1.
Understanding Physicians Online
Greg Matthews
October 18, 2012
Contents are proprietary and confidential.
1 #MayoRagan | @chimoose

2.
Fundamentally, Twitter allows for medical content curation in
easily consumable bites with rapid visual access. Truly the
popcorn version of medical news (and yes, with movie butter!).
Farris Timimi
Medical Director, Mayo Clinic
Center for Social Media
twitter.com/farristimimi
Contents are proprietary and confidential.
2 #MayoRagan | @chimoose

3.
With over 18,000 followers from medical communities, with
the right strategy and communication, I can leverage the real
power of my networks by using crowdsourcing very difficult
questions and issues. Twitter is the fastest and most
interactive social media channels in my work.”
Dr. Bertalan Mesko
twitter.com/berci
linkedin.com/in/bertalanmesko
Scienceroll.com
Contents are proprietary and confidential.
3 #MayoRagan | @chimoose

4.
They’re here…
#MayoRagan | @chimoose

5.
A benchmark
In 2010, Dr. Katherine
Chretien of the VA Medical
Center in Washington led a
team in producing the first
known scholarly study of
physicians’ use of twitter
5
[ New, automated tools have enabled
us to broaden the scope of our study
Contents are proprietary and confidential.
#MayoRagan | @chimoose
[

6.
Standing
on the
shoulders …
The Chretien Study
260 5,156 Data Collected and
tweets Analyzed between May 1st
US Physicians and May 31st, 2010.
from 260 physicans – the most
recent 20 from each
The power of automation
Study
1,397 403,553 Data Collected and Analyzed
US Physicians tweets between October 3 and
validated against CMS’ National generated between October 15, 2012
Provider Identifier database May 1, 2012 and September 30, 2012
6 Contents are proprietary and confidential. #MayoRagan | @chimoose

7.
Study Demographics
7 Contents are proprietary and confidential. #MayoRagan | @chimoose

8.
Connection promotes health, and twitter proves the model
that simple digital tools can vastly increase connection.
Aaron Stupple
Resident, Beth Israel Deaconness
Medical Center
twitter.com/astupple
http://adjacentpossiblemed.blogspot.com/
Contents are proprietary and confidential.
8 #MayoRagan | @chimoose

9.
Reflecting the Population Plastic
Surgery
3%
… indexed within
1,397 +/- 3 %
of the total count
US Physicians*
99.5 %
Of Specialties…
Residents
-6 %
9 Contents are proprietary and confidential. #MayoRagan | @chimoose

10.
Reflecting geographic distribution
49 states
indexed within +/- 4%
of the total count
overindexes
underindexes
10 Contents are proprietary and confidential. #MayoRagan | @chimoose

11.
Reflecting gender distribution
Overindex
on twitter
by
8%
Underindex
on twitter
by
8%
11 Contents are proprietary and confidential. #MayoRagan | @chimoose

12.
Accounts Created per Year
532
301
216
165 154
1 28
28
2006 2007 2008 2009 2010 2011 2012
12 Contents are proprietary and confidential. #MayoRagan | @chimoose

13.
Early Adopters ’06 -‘08
Emergency Medicine
Pathology
Preventive Medicine
13 Contents are proprietary and confidential. #MayoRagan | @chimoose

14.
Rate of Adoption by Specialty
Internal Medicine
Neurological
Surgery All MD
Dermatology Anethesiology
Psychiatry &
Orthopedic surgery
Neurology
Ophthalmology Urology
Plastic Surgery Family Medicine
Obstetrics & Org. Health Care
Gynecology Ed/Training Student
Surgery Pediatrics
Preventive
Radiology
Medicine
Otolaryngology Pathology
Allergy & Emergency
Immunology Medicine
14 Contents are proprietary and confidential. #MayoRagan | @chimoose

15.
Physician Profiles
78 %
identify
themselves
clearly as
such in their
twitter bio
32 %
link to a personal blog
or website
80 %
contain a
URL in their
bio
15 Contents are proprietary and confidential. #MayoRagan | @chimoose

16.
How are MDs using their accounts?
Bio URL Distribution
6.90%
1.90%
93 %
of all Plastic Surgery
37.70%
URLs are links to their
practice
31.90%
Business Medical Resource Personal Blog/Website Practice
16 Contents are proprietary and confidential. #MayoRagan | @chimoose

