Medical practice

How to use Social Media to increase your medical practice.

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Social media is the fastest trend in the world with more than  2 billion monthly active users as of first quarter of year 2018. These are some of the important tips , which can be used increase your medical practice using popular social media profile.

Promotion of practice : why is it important ?

It’s not about you , its about them

                                                         Clint Eastwood

 

The medical practice is always centred around the patient not the doctor. Promotion of the medical practice is all about the patients. It is all about protecting the interest of the patients , adding  value to his/her life and providing him/her the best possible services. If there no patients , there is no practice.

Practice must be promoted so that you are on the patients radar when he or she is in need. You should promote your practice to let him know that you have solution to his problem. Patient should know his/her problem and also that you are the best person to solve it. If you do not promote yourself, it’s quite likely the patient will end up with someone he/she should not.

Its common to see patients receiving wrong treatment from untrained doctors in spite of a competent doctor practicing just a block away. The untrained one had not had enough moral courage to say no to the patient and trained one was had not had enough time and energy to promote himself.

Good doctors often do not promote themselves. They think that so long as they are doing good job, there reputation will spread by word of the mouth. This was correct at times when the medical practice was not as competitive as it is today and we did not have the social media. There is so much of the noise around, it is difficult to have your voice heard. But it is impossible if you do not speak at all. Doctors should realise that he/she should speak so that interest of the patients can be protected. They should speak so that patient can differentiate a good doctor from an ordinary. It is not about you, it is about them.

Promotion of the practice becomes unethical when the it is directed to to the soul agenda of furthering the financial/ personal interest of the doctor or the hospital.  In today’s competitive landscape, medical practice is more of an investment, for which one needs an immediate return. As the return has to come from the patients one need them at all cost. If that means trapping the patients through wrong  information or false promises then so be it. Things become bad when doctor becomes party to it.

It may be profitable in a short run. Slowly the number of unsatisfied clients begin to swell and everybody know that you don’t know your job. Medical practice is all about to trust. Once you lose it you cannot get it back by giving the discounts. In the long run it is a poor business strategy.

Ethical promotion of medical practice is all about slowly building the pool of satisfied patients which in turn influence and bring in more more patients of similar social profile. The newer patients have clear idea of what you have to offer and have trust in you. The trust comes from the fact that you are recommended by someone patient know and trust. Ethical promotion of medical practice is the best business strategy.

How to ethically promote your practice?

So if you do not trust the messenger, 

Why would you trust the message?

  • Chris Martin

 Medical practice is all about the reputation of the practitioner. The sole purpose of the promotion is to build a good reputation of the practitioner in his field of practice. The dictionary defines it as “ the beliefs or opinions that are generally held about someone or something” or “ a widespread belief that someone or something has a particular characteristic” . Simply put, what comes to the mind of a patient, when he hears your name ?

  1. Patients views about you, your competence and clinical skills.
  2. Patient trust you and your facility.
  3. Patient hopes from your treatment.
  4. Patient experience  with your services.

And how do you do that ?

There are no magic tricks to do that. All you have to do is to keep the following points in your mind, and inculcate in your  day to day clinical routine.

1 : Define your identity

If you can not describe what you do in a single sentence of few simple words, how do you expect a patient to understand,  let alone remember it. Keep your introduction precise and simple for patient to remember.

Keep your looks strictly formal and professional. That is how people remember you, and your professional  looks help a patient to trust you.

Clearly define your identity in following headings

  • Specialty, subspeciality and  and area of expertise.
  • Geographic area of professional activity.
  • Demographic age group you are primarily targeting.
  • Socio-economic class of patients you plan to cater.
  • Working days and hours you are professionally active.
  • Social media platforms and professional groups in which you are active.

This will help you to avoid wasting your time and energy in low priority areas. In medical practice , time and energy are always  in short supply. Use them wisely.

2 : Be Consistent

Stay consistent in promoting your practice in the priority areas defined in your identity. Consistency is not only important in the field of specialisation but also in other defined spaces, like targeted patient profile and  social media platforms. Its is not important to be active on many social media platforms, but whichever you choose, its better you stick to it.

