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 Communicating with patients: A Brave New World Dr Jaita Mukherjee, Specialty Registrar in Rheumatology, Imperial College London Dr Amrita Jesurasa, Specialty.

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Presentation on theme: " Communicating with patients: A Brave New World Dr Jaita Mukherjee, Specialty Registrar in Rheumatology, Imperial College London Dr Amrita Jesurasa, Specialty."— Presentation transcript:

1  Communicating with patients: A Brave New World Dr Jaita Mukherjee, Specialty Registrar in Rheumatology, Imperial College London Dr Amrita Jesurasa, Specialty Registrar in Public Health, University of Sheffield


3 

4 Introduction  Many sources of health ‘information’ accessible to patients  However the medical profession remains one of the most trusted professions  Main determinant of trust in doctors = interaction during consultations  Shift in the dynamic of the doctor-patient relationship  More widely, does the medical profession have a responsibility to mitigate the risks to patient safety of inaccurate information?

5 Resources  Traditional  TV, radio, newspapers  Internet search engines / Wikipedia  Social media  ‘Apps’  Trusted sources  e.g. NHS Choices,, Royal Colleges, charities



8 Health Literacy  Limited health literacy associated with:  Poor self-management skills and use of preventive services  Late presentation and delayed diagnoses  Understanding medical conditions  Adherence and compliance  Poorer health and greater mortality risk  Protect patient safety  Health inequalities  Evidence-based best practice

9 Testing Treatments “ Sometimes this can be in the presentation of facts and figures, telling only part of the story, glossing over flaws, and ‘cherry picking’ the scientific evidence which shows one treatment in a particular light We have an understandable desire for miracle cures, even though research is frequently about modest improvements, shavings of risk, and close judgement calls. In the media, all too often this can be thrown aside in a barrage of words like ‘cure’, ‘miracle’, ‘hope’, ‘breakthrough’, and ‘victim’. ”

10 Patient stories from Rheumatology Clinic  Case 1  Ms SF, 34 y old, mother of 2 children, teacher  Newly diagnosed with rheumatoid arthritis (RA) after 3/12 of painful hands  Keen to receive information about arthritis charities and meeting others who suffer from the condition  Case 2  Mrs AR, 58 y old, cleaning lady  Known diagnosis of RA, attends clinic with ongoing pain  Brings tabloid newspaper cutting of headline reading: “Painkillers double the risk of heart attacks”

11 Patient stories from GP/ Paediatric A&E  Case 3  Parents of 18-month old SJ, both university lecturers  SJ has a fever and viral symptoms  Parents aware that viruses not treated with antibiotics  Reassured by assessment and explanation of viral illness  Case 4  Parent of 2-year old LM, travelling family  LM presents with features of measles  Neither LM nor siblings have received childhood immunisations

12 Social media and medical education  Prevalence of social media  Maintaining the trust of the public  Blurring boundaries  Keeping a pace of modern technology  Connect with:  Professionals  Patients

13 Social media and health promotion  Context: evolving doctor-patient relationship  Positives  Social marketing technique  Potential to improve health of historically underserved  Widening ‘lay referral networks’  Negatives  Inverse care law  Widening the ‘digital divide’  Worsening health inequalities

14 Key Messages 1. Internet safety and literacy present enormous challenges, as basic health literacy is still a hurdle to overcome 2. The dynamics of the doctor-patient relationship are evolving 3. Doctors need to ensure more rigorous use of evidence and recognition of lay sources of information 4. Familiarity and confidence using social media may be necessary for doctors in the future

15 How do we achieve this? 1. Integrating digital health literacy and awareness of online safety into schooling and adult education 2. Widening understanding of lay sources of health information in UG and PG medicine 3. Increasing access to postgraduate level qualifications in clinical research for doctors 4. Enhancing the role of the BMJ, Lancet and other high profile medical journals in improving the health literacy of doctors

16 References 1. Agency for Healthcare Research and Qulaity [online]. Wolf MS, Cooper Bailey S. The Role of Health Literacy in Patient Safety. August 2012. Available from: (Accessed on 11 th January 2013) 2. World Health Organisation [online]. Safety and security on the Internet: Challenges and advances in Member States. Global Observatory for eHealth series - Volume 4. Available from: (Accessed on 11th January 2013) 3. GMC [online] Doctors’ use of social media. A draft for consultation. Available from: http://www.gmc- (Accessed on 11th January 2013)http://www.gmc- 4. Evans I, Thornton H, Chalmers I, Glasziou P. Foreword – Goldacre B. Testing treatments: Better Research for Better Healthcare. Second Edition 2011, Pinter & Martin Ltd. 5. 6. Chretien KC, Greysen S, Chretien J, Kind T. Online posting of unprofessional content by medical students. JAMA. 2009;30(12):1309-1315.

17 References cont. 7. Federation of State Medical Boards, Model Policy Guidelines for Appropriate Use of Social Media and Social Networking in Medical Practice. April 2012, page 9. 8. Understanding the factors that influence the adoption and meaningful use of social media by physicians to share medical information. J Med Internet Res. 2012 Sep 24;14(5):e117.J Med Internet Res. 9. Bahner DP, Adkins E, Patel N, Donley C, Nagel R, Kman NE. How we use social media to supplement a novel curriculum in medical education. Med Teach. 2012;34(6):439-44Med Teach. 10. Lewis G, Sheringham J, Kalim K. Mastering Public Health. September 2008. Royal Society of Medicine Press Limited. 11. 12. Montague E, Perchonok J. Health and wellness technology use by historically underserved health consumers: Systematic Review. J Med Internet Res. 2012; 14(3): e78

18 Workshop  Groups of 5-10 people  Question:  How can we improve the health literacy of the most vulnerable?

19 Discussion


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