17.
Twitter Activity – Time and Frequency
17 Contents are proprietary and confidential. #MayoRagan | @chimoose

18.
I use Twitter not to apologize but as an apoligist. I introduce
the view from the other side of the stethoscope.
Jordan Grumet,
Internal Medicine
twitter.com/ordangrumet
http://jordan-inmyhumbleopinion.blogspot.com/
Contents are proprietary and confidential.
18 #MayoRagan | @chimoose

19.
Tweets Over Time
Trending steadily upward
4500
4000
3500
3000
2500
2000
1500
1000
500
0
1 11 21 31 41 51 61 71 81 91 101 111 121 131 141 151
19 Contents are proprietary and confidential. #MayoRagan | @chimoose

20.
Tweets per day over
Account Lifetime
Pediatrics
Ophthalmology
Radiology
Otolaryngology
Emergency
Medicine
All MD Average
20 Contents are proprietary and confidential. #MayoRagan | @chimoose

21.
Tweets per day over
5 months
May’12 Jun’12 Jul’12 Aug’12 Sep’12
Anesthesiology
Radiology
Ophthalmology
Family
Medicine
Pediatrics
All MD
21 Contents are proprietary and confidential. #MayoRagan | @chimoose

22.
Tweets per day over
5 months
May’12 Jun’12 Jul’12 Aug’12 Sep’12
42
are
%
increasing
frequency
34
are
%
tweet at least 1 time
per day
9 % maintaining
frequency
50
are
%
decreasing in
frequency
22 Contents are proprietary and confidential. #MayoRagan | @chimoose

23.
Tweets per day over
5 months
May’12 Jun’12 Jul’12 Aug’12 Sep’12
MOST ACTIVE Anesthesiology
LEAST ACTIVE Neurological Surgery
23 Contents are proprietary and confidential. #MayoRagan | @chimoose

24.
When can I find MDs on Twitter?
Eastern time
Morning Workday Work PM Evening Overnight
(0500 – 0800) (0801 - 1200) (1201 - 1800) (1801-2300) (2301-0459)
18 % 22 % 32 % 12 % 17 %
32%
22%
18% 17%
12%
Morning (0500 - 0800 Workday (0801 - 1200) Work PM (1201 - 1800) Evening (1801-2300) Overnight (2301-0459)
0500-0800 0801-1200 1201-1800 1801-2300 2301-0459
24 Contents are proprietary and confidential. #MayoRagan | @chimoose

25.
Twitter and the MD Workflow
Localized time
Morning Workday Work PM Evening Overnight
(0500 – 0800) (0801 - 1200) (1201 - 1800) (1801-2300) (2301-0459)
18 % 21 % 31 % 8% 22 %
31%
21% 22%
18%
8%
0500-0800 0801-1200 1201-1800 1801-2300 2301-0459
25 Contents are proprietary and confidential. #MayoRagan | @chimoose

26.
The Connected Physician
26 Contents are proprietary and confidential. #MayoRagan | @chimoose

27.
I think using Twitter and other social media outlets has
benefited me by letting me know where the patients are. I
learn from their stories and I have a chance to truly hear
them. In addition, I find social media beneficial as a learning
source to interact with other physicians and med students I
never would have met if I were confined by the walls of my
own hospital.
Danielle Jones,
Medical Student
twitter.com/daniellenjones
Mindonmed.com
Contents are proprietary and confidential.
27 #MayoRagan | @chimoose

28.
My use of twitter allows me to expand the diversity of my
network, and therefore my knowledge in my areas of interest :
prevention, diversity/equity, integrated care, and Washington,
DC (the #epicenter!).
It also allows me to model open leadership as a physician,
and promote this approach among my medical and nursing
colleagues.
Ted Eytan
Family Medicine, Kaiser Permanente
twitter.com/tedeytan
linkedin.com/in/tedeytan
tedeytan.com
Contents are proprietary and confidential.
28 #MayoRagan | @chimoose

29.
How Many People do MDs Follow?
23.9%
21.3%
15%
13.4% 13.5%
8.2%
4.8%
0 to 10 11 to 50 51 to 100 101 to 300 301 to 1000 1001 to 3000 3000+
Number of Following
29 Contents are proprietary and confidential. #MayoRagan | @chimoose