Consistency is also important in temporal sense. It matters how often you post on a social media platform, but it matters  more that you maintain the consistency.

People start posting on twitter daily for a month or so and then slowly lose the enthusiasm. They might be missing for next 3 months before coming back. A better strategy is to start slow, may be single post in a month and then slowly increase the count. Whatever frequency  is convenient, maintain it. Medical Practice is a marathon not a sprint.

3 : Speak for yourself

Books and publications

The importance of scientific publications cannot be emphasized enough. Publications in peer review journals and scientific text book gives you a distinct identity of an expert that goes beyond the geographic boundaries. If this is not in your priority, than you should have it as new year’s resolution for the next year.

Though the readership of the these type of scientific literature is limited to fellow doctors only, the  reputation finally diffuses to the patients. It takes long time but the returns worth the efforts. It requires lot of patience and hard work, if you can do it, there is nothing better than that.

Blogs

 

Blogs has certain distinct advantages as a mean to attract the attention of the common people and doctor of other specialities to the issue you intend to highlight. It demands low investment as compared to textbooks and peer review journals and has larger readership. It is probably the best way to let everybody know that you can provide solution to a particular patients related issue, which you are discussing in the blog.

Social media

Participating in the debates going on on the social media is a great way to promote your name in your specialty of you practice. Make sure that you are focused on clearly define objectives related to your practice. One should avoid the temptation of participating trending topics especially controversies and politics.

4 : Listen what others has to say

Willingness to take feedback is very important to modulate your promotion to the changing landscape of medical practice. Its is important to listen what others are talking about you and your services. It is equally important to listen what they are talking about your fellow practitioner.

Social media : The fastest trend

 

Wikipedia defines it as “Social media are computer-mediated technologies that facilitate the creation and sharing of information, ideas, career interests and other forms of expression via virtual communities and networks

It has three important components

Rapidly spreading internet devices and usage , combined with multiple  social networking apps  has produced an absolutely  spectacular new medium for social interaction. The medium is fast, ubiquitous, addictive and very efficient.

Social media is the fastest trend in the world with more than  2 billion monthly active users as of first quarter of year 2018. Most of you will not be surprised to know that Facebook is the most popular social network worldwide, with a global usage penetration of 22.9 percent. But some of you may be surprised to know that India is at  first place with 270 million users in the list of countries with maximum number of users. It is ahead of the   United States which is at second-ranked with 240 million users. 

If Internet and Mobile Association of India (IAMAI), is to be believed, India has 478 million mobile internet user by the June of 2018. It also claim that 59 percent of the urban population has access to mobile internet and the rural population is fast catching up. Almost half  of the user are younger than 25.

India currently has in between 300-400 million smartphone users and those who do not have one are rapidly upgrading into smart phones

How can social media increase your medical practice ?

1  : Creating  a strong  brand identity 

As Amazon’s Jeff Bezos says  “branding is what people say about you when you’re not in the room.” As a medical practitioner , it basically means what perception the  people have about your reputation and  professional connectivity. The perception is significantly affected by the patient ‘s experience and services that you provide.  The social media is increasingly getting flooded with the content which is either directly about you, or a person you interacted with or an event you participated in. 

So its totally your choice. You can actively control it to shape the public perception the way you want to them perceive, or you can leave it to chance. Its unlikely that your competitors are would take this issue casually.

Greater is your engagement with patients in social media, easier will it be for you to achieve you targets of practice, be it in getting newer patients or their  willingness to accept your services.

 2 : Increased patient engagement

Your authority over the field of your specialization and activities on the social media will help users to find your content and if it is really engaging that might share it. It’s the sharing of your content which is ultimate litmus test of the quality of the content. It also shows how accurately have you  targeted your content. If the good quality content is targeted to wrong audience, the effort to create that content will go down the drain.

That bring us to the issue of users or audience. The doctor should have very clear ideas who are the people you are targeting. If you are a kidney transplant surgeon , naturally you will not Target your content to Young working female. But that will be the target population for a Lasik surgeon.

