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Social media in healthcare and why the doctorsaurs became extinct

Sometimes I feel very alone and vulnerable here.

You see, it is rare that doctors air their views on social media (SM), and I have done a fair bit of that on this forum. If you sift out all my posts pertaining to healthcare and read them in sequence, you will have a pretty representative idea of how the average South African doctor feels about the changes and current status of our profession. It’s all there, every sorry complaint about an industry that in its state of disruption has little to cheer about. These are issues about which you, the lay public, are generally unaware until things fall apart. I believe you should be, because they impact you directly every time your health takes a knock.

Little of what I say is new to my colleagues. There are many other doctors who write far more eloquently than I do about the challenges we face, and by proxy that you, the consumer, face, but they publish predominantly in medical journals or medical newspapers — media that are read by the medical community alone. The issues we fight about impact directly on our ability to offer good medical care to you. You don’t get to read about them. So you, the consumer, have little idea how much angst pervades the doctors you rely on to get you out of a bad health situation. Unless a few of us spill the beans in places like this.

So it is fitting that I bleed my heart out here, for the world of SM is where opinions are aired, challenged, established and changed. SM is a realm of revolt and upheaval, the domain of the common man, where every person has a voice.

You would think that the organisations that profess to recognise doctors’ rights and represent us would have a good grasp of this potential. I hoped that they would. My experience over the past two years suggests that this is not the case.

I have made a careful study of the impact SM will have on the practice of medicine in this country, based on the already remarkable changes that have taken place in the US and Europe. There are rules to be followed, things a doctor should or shouldn’t do, massive advantages of engaging with patients via SM, and equally big risks in doing so. It is an ethical minefield pocked with big rewards. Every point of the SM universe has advantages and pitfalls.

Impressed and enthused by what I saw, I put together a talk on all these elements, encompassing every aspect and the pros and cons thereof. Anxious to share these with my colleagues, I requested recognition for the awarding of Continuing Professional Development (CPD) points to doctors who attend, the carrot on a stick to get them to come to a presentation so that they make up their annual CPD requirements.

The last thing I anticipated was the reaction from my profession’s representative organisations. The South African Medical Association (Sama), of which I am a member, turned down my request for CPD points two years in a row on the basis that there was nothing “ethical” in my presentation, a classic case of what they “didn’t know they didn’t know”. The first time it happened I was able to reverse that decision via contact with Sama’s acting president who knows something about social media and quickly corrected the error. The second time the reaction was exactly the same, with the final decision being made by Sama’s senior legal representative, in the same instance questioning the validity of the decision made a year previously.

The email of refusal sent to me on the first occasion contained a delicious irony in the banner that headed it. “Beyond traditional boundaries,” it said. And yet Sama clearly had no idea what I was talking about, two years in a row.

I phoned the man who made the decision. Lawyers, whose livelihoods exist around delivering and receiving threats, don’t like being spoken to angrily by doctors and perceiving the same — it is a “reversal of the norm”, and my suggestion that I write about this situation using the very medium I was trying to reveal was not well-received. But I cannot think of a better way to demonstrate the power of SM. Sama won’t like it, but at least they can learn from it. I hope.

And so, it leaves me with this. Like in the US, through the power of SM, it is going to be up to YOU — the consumer — to embrace all that the new technology in SM can offer, to become the driving force that creates change. I and a few other like-minded doctors cannot do it on our own.

There are no organisations that ab initio represent the consumer in every aspect in South African healthcare. That could and should change, especially with the wide reach and immediacy of SM and the power to engage. Leaders ignore it at their peril.

You, the consumer, can stand up to the machinations that hamper efficient healthcare in our country. You can ask questions of medical aid administrators as to why their profits are increasing and their benefits decreasing. You can ask why hospital groups see fit to build new hospitals in every new suburb. You can ask pharmaceutical companies why drugs cost so much here in South Africa and so much less in Europe. You can ask our government why your healthcare tax money is so badly and inefficiently spent. On SM your opinion does count. Your voice can be heard.

Sadly, doctors in this country don’t get the power of SM to affect change. Sama certainly didn’t get it. I hope you get it.

I start my talk with a video clip of the asteroid that wiped out the dinosaurs making impact with the earth. SM is that asteroid, and the dinosaurs the Sama-minded doctors and lawyers who are oblivious of the new era. They cannot escape the changes. The SM genie is out the bottle and will not be put back.

I like to think I am the annoying little rat-like mammal in the clip that escapes predation by the last remaining doctorsaur.

It’s a lonely place to be, but one filled with huge potential.



  1. Mark Kerruish Mark Kerruish 7 September 2013

    I think you have forgotten the other meaning of SM: Sado-Masochism.

    I, for one, appreciate your blogs. Good luck with the powers that be.

  2. Heinrich Heinrich 7 September 2013

    I like this doctor.

    Tell me, someone : Why should there be “private” healthcare in S.A. ?
    Why must there be someone between me and the doctor? Someone so rich?
    Why can’t I select some doctors and pay them… like a “retainer”… for future use?
    Why can’t state employees like the President and our ministers all use public health care?

    To me, health care should not be seen as a “market”. Health is a basic human right.

