’s Association, is proud to host a fireside chat on Alzheimer’s with Gwen Richards and Libby Embry.


Alzheimer's Association logoGwen and Libby are members of the Early-Stage Advisory Group of Alzheimer’s Association and have graciously agreed to tell their stories about facing Alzheimer’s on our Twitter chat – the first of its kind, where Gwen and Libby will have the chance to take questions from physicians, nurses and the public through the medium of Twitter.

Gwen and Libby were diagnosed with younger-onset Alzheimer’s, but their stories about how and when they were diagnosed – and treated – are different, shedding light on the need for much better awareness of the course of this disease and its impact on the people with it, their loved ones and healthcare providers.

Their role on the Early-Stage Advisory Group has helped better inform both the Alzheimer’s Association and the medical community on how to improve patient-provider communications.

Here are their full profiles, courtesy of Alzheimer’s Association:

I spoke with Gwen and Libby, courtesy of Alzheimer’s Association, to give them a sense of how Twitter works, to explain the uniqueness of Twitter chats, to hear their stories and to get to know more about them. They are each wonderful and kind women, and I’m honored to work with them.

“With Alzheimer’s especially, Einstein and MDchat saw an opportunity to create a chat format that fills a largely unmet need: allowing people in the early-stages of the disease to tell doctors and other health care providers exactly how they want to be treated and included in their diagnoses and treatment plans,” said Paul Moniz, director of communications and marketing at Einstein.

The chat is also timely.

On January 20, 2011, an FDA advisory committee recommended conditional approval the use of a dye that detects brain plaque using PET scans. The reality is if the full FDA approves the use of PET scans for this purpose many more patients, including those in the earliest stages, could have a much more clear and credible understanding of what is causing their symptoms.

It’s important to recognize Gwen and Libby for the courageous leaders that they are. Their role on the Early-Stage Advisors panel has helped better inform both the Alzheimer’s Association and the medical community on how to improve patient-provider communications.


This is an unique moment, one where we hope to advance communications among patients and providers in light of the technological changes of the 21st Century.

Since the dignity, safety and enjoyment of Gwen’s and Libby’s time are my my top priorities, I’ve outlined a few points and made a video concerning etiquette and process during the chat. Please review the points below and view the video prior to attending the chat.

Here are the basics of the format:

  • We’ll introduce Libby and Gwen. Since Gwen and Libby are not active users of Twitter, they will receive some help for the actual tweeting.
  • For the first half hour, @MD_chat will ask questions directed at Gwen and Libby and they will use those questions to tell their story (at this point, participants are asked to hold off questions until the second half)
  • Links to Alzheimer’s resources will be provided according to the pace of the chat
  • During the last half of the chat, participants will have the opportunity to ask Gwen and Libby questions, which @MD_chat will moderate.

We believe this is the first time such a chat has taken place on Twitter.

Why Twitter?

Twitter’s simplicity and intimate ambience provide an opportunity to reveal key points about a social object. It’s also a paradoxically democratic media: the dictatorship of the 140-character limit puts all users on content-parity.

Twitter is by no means a diagnostic nor treatment medium. That would be a misunderstanding of its usefulness in health care. Rather, it’s a propellent for social connections, brief sharing of content elsewhere and the exchanging of essential viewpoints and experiences.

Read MDchat’s About page for more on Twitter’s role here.


We hope this chat reveals the promises and challenges facing health care in the 21st Century. Nurses, physicians and the public do need better ways to understand each other. Twitter’s far from a solution. Rather it’s a wing for gently lifting hope of better care.

The hashtag is #MDchat and you can follow along on TweetChatTwitter Search or the Twitter client of your choice. If you’re new to Twitter or Twitter chats, here’s a video tutorial I did for RNchat (just substitute MDchat).

This special fireside MDchat on Alzheimer’s will be held on Tuesday, January 25 at 9pm Eastern. Feel free to participate respectfully, or simply follow along the chat.

@PhilBaumann@MD_chat@EinsteinMed – @HealthIsSocial

Our Newsletter


MDchat January 18, 2011

MDchat for January 18, 2011:

Topics discussed:

  1. T1 Withholding Info: Are there times when w/holding info from patients is ethical & less harmful than truth? See]
  2. Nutrition: How can physicians do more to educate patients on nutrition? Does medical school provide enough training?

Here’s the transcript:

Concerning Topic 1 (T1), here are just a few favorited tweets (click image to enlarge):

[Link to the chat’s transcript if you can’t view it here.]

For regular updates, follow MDchat on Twitter: @MD_chat.


Guest Host of MDchat – Einstein Medical College

Tonight, Albert Einstein Medical College of Yeshiva University will host #MDchat. Paul Moniz will be tweet the topics out of Einstein’s Twitter account @EinsteinMed.

The theme of tonight’s chat will be Diabetes. Topics will range from the effect on the care of patients with diabetes of low insurance reimbursement, adherence, the growing epidemic of diabetes and other areas of interest.

This is the first time that a third party is hosting MDchat – and it’s an encouraging sign of getting providers and organizations to contribute their perspective and to participate in emerging media.

We are delighted and honored that Einstein Medical College and its staff have agreed to participate in tonight’s chat and we wish them well.

Details of tonight’s chat, including resources and a transcript, will be published after the chat is finished.

If you would like to be considered as a host for MDchat, please email: or call Phil Baumann: 484-362-0451.