Social media promotion and visibility will help the user to engage with your content and will visit you website or clinics , and so on. But it is not a one way traffic. It also give you client a control to express and disseminate his or her view about you. It is for sure that user will share his or her experience on social media. What a practitioner can do is to provide a platform where at least the doctor can reply back. Failure to do that will result in dissemination of one side of story in isolated communities of social media. It may be out right misinformation about you, and worse still you may remain totally uninformed.

A tweet sharing an obvious over-prescription of drugs , by a practitioner. it’s retweeted by many who came across. Right or wrong, good or bad , a news spreads fast on social media.​

It’s not that the patient only have their grudges to share on social media. Satisfied patient use social media to share their good news among their communities. That’s is better promotion of your capabilities if a patient is sharing is good experience. All you have to do is to amplify it among the appropriate user.

Users share the information not only about you but also about your competitors. No business can decide a business strategy without factoring in the competition. In the competitive landscape of clinical practice, it’s even more relevant. Social media is a prefect tool to get accurate estimate of your competitors, not just what they are doing wrong, but also what is working for them.

In practice, patient is god, but a competent and loyal employee is no lesser god. People gather information  regarding the prospective employer before even thinking about applying. The social media also gives you an eagle eyes view of the professional landscape, if you are out for head hunting of new employee. Of course you can keep an eye on existing employee through their social media activities.

3 : Break physical boundaries

Seth Godin describe “

Revolutions destroy what is perfect and make the impossible a reality”.

Social media is a revolution which is not only spreading like a wild fire, it is disrupting every established business that is  coming it’s way.

If you think the music , retail and travel industries were vulnerable , and medical practice will be resilient for disruption, than it will be a mistake.

The online services are not limited to the doctor discover and ordering and delivery of medicine. On-line consultation and tele-medicine , with all it’s limitations are are slowly gaining the ground. It’s not limited to the teaching institution’s sponsored programs, it’s very much becoming a   business.

The US bases company doctor on demand has not only received a fresh round of funding, it has also been accepted by government to be included in the public funded health plans, there by giving it formal legitimacy. The reason is simple, the online services are cheaper, so more people can afford it. At least it’s better than absolutely no access to the doctor. Now it can be anybodies guess how would Indian government react if it gets any such proposal.

 If anything is online, it is on social media.

Social media offers a parallel channel to every possible service that is delivered online. It not only provide you with your own canvas to paint your own picture, it also guarantee that the canvas is big and choices of color are infinite.

Take the example of doctor search site Practo. You can have profile which the patient can access, so also your competitors. They have strict format of what can you can display and  what you can not. Anything that allows a direct communication between the patient and doctor is not allowed, because that will make the sites irrelevant.

The site ensure everyone looks the same. So user can choose the one who is cheap and easily accessible. But the doctor are not the same, just like any other field, there are good ones and exceptionally good ones. Now the question is how does an exceptionally good doctor stand out of the rest.

Now look at the Facebook page of doctor.You paint your picture the way you want. Have you photos,share you videos.let people post comments and connect. You can display everything that you want your client to know. They actually encourage you to communicate.  Facebook is no mediator, filtering every message.

Strategy: Best use of social media

1 : Focus

 Start focusing on social media, among the options of the promotion you have. In terms the demand for time and money, it’s still the cheapest. for the a beginner, there are plenty of the option which are totally free. If you are new in the practice, you don’t need to purchase any paid ads. Facebook profile, Facebook page, LinkedIn profile, Twitter and Instagram account are in them self best advertisement, for free.

If you are already using these medium than you should start taking it more seriously. Most of the social media network help you advertise . All the network help you target the ads to the user details. Facebook can help you pin point your ads not only to a geographic area, demographic parameters, but also on taste, preference and more.

2 : Integrity

Medical practice is among those profession which is greatly affected by the reputation of the the doctor. Like a film star you are known by you last hit. Or miss. People make a perception about you from the variety of the content they notice about you on different social media and communities. You can not be a reputed surgeon holding a scalpel on one site and contesting assembly elections donning khaki on other. You should clearly define what kind of image you want for yourself (scalpel or khaki) and stick to it across the media be it Facebook or Instagram. This holds good for photos, you post, comments you make and the content you share tweet ,tag or pin.