  3. niall niall 7 September 2013

    Hi Martin

    I really admire and support your sentiments


  4. proactive proactive 7 September 2013

    It’s tough for all!

    Ever considered and would it be possible having your blogs on m&g copied over to your own website to allow further interactions for those interested?

    For the younger folk and the ones blessed by natural health- medial issues, government and SAMA’s medical politicking, the various health care and cost options, are of lesser priority- gaining only in importance in a more distant future.

    Equal in importance of developing an early interest in a healthy lifestyle or providing for adequate savings for retirement- to reasonably survive life, until ‘natural solutions’ eventually solve all earthly problems!

  5. Dr Haresh Dr Haresh 8 September 2013

    Well written and true to the last word.

  6. Zepiel Zepiel 8 September 2013

    SAMA is a woeful organisation that I thankfully am no longer a member of. Have no direction or skill to resolve any healthcare crisis in SA. Sad that many young doctors don’t have an alternative.

  7. Aliki Aliki 8 September 2013

    Thank you! I am sharing this on Face book. :)

  8. Ula Ula 8 September 2013

    Martin, its like changing the course of a tanker. A small cause has a delayed but effective result.Gradually theings like fluoridation , dimercasol and other pollutants which have for years been promoted by government to be safe and effective are being found to be severely compromising to health and being discontinued or modified. I wonder how many pharmaceutical and state health decision makers have filters on their municipal supplied water!

  9. Ula Ula 8 September 2013

    My mother, when her offer to donate of the Faculty of Homoeopathy journal to Wits medical library was turned down by the then Dean, said ” Nothing stands in the way of progress more than bias and ignorance”

  10. Karney Karney 8 September 2013

    I have studiously resisted becoming a member of SAMA for the reasons you outline. Starting with the HPCSA I have found bodies purporting to support Doctors, a complete waste of membership fees.

  11. Lindsay Lindsay 8 September 2013

    Many people just don’t get it with social media – have you seen #pencilchat on twitter? The lack of awareness is epitomised in the way Wits is responding to the sexual harrassment crisis – ban contact via bbm, twitter, facebook sms etc between lecturers and students. Following that logic then phone calls, emails should be banned and probably one on one conversations of all kinds. Its absurd!

  12. Martin Young Martin Young 8 September 2013

    Thanks to all for the supportive comments.

    Dear Proactive – my website gives an email address to contact me – happy to hear your thoughts and set up a dialogue.

    Why post here rather than my ‘own’ blog? All because of readership numbers, and readers of ‘the right kind.’ I see no point in preaching to the choir in the medical newspapers. I post quite extensively overseas as well.

    The ‘social revolution’ in healthcare will be driven by the consumers, neither the doctors nor the administrators. This is an important aspect included in the talk I refer to.

  13. bewilderbeast bewilderbeast 9 September 2013

    Well said. Most “professional bodies” are anything but. Your word ‘doctorsaurs’ accurately describes them. MOST of the people on them are there to fiercely defend the staus quo – AND/OR to organise unfair advantages for themselves*.
    *I’ll give you an example: It was always forbidden to call your practice by an “institution-sounding” name (making it sound more important than other practices). However, “The Eye Institute” was a private practice started by a leading SAMA and HPCSA doctor who flouted the rule for years – until the rule became ‘honoured in the breach’. Now many practices are called by misleading names. MANY of the “leading lights” in professional medicine are rogues with haloes; Rogues with “outstanding service awards”.

  14. Kathi Browne Kathi Browne 9 September 2013

    There are so many exciting social tools to get your message out there, Martin. Have you participated in Google+ hangouts (on air)? Shared your thoughts in public communities? There are many healthcare professionals who want to take advantage of technology and many engaged patients who want to see it happen. Perhaps you should focus your attention on creating a groundswell that has enough momentum to make changes happen… or even unite forces with some other influencers to spread the word.

  15. proactive proactive 9 September 2013

    Martin thank’s,….your point of exposure is well understood. M&g blogs seem to have a reading life of what- 1-2 weeks The thirsty news media needs to be current, varied & entertaining- blogs drain away like a river into the sea!

    Your web archive stopped in July 2012. Besides filling in consent forms- where is the diagnostic process? The most important & difficult inquiry to begin with! Followed by obtaining consent from your medical aid before the hospital is satisfied payment is secured to let you in.

    The sequential visits via GP, Specialist, tests like MRI scan form part of the diagnostic processes. How much does your consent form help? One has to sign the right to liability/sue a doctor away as soon you sign the hospital application form!

    Listening to our good Minister of Health Dr. Motsoaledi- his NHI plan (catering for the 84% having no cover) will take 15-20 years to emerge. The 16% of private medical aid scheme members seem not to bother him too much. He wants all (84%+16%) to contribute anyway- how?- a pipe dream?- how to marry all these ideas?

    As a first step why not (force) amalgamate all 112 different private medical aid schemes into one only? That should give the 16% of the population economics of scale. Let the good Minister struggle of how to sort out the other 86%- if he can ever cross this finishing line in his lifetime!

    Not possible?- than anything better might be impossible as well.

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