30.
How Many People Follow MDs?
30.8%
16% 16.7%
14.4% 14%
6% 3.9%
0 to 10 11 to 60 61 to 150 151 to 700 701 to 2000 2001 to 10000 10001 +
Number of Followers
30 Contents are proprietary and confidential. #MayoRagan | @chimoose

31.
Ratio of following to followers
Ratio of Following to Followers
32.40%
Median
21.50% Ratio
1.1 : 1
16.20%
14%
6.70%
4.90%
2.80%
1.60%
0.- .1:1 .11-.2:1 .31-.7:1 .71-1.5:1 1.51-3.0:1 3.1-11.0:1 11.1-100.0:1 100.1-2808:1
31 Contents are proprietary and confidential. #MayoRagan | @chimoose

32.
MDs Most likely to be followed by peers*
25%
53%
Personal Blog/Website
27% Business/ Organization
All_Doctors
No Bio URL
practice
34%
40%
*Percentages measure MDs followed by at least 20 others in the data set
32 Contents are proprietary and confidential. #MayoRagan | @chimoose

33.
How connected are online physicians?
%
34 of all MDs are followed
by at least 20 MDs
Pediatrics
Specialties who Emergency
are followed by Medicine
other MDs
Family
Medicine
33 Contents are proprietary and confidential. #MayoRagan | @chimoose

34.
Who are MDs talking to?
TOP @ MENTIONS
@kevinmd
@drdubrow
@hrana
@ryanmadanickmd
@drmikesevilla
@drghaheri
@healthcarewen
@kentbottles
@drjengunter
@hjluks
34 Contents are proprietary and confidential. #MayoRagan | @chimoose

35.
Connected MDs – Nearly half follow Kevin Pho
Most followed by other MDs in the database
43% 25% 22% 21% 20%
kevinmd Atul_Gawande MtnMD Doctor_V SeattleMamaDoc
Follow the most other MDs in the database
41% 37% 27% 27% 26%
KreinMD DrScottPearlman docpreneur medicalaxioms DrJenGunter
35 Contents are proprietary and confidential. #MayoRagan | @chimoose

36.
Topics
36 Contents are proprietary and confidential. #MayoRagan | @chimoose

37.
The biggest advantage to tweeting for me has been learning
what people I admire are reading, using, watching, listening
to, both within social media and outside of it. Even better have
been the IRL connections, and the DM possibilities: it's great
to be able to meet someone at a conference whose thought
processes, links or research I admire and have discovered
thru a tweeted link. I don't think I've had any new patients
because of a tweet, but my relationships with existing patients
are probably better because I'm better informed about what
they're reading and watching.
John La Puma
Internal Medicine; Author
twitter.com/johnlapuma
Contents are proprietary and confidential. linkedin.com/in/johnlapuma
37 #MayoRagan | @chimoose

38.
Top Hashtag used by MDs
health teamfollowback ncsc12
meded hitsm mhealth
parenting ff healthcare phm2012 gopfail p2 socialmedia
30s4health amee2012
tcot hcsm abcdrbchat telemedicine digitalhealth dnc2012
hcsmny tedx medx
mhealth medicine meded aafpalf hcmktg ehr fmrevolution
futuremed
breastcancer med2 gop orthopedics h20chi topprog healthtap eyes
leadership ipad
ipodteletrauma bcsm melanoma womenshealth hcsm myeloma
ags12 obamacare dr4a
fb medsm scotus healthdata science diabetes olympics
flavorwire aafp cdom
fmrevolution asco12 hrs2012 cancer diet obesity
mccsm quote s4pm nutrition hiv palliative
homebased healthit
pediatrics jobs cnn aafpncsc hpm music vision ilovebreasts testosterone aafpnc
plasticsurgery meditation primarycare
hcr aca medicare familydoc
38 Contents are proprietary and confidential. #MayoRagan | @chimoose

39.
What are MDs Talking About?
TOP HASHTAGS
Family
Medicine Most used by #health(8,215)
#meded (4,547) Most used by Residents
#hcsm (4,532)
#mhealth (3,412)
#fmrevolution (2,721)
39 Contents are proprietary and confidential. #MayoRagan | @chimoose