It’s not about you, it’s about them.

It can be used as a test to assess if you are posting is good. Ask yourself if this post will add any value to you patient or not. If yes, post it, If not, than you know what should be done with it. A simple post about how a patient can avoid falling in washroom is great. So is the arrival or a new CAT Scan in your facility, it must be shared with others. But can you say the same for the photos of the inauguration party of new CAT Scan , with cake smeared on the doctor’s face ? I will say it can be avoided as it’s not about them.

3 : Content

Everything that you share on social media is content. your profile photo, photo of your foreign trip, a comment on someone else photo, a video shared or tweeted, a blog written by you. every thing is content. an every type of content has its own utility depending on the platform you are using. 

4 : Consistency

No body likes someone who publishes in bursts for a week  than suddenly he/she is  nowhere to be seen for next three months. Its important to have good content , but its even more important to publish it consistently. Start with once a fortnight , if that is all you can manage in your busy practice. You can always increase it up to once a week or more, as is possible. Than stick to it.

5. Engagement 

It basically means the interaction of people with the content you publish on social media. It can be a like, a recommend, a comment, a share retweet or up-vote. Your target should be that others share your content, and that is the best gauge of its quality.

Not everyone is active on social media every second of the day, plus the there are millions of viewers and an equally staggering volume of the content uploaded on the social media, every second. How do you ensure you content meets the right eyes? The best policy is to share your media on multiple platforms and frequently. If you have published it once, it’s absolutely okay to post it again twice or few times a day. You also need to know how to target the content for a particular profile of users. 

 

HASHTAGS # though you will see it more frequently on twitter, they’re a very common used use to add meta information to your content. It helps in targeting the content to particular group of users using or searching the content using these hashtags.

There are more than 200 hundred social media networks and many are added to the list every week. Facebook  LinkedIn , twitter, Instagram ,  Pinterest , Google plus , Reddit and Quora  and the list goes on an on. You need whole team of skilled people who can professionally manage all of them together. But you can choose a few, depending on your taste and amount of time  you are willing to spent.

Facebook, LinkedIn and Twitter are three every doctor should invest in. add Instagram a if you have still more time and energy left with you.

Practice makes a man perfect.

Tweet , tweet and  tweet, to make a perfect practice.

It’s like a metro station, there are lot of people around, but everyone is busy and no one has time to listen to what you have to say.

There are more than 18000 new tweets posted on twitter every second, so you should have something interesting to say , for people to stop and listen. It’s no surprise that the average lifespan on a tweet  is less than quarter  of what a post last on facebook. Its difficult to make a ‘place for yourself and it’s easy to get lost in the crowd.

‘But it has a distinct advantage over others, which makes it so popular among marketers.

It’s a big party where everybody is there,  you can talk to anyone, even the strangers. You don’t have to introduce yourself, pursue or comment.  Just go and talk. All you have to do is to tag him in your content, to get a person’s attention, if you are lucky than a reply also. This makes it so valuable a platform, if you have right mix of talent and patience.

What can you  achieved with twitter ?

  1. Get more people visit your profile and learn about you and your services.
  2. Get more people who actual avail your services
  3. Better connectivity with patients
  4. Build followers.

These are few tact of the trades which will help your practice stand out, if done in a way the successful people have done it.

You cannot expect others to talk about you, when you yourself is not doing that. Use your profile to accurately display your qualification, abilities  and services that you provide in your facility. You can even use use it to display your contact details.

1 : Profile

Photos : Medical practice is all about trust. Photos should be identifiable and professional. The option of background photograph provides a good  opportunity to display your facility or brand.

Write your Twitter bio to address the audience you are targeting. keep it simple and include the information, which  what matter most your patient chest specialist. If the space allowed write about your achievements and associations medical practice is a serious business

 Practice is a serious business so casual photographs, funny pictures  and comments should be to be avoided

Add relevant hashtags so that people can find the account that looking for you.

These are few examples how profile photograph background photograph and fire can be used stipulate an excellent profile.

