“It is our duty to remember at all times and anew that medicine is not only a science, but also the art of letting our own individuality interact with the individuality of the patient.” Albert Schweitzer (1875-2965)

Word-of-Mouth is the world’s most effective marketing strategy. As the old ads used to state “Friends tell friends and so on and so on….” Medical blogging has the potential to convey a provider’s/ physician’s sense of caring and knowledge about medicine. If used as a tool to improve communication to your patients/customers, medical blogging could be part of a plan to make you known as the most famous and friendly doctor in the community.

First a short story:

Two weeks ago, one of the physicians I work with was walking a patient to the reception area after seeing her. They walked right past my door and I could hear the patient asking the doctor for some advice on things she could do to improve her health status. The doctor responded with two brief suggestions and then stated, “Why don’t you visit my blog. I’ve got a number of other helpful suggestions there.”

Evidence and clinical research data seems to suggest that the
patient-provider relationship can influence treatment adherence and health outcomes in a variety of different disease states.

In fact a study by Felicia Trachtenberg and colleagues (2005) at the New England Research Institute published in The Journal of Family Practice , found that increased levels of trust in physicians is associated with greater willingness to seek care, to follow recommendations, and to grant physicians decisional authority over treatment. Additionally, higher trust in a specific physician is strongly associated with greater reported adherence to treatment.

In the days of 10-15 minute physician appointments, the patient-provider relationship is tenuous, at best. How could any sense of trust be built in such a short time? Doesn’t trust building require finding some commonalties between two people?

I would venture that given the current system, many patients feel that physicians are interchangeable. That’s just a travesty. Most providers go into healthcare because they really want to help people. However, the system they work in has squeezed the bedside manner and art of caring out of most work days. How can anyone be passionate about their job if their customers view them that way?

I would pose that medical blogs, while an investment of precious time, can be a tool to foster patient-provider relationships. Blogs are supposed to be a bit personal. However because of today’s climate in healthcare I avoid using an identity-type blog (Mommy blogs, or web diarys) as a communication tool with patients. Instead, perhaps utilize a more fact-based tone where key concepts and best clinical practices are emphasized with personal examples.

Example: Lets say you want to give some detailed information on how patients can fit more activity into the day. Instead of just writing down a list of ideas, you could frame the list as “6 things I’m trying this month to increase my activity level.” You are giving the same information, but you are adding a personal tone to it.

So how is this going to help?

In closing, I’m not claiming that blogging is the only tool needed in a healthcare marketing toolbelt. However, it can have some time-saving benefits and can help patients take a more active role in their healthcare. I also believe it could possibly make you the most-likable Doc in your community!

“The treatment of a disease may be entirely impersonal; the care of a patient must be completely personal.” Francis Weld Peabody, MD, Harvard Physician (1881-1927)

Carol is the Vice President of The Promedica Research Center. She has a masters degree from Mercer University in Health Policy and Administration and currently teaches a master’s level course on Health Care Organizations for the University of Phoenix (Online), College of Health Sciences.

In October 2005, Carol started a blog for her continuing education company to help to provide a value added resource to the programs her company provides. Starting in December 2005, she began consulting with physicians help them determine a blog strategy for their businesses. Carol is also a co-writer with Marketing Diva, Toby Bloomberg of a Medical Marketing column that appears at http://www.healthvoices.com. In the future, she hopes to use her knowledge about adult, professional, and patient education to promote and implement new blogs as customer-oriented marketing tools for the healthcare industry. Drop by Carol’s Blog to for further contact information.

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My grandmother died last year. She passed away after an eight month stay in a nursing home, following a stroke that had taken her speech and much of her mobility. In the last months that she was alive, I witnessed my family scrambling to figure out what to do in case she would live that way for many years, while at the same time, hastily throwing together plans in preparation for her eventual death. In retrospect, much of the stress and disagreements that ensued might have been avoided if we had held a mediation session beforehand.

Before the stroke, my grandmother had also begun to exhibit symptoms of Alzheimer’s disease, and I watched as this once spunky woman became troubled by her increasing inability to remember the simplest of things. She had never had to rely on anyone, having been the one to take care of everyone else, and my grandfather found himself becoming more and more her caretaker as the time went by. For the three years we knew the diagnosis, there was no coordinated sit-down among the family members to determine her feelings about what was happening to her, nor were there any proactive decisions as to what the future might hold regarding her care, although the family did check in regularly and monitor her progress. It took something exigent before any firm action was taken, and at that point it became a tremendous dilemma to solve.

Due to advances in medicine, heightened attention to diet, and desire to maintain an active lifestyle, people are now living longer than ever. (My grandmother, at 87, was still walking several miles a day just prior to her unexpected stroke.) But, in the blink of an eye, our lives can drastically change, and it is imperative that our wishes are made known to the people around us, so that they aren’t left guessing what to do if a life-changing event should occur. Mediation is a growing field of alternative conflict resolution that allows families to come up with their own solutions to their problems. Both sides meet with a neutral third party, called a mediator, who helps them to focus and spell out their agreements in a document termed a Memorandum of Understanding (MOU). This document would be used in the future to execute necessary plans.

Elder mediation, in addition to a core mediator, often utilizes the services of trained professionals such as nurses and family therapists. Their presence helps to inform family members of options available and assists with the emotions that may arise. This collaborative environment, unlike an informal gathering at home where there may not be focus, allows for cooperative and deliberate decision-making, and, at the conclusion, ensures that delicate circumstances, should they occur in the future, will be handled with ease.