40.
#hcsm
63% 73% 13%
of #hcsm Of all #hcsm
of all
#hcsm mentions were hashtags are
classifications
from MDs with a from
mention
Health Care personal blog or Anesthesiologists
#hcsm
Social Media – website .
Socially
Savvy MDs
40 Contents are proprietary and confidential. #MayoRagan | @chimoose

41.
A closer look at conversations…
Top Hashtags for Top Hashtags for Top Hashtags for
Family Medicine MDs with Business URLs Pediatrics
#health (3,349) #jobs (12,634) #meded (1,307)
#fmrevolution (2,223) #homebased (1,562) #hcsm (596)
#hcsm (728) #mhealth (816) #med2 (521)
#aca (621) #healthIT (815) #pediatrics (450)
#30s4health (597) #ff (490) #health (437)
41 Contents are proprietary and confidential. #MayoRagan | @chimoose

42.
Mining the Data
A sample
• Breast Cancer: (breast AND (cancer OR carcinoma)) OR (inflammatory AND
breast) OR (inflammation AND breast) OR (breast AND (metastasis OR metastic))
OR (duct AND (carcinoma OR cancer)) OR (lobe AND (carcinoma OR cancer))
OR "DCIS" OR "LCIS" OR (estrogen AND receptor AND positive) OR "HER2" OR
(breast AND MRI) OR (breast AND biopsy) OR (breast AND ultrasound) OR
"mammogram" OR "mammography" OR "tamoxifen" OR (aromatase AND
inhibitor) OR "exemestane" OR "trastuzumab" OR "Herceptin" OR "lumpectomy"
OR "mastectomy" OR "komen" OR "BRCA1" OR "BRCA2”
• Diabetes: "Diabetes" OR "Mellitus" OR "Insipidus" OR "Diabetic" OR "Gestational"
OR "blood glucose" OR "Blood Sugar" OR "NIDDM" OR "IDDM" OR "LADA" OR
("Antiduretic Hormone" OR "ADH") OR ("Arginine Vasopressin" OR "AVP") OR
"oral glucose tolerance" OR "fasting plasma glucose" OR "glycated hemoglobin
OR HbA1c OR A1c" OR "insulin" OR "SMBG" OR "hyperglycemia OR
hyperglycemic" OR "biguanides" OR "Sulfonylureas" OR "Meglitinides" OR
"thiazolidinediones" OR "alpha glucosidase inhibitor" OR "GLP-1 agonist" OR
"DPP-IV inhibitors" OR "DKA" OR "HHS"
Contents are proprietary and confidential.
42 #MayoRagan | @chimoose

43.
Diabetes & Breast Cancer – Sample Search
Contents are proprietary and confidential.
43 #MayoRagan | @chimoose

44.
Disease Conversation Volume Over Time
100
90
80
70
60
50
40
30
20
10
0
Diabetes Breast Cancer Prostate Cancer
44 Contents are proprietary and confidential. #MayoRagan | @chimoose

45.
Disease Conversation Volume Over Time
(Minus 1 “Zealous” Physician)
100
90
80
70
60
50
40
30
20
10
0
Diabetes Breast Cancer Prostate Cancer
45 Contents are proprietary and confidential. #MayoRagan | @chimoose

46.
The PSA Controversy
36
117
Doctors who state an opinion are
more than 3:1
against the USPSTF’s
ruling on PSA Tests
182
Negative Neutral Positive
46 Contents are proprietary and confidential. #MayoRagan | @chimoose

47.
Top Diabetes Tweeters
Talking About • Internal Medicine
• Family Medicine
DIABETES • Pediatrics
83 %
of all
classifications
mention
diabetes keywords
at least 1 time
in their tweets.
47 Contents are proprietary and confidential. #MayoRagan | @chimoose

48.
Top Breast Cancer Tweeters
Talking About • Internal Medicine
• Surgery
BREAST CANCER • Radiology
77 %
of all
classifications
mention
breast cancer 1 or more
times in their tweets
48 Contents are proprietary and confidential. #MayoRagan | @chimoose