2 : Do basic research

Use the common hashtags for your specialty or the services to search for what is happening in your field. You can see the news, views,  people, clinics, hospitals and more.

A : Patients profile

Scanning the patient profile will let you decide what kind of issues the patients are raising in your filed of specialisation.

B : Service providers

Keeping an eye on the content posted by others especially the fellow doctors gives the best idea what type of content is working and how the users are reacting to it. Find out the influencers in your field and find the ways to connect them. Interact with other professionals related to the field who may not be your actual competitors like paramedics and other supporting staff. Following them not only gives you a great  Insight into practice but also helps build your brand.

4 : Content:

It’s not  about you , it’s about them.

    As already said, it’s like a party. One attribute that really helps twitter stand out among other social media platforms,  is that people can talk. You can start a discussion , or participate in debate already on. Only if you contribution is wise and positive , others will like it, and some will start following you. The best way to increase your following on twitter is to participate in the discussions. You can use hashtags to find what is being discussed on any topic. 

1 : Help others

Your posts should clearly demonstrate the value that you are trying to add to others, directly or indirectly. Showcasing that’s that you are trying to make people’s life better is always appreciated

2  : Educate others

One of the reasons why people come to social media is to find answers to their questions, which they may or may not accurately articulate. People will stop and listen you, if you have something important and useful  to say.

3 : Appreciate others

People always reciprocate by appreciating you back . Appreciate what others are doing, share and retweet what other are tweeting. It always help.

4 : Promote

Once you are done with everything, promote. Why should people come to see you unless you do not ask them? Clear call for action is very important for people to know what you and decide to avail your services. 

5 : Promote without pitching

You can promote even without saying so explicitly. Providing information to the usual patient related issues are the best way to attract the attention of the potential patients

6 : Share the happiness

Let others know if patients are happy. Positive experience shared by a fellow patient is one of the commonest way people use to decide their doctor. Use it whenever possible.

7 : Be interesting

There are no hard and fast rule , for what works on twitter, what doesn’t. Just make sure that it is interesting. Ensure that the topic is rightly timed and has the correct context.

8 : Count and frequency.

Ideal situation is to post as many post as you cana but that you will have no time for your practice. Best way is to start will minimum number you can manage. It may be once a day or once a week as is convenient. You can slowly increase the count as you manage or delegate someone else to do it, but consistency is important. As  an average tweet last only for few minutes, so it is advisable to retweet is as many times as possible so that it can be seen by maximum number people.

9 : Timing

It’s often advised that one should tweet daily at a fix time . We do not agree with that as everybody is not available at same time . At breakfast time, at lunch and in the evening are the three convenient slots which should be used interchangeably to tweet. That givens a tweet the bets changes of been seen by maximum number of users, at least, theoretically.

 

5 . Analyse how your tweets are performing

A : Profile views

Twitter provides you the tools to see how your tweets are doing. The total number of the tweets are directly related to the number of impressions it get, and more importantly the profile views. It is the profile views which matters for practice point of view. So more you tweet better it is. Unlike Facebook , twitter do not penalize you for tweeting more.

 

Regular tweeting not only attract the people you are following, it also attract the people who follow you.

Mentions tells us about how people are discussing about our tweets. It tell about how interesting out tweets are.

If you stop tweeting, people quickly forget you, as many new tweets are pouring in regularly. So tweet, tweet and tweet.

B:  Followers

Followers decide who you are. It is not only the numbers, but also the profile of followers. The most important fact is how popular they themself in their domain of influence. Your followers can not only introduce you to whole lot of new people but stamp their approval on what you are pitching.

C : Effective of Content

You need to look into what is working and what is not. The  well received content needs to be frequently tweeted and retweeted so that others may also see it

linkedIn

The best place on social media where doctors feel at home is LinkedIn. The discourse is serious and every body just mean business, exactly the way doctors  want.

There are few interesting points which worth to be mentioned hereT

1: Profile

One cannot emphasize it enough that you should have an updated profile on LinkedIn.