Whether you are an elder or the family of an elder, here are some of the things that are important to sort out through a mediation session:

If you are an elder, do you have a specific view about the way things currently are, and possibly know things about which your child/children may not be aware? If you are the child of an elder, do you have specific concerns about the health/mental state of your parent that you feel you need to address?

Are there any directives for a living will? If your life is being supported by a machine, is there a finite time period during which you would want to remain on that support? If you were to lose consciousness, do you want to be resuscitated?

If you are currently sick, do you have a vision for your treatment, and are there options that you do not wish to consider under any circumstance?

If you become incapacitated, what services would you need in order to live? Is there a desired nursing care facility you would want? Would you access private care? Would you move to the home of a child, sibling, or other friend/relative for care? Would you designate someone specific to make decisions for you on your behalf in the event that you were unable?

Who is responsible for payment of essential services? Would a portion be paid by Medicare, private insurance, personal savings, or the savings of the children, siblings or other friend/relatives?

If you should pass away, what are your wishes regarding funeral arrangements? Would you want to be buried, cremated, or possibly donated to science? It is crucial for those left behind to know now so that your desires may be followed.

Once an MOU is drafted, it can also be the starting point for legal documents such as a will or a living will; however, it is important to check the requirements for your specific state, either by investigating on your own or by obtaining the advice of an attorney, to make sure that all requirements are met to make your agreement legal and valid.

The time to devise solutions to the challenges you might face later in your life, or for the life of a loved one, is now. It is optimistic to think that families bond more strongly during times of crisis, but, unfortunately, chaotic events can often turn essential discussions into something contentious. Therefore, seize control of your destiny and make an appointment for mediation today.

Jennifer D. Grassini is the Executive Assistant for IADR - The Institute for Advanced Dispute Resolution (http://www.advanced-resolution.com), a school which provides in-depth specialized training in mediation, including specific instruction in healthcare mediation techniques. IADR also offers mediation services for the community through their practicum program. She is passionate about the mediation process, and speaks to various groups regarding the benefits of alternative dispute resolution.

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California this week took a bold step. Not into the great unknown mind you, but rather into the great already known. Their Assembly approved yet another experiment to once again show the failures of top down, socialist bureaucracies when it approved a bill that would mandate state issued health insurance for everyone man woman and child in the state. Yes, as though we need another failed social experiment stemming from modern liberalism’s embrace of centralized authority and government control. Sure it could be an excellent lesson for not only the liberals of California but the entire nation as well but not one that is necessary.

These elected officials have shown that history and economics certainly are not their strong suits and that serious attention to these subjects must be added to the curriculum of California schools.

But in a state that already knows the pain that letting people have “free” access to their healthcare system this maneuver is a stunning display of colossal ignorance. Hospitals, in parts of the state, are already under the stress of providing “free” healthcare for innumerable illegal aliens who don’t pay their bills.

And on even a national scale have we not seen what happens when money is confiscated from workers to pay the bills or others? Social Security and Medicare, both of which are on the fast track to insolvency, that were to be glittering gems of the socialist welfare state are perfect lessons. And heck, let’s not forget about Welfare itself which actually needed to be “reformed” in order to start getting slackers off the rolls and is still highly abused.

And let us not forget that such power grabs raise serious Constitutional issues. Two I can think of off the top of my head are the law’s restriction on the freedom to contract (prohibited under Article I, Section 10) and also the prohibition on the restriction of liberty without “due process” (Amendment XIV).

In fact this entire law smacks of a case called Allgeyer v. Louisiana (1897) in which the State of Louisiana attempted to pass a law to restrict whom their citizens could contract with for - you guessed it! Insurance!

That law was struck down.

Here we have another case where the liberty of citizens and their right to contract is clearly being infringed. And there certainly should be a legal case brought against the State for this egregious offense.

Oh, but it gets better. Proponents of the measure claim that covering all Californians would cost no more than it currently costs to cover only a portion of them. Isn’t that what they always claim? Uh, hello! How about addressing the Constitutionality of this plan first! So much for Stare decisis if it were to be upheld!

After that then maybe we can address how the plan also means increasing taxes to the tune of an 8% payroll tax on workers and another 3% in actual personal income taxes in order to make sure people pay in and the fund has money according to the Lewin Group. In essence they are looking at slapping working Californians with an effective 11% tax increase! Wow! 11% of a working Californian’s income would be required to pay for health insurance under this great state run plan? My wife and I pay roughly half that rate for our top-notch private insurance!

But that’s ok. Let’s see how long this asinine attempt at communal living lasts before the system bankrupts itself, politicians enter full hyper-whine mode about how taxes have to be raised (again) to cover the costs and send the state of California even further down the road to destruction.

Maybe we should start bussing in all the homeless and poor people from around the country just to expedite the process. Right now California is basically begging the nation’s poor, destitute and homeless to flock across their borders for a freebie that they will never see a bill for. Who could resist that deal! As people seeking the perks of being a citizen of the People’s Republic of California flood in, and the productive flee we will be left to watch what happens and point and laugh at the silliness.

So I say GO WEST! There’s gold once again in them thar hills! Except this time the “gold” is more of the same from the liberal left - government handouts of other people’s money. You know, what they often refer to a “free” [insert program here] that liberals and their constituents salivate over.

We can only wonder if this plan actually becomes law, how long it will be before Californians are flocking to Mexico or, God forbid, Canada to receive healthcare.

J.J. Jackson is the owner and Lead Editor of American Conservative Politics - The Land of the Free (http://www.thelandofthefree.net) and American Conservative Daily (http://www.americanconservativedaily.com) He is also the owner of American Infidel T-shirts (http://www.cafepress.com/americaneagle04)

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