49.
Top Prostate Cancer Tweeters
Talking About • Urology
• Internal Medicine
PROSTATE CANCER • Family Medicine
70 %
of all
classifications
mention
prostate cancer keywords
1 or more times in their
tweets.
49 Contents are proprietary and confidential. #MayoRagan | @chimoose

50.
Top Links
OVERALL TOP HOSTS TOP HOSTS WITH CROSS-
CLASSIFICATION LINKS
yourhealthchoice.net
online.wsj.com
www.handsontelehealth.com
www.usatoday.com
hchlitss.blogspot.com
www.nytimes.com
www.drken.us
www.nhlbi.nih.gov
online.wsj.com
www.cnn.com
50 Contents are proprietary and confidential. #MayoRagan | @chimoose

51.
Twitter primarily helps me remain amazingly current in topics
of my interest. I also reciprocate and share much of this with
my followers.
Steven Tucker
Medical Oncology
twitter.com/drsteventucker
linkedin.com/pub/steven-tucker/13/6b/235
Contents are proprietary and confidential.
51 #MayoRagan | @chimoose

52.
Twitter has been very helpful in helping me crowd source
information from my community of practice of 7200 twitter
followers. For example, when I was asked to give a presentation
to a medical school about how social media could be used in
undergraduate medical education, I posted on
twitter: "Help, need best practices examples of how to use social
media in med school education" I received dozens of response
with concrete examples I was able to use in my presentation.
Kent Bottles
twitter.com/kentbottles
http://www.kentbottles.blogspot.com//
Contents are proprietary and confidential.
52 #MayoRagan | @chimoose

53.
Thank you
#MayoRagan | @chimoose

54.
Acknowledgements
Physician Advisor – Bryan Vartabedian (@doctor_v)
R&D Lead – Matthew Hager (@iSmashew)
Research Analyst – Kayla Rodriguez
(@Kaylarodrigue11)
Visualizations – Ryan Ebanks (@ebanksre)
Designer – Nidhi Raina (@NidhiRaina)
#MayoRagan | @chimoose

55.
#MayoRagan | @chimoose

56.
Appendix
#MayoRagan | @chimoose

57.
Appendix – Classification Count
Row Labels Count of classification
Internal Medicine 314
Family Medicine 168
Pediatrics 116
Psychiatry & Neurology 100
Student in an Organized Health Care Education/Training
Program 83
Obstetrics & Gynecology 76
Surgery 74
Orthopaedic Surgery 74
Dermatology 55
Emergency Medicine 53
Plastic Surgery 46
Otolaryngology 42
Anesthesiology 28
Radiology 27
Opthalmology 26
Urology 24
Allergy & Immunology 16
Pathology 14
Neurological Surgery 10
Preventive Medicine 10
#MayoRagan | @chimoose

58.
Appendix – Classification Count
Thoracic Surgery (Cardiothoracic Vascular Surgery) 9
Physical Medicine & Rehabilitation 9
General Practice 8
Pain Medicine 4
Colon & Rectal Surgery 3
Hospitalist 2
Nuclear Medicine 2
Neuromusculoskeletal Medicine & OMM 2
Medical Genetics 1
Phlebology 1
(blank)
Grand Total 1397
#MayoRagan | @chimoose

59.
Appendix – Specialty count
Allergy & Immunology 16
Allergy 7
Allergy & Immunology 8
Clinical & Laboratory Immunology 1
Anesthesiology 28
Anesthesiology 21
Pain Medicine 6
Pediatric Anesthesiology 1
Colon & Rectal Surgery 3
Colon & Rectal Surgery 3
Dermatology 55
Clinical & Laboratory Dermatological Immunology 1
Dermatology 36
Dermatopathology 2
MOHS-Micrographic Surgery 5
Procedural Dermatology 11
Emergency Medicine 53
Emergency Medical Services 2
Emergency Medicine 51
Family Medicine 168
Addiction Medicine 3
Adolescent Medicine 1
Adult Medicine 5
Family Medicine 151
Geriatric Medicine 2
Sports Medicine 6
General Practice 8
General Practice 8
Hospitalist 2
Hospitalist 2
#MayoRagan | @chimoose

60.
Appendix – Specialty Count
Internal Medicine 314
Adolescent Medicine 1
Allergy & Immunology 2
Bariatric Medicine 1
Cardiovascular Disease 39
Clinical Cardiac Electrophysiology 5
Critical Care Medicine 2
Endocrinology, Diabetes & Metabolism 10
Gastroenterology 18
Geriatric Medicine 19
Hematology 2
Hematology & Oncology 17
Hospice and Palliative Medicine 5
Hospice Care & Palliative Medicine 2
Hospitalist 1
Infectious Disease 9
Internal Medicine 135
Interventional Cardiology 7
Medical Oncology 9
Nephrology 14
Nuclear Cardiology 1
Nutrition 1
Pulminary disease 1
Pulmonary Disease 3
Rheumatology 7
Sleep Medicine 3
Medical Genetics 1
Clinical Genetics (M.D.) 1
Neurological Surgery 10
Neurological Surgery 10
#MayoRagan | @chimoose

61.
Appendix – Specialty Count
Neuromusculoskeletal Medicine & OMM 2
Neuromusculoskeletal Medicine & OMM 2
Nuclear Medicine 2
Nuclear Cardiology 1
Nuclear Medicine 1
Obstetrics & Gynecology 76
Gynecologic Oncology 5
Gynecology 6
Maternal & Fetal Medicine 2
Obstetrics 1
Obstetrics & Gynecology 57
Reproductive Endocrinology 5
Opthalmology 26
Opthalmology 26
Orthopaedic Surgery 74
Foot and Ankle Surgery 5
Hand Surgery 6
Orthopaedic Surgery 48
Orthopaedic Surgery of the Spine 5
Orthopaedic Trauma 2
Orthopedic Surgery 1
Sports Medicine 7
Otolaryngology 42
Facial Plastic Surgery 9
Otolaryngology 23
Otolaryngology/Facial Plastic Surgery 6
Pediatric Otolaryngology 2
Plastic Surgery within the Head & Neck 1
Sleep Medicine 1
#MayoRagan | @chimoose

62.
Appendix – Specialty count
Pain Medicine 4
Interventional Pain Medicine 3
Pain Medicine 1
Pathology 14
Anatomic Pathology & Clinical Pathology 13
Blood Banking & Transfusion Medicine 1
Pediatrics 116
Adolescent Medicine 4
Developmental Behavioral Pediatrics 1
Neonatal-Perinatal Medicine 1
Pediatric Allergy/Immunology 3
Pediatric Cardiology 3
Pediatric Critical Care Medicine 1
Pediatric Emergency Medicine 2
Pediatric Endocrinology 4
Pediatric Gastroenterology 2
Pediatric Hematology-Oncology 3
Pediatric Infectious Diseases 3
Pediatrics 89
Phlebology 1
Phlebology 1
Physical Medicine & Rehabilitation 9
Pain Medicine 4
Physical Medicine & Rehabilitation 5
Plastic Surgery 46
Plastic Surgery 42
Plastic Surgery Within the Head and Neck 2
Surgery of the Hand 2
#MayoRagan | @chimoose

63.
Appendix – Specialty Count
Preventive Medicine 10
Occupational Medicine 2
Preventive Medicine/Occupational Environmental Medicine 3
Public Health & General Preventive Medicine 5
Psychiatry & Neurology 100
Addiction Psychiatry 1
Child & Adolescent Psychiatry 10
Clinical Neurophysiology 3
Forensic Psychiatry 2
Geriatric Psychiatry 1
Neurodevelopmental Disabilities 1
Neurology 25
Psychiatry 56
Psychosomatic Medicine 1
Radiology 27
Body Imaging 1
Diagnostic Radiology 17
Diagnostic Ultrasound 1
Radiation Oncology 6
Vascular & Interventional Radiology 2
Student in an Organized Health Care Education/Training Program 83
Resident 83
#MayoRagan | @chimoose

64.
Appendix – Specialty Count
Surgery 74
Pediatric Surgery 7
Plastic and Reconstructive Surgery 22
Surgery 32
Surgery of the Hand 1
Surgical Critical Care 2
Surgical Oncology 4
Trauma Surgery 4
Vascular Surgery 2
Thoracic Surgery (Cardiothoracic Vascular Surgery) 9
Cardiothoracic Vascular Surgery 8
Surgery 1
Urology 24
Urology 24
(blank)
(blank)
Grand Total 1397
#MayoRagan | @chimoose