A report from  U.S. News survey from 2014 says more than one fourth  of Americans  searches online to find a doctor. We are observing a similar pattern from India as well. That is not surprising. What is amazing is the fact that they make their decisions on the basis of doctor’s education and medical training, and their hospital affiliation. 

LinkedIn profile provide the best online platform to do that. It has options to showcase your skills and scientific publications, patents and rewards. It’s quite understandable that all patients might not understand your publications and patents, but your colleagues and people from related fraternity can.

Contact details

Unlike the doctor discovery website, most social media websites allow, the user to display their contact details. Here you can show your clinic address, your website and contact number. Make the best use of it.

This bring us to the second important point in LinkedIn profile, your connections.

2 : Connectivity

More than third of the patients rely on recommendations from their friends to decide who they should consult. Patients think now they have enough information about a doctor to make an informed choice. So it really matters that you are well contented. What matters even more, that the people that you are connected with, know what you are best in. 

LinkedIn offers the options of the professional groups, which are similar to that of Facebook. Only difference is that people do not join LinkedIn group for fun and gossip. As people are basically there to do business, they appreciate if you showcase your skills, specialty services, newer observations and research. Use the groups to let everybody know your services and how do you stand out from your competition.

All this is possible if you know what type of content is popular on LinkedIn.

 

3 : Content 

Long form , detailed and well researched article, coming from a person of authority in the field,  have traditionally done well on LinkedIn. Length of the article is not an issue as  long as you know what you are talking about.  If targeted to appropriate audience and groups, engagement rates are good, as everybody here means business. 

The videos are also getting progressively popular on LinkedIn. If you stick to your core speciality , video do just as well on LinkedIn

Once in a while you will also come across the  motivational post, which are well  accepted by others. but these should always be the last choice of content to post, not the first.

4 : Content Sharing and Promotion

LinkedIn provide excellent tools to assess who are engaging with your content. LinkedIn has higher engagement rates than Facebook. LinkedIn also provide options of paid ads if you want your content to advertise.

Facebook

Though , Facebook is supposed to be a social media site, but the shear number of user make it the first choice among the marketers as well. It is not surprising that the  number of Facebook users and the  Facebook advertisement rates are constantly rising .

CREDIT: NEILPATEL.COM

As a practicing clinician,   Facebook should not be ignored as it is becoming primacy mean of communication and exchange of information , in our society. Its common to see people missing to take their medications, but  at the same time , people are finding it difficult to stay away from Facebook.

Facebook business page

It is common to see doctors being active Facebook but not having the Facebook business page of their practice.

You have the option of displaying the details of the services that you offer, including the price (if you wish to), and the contact details so that patient can contact use directly. This is beside the regular messaging services offered by Facebook. You can post the details about any event related to your practice and even create an entire community around it. This is far better that any doctor search and discovery website, you enrol with.

Facebook groups

Facebook groups offers two distinct advantages to the user.

  1. You can target your content to a very specific group of people with a clearly defined characteristics.
  2. Keep an eye on trends and activity of competitors.
  3. Interact with potential patients, as groups are commonly used by patients to inquire about health issues.

Groups are the best places to display and advertise your skill and services. Try to add value helping a patients by providing him with valuable information about any medical issue, so that others are encouraged to share. Avoid placing an overt sales pitch, as these are discouraged by admins and other users.

Instagram

If you think that Instagram is only for the kids then you should think again. Not for nothing brands like Harvard Business Review and MasterCard promote their products on Instagram. And so also the doctors, clinics and hospitals.

Instagram provides a very little space to provide details in a profile, so use it smartly. Be short and precise in your introduction. Clearly define the services you wish to provide your clients. You can provide your contact address and website link. As Instagram does not differentiate between business and private profile, you can have your logo as your profile photo to advertise your brand.

Profile have option of giving your phone number email address and even the Google location. All you have to do is to draw the user’s attention so that it looks to your profile.

Post

Instagram allows you to post pictures and short duration videos in the description segment there is no word limit but you cannot add a link to it.

It is not surprising that visually appealing photos, pictures with motivational text are very popular on Instagram so make sure that you published something which is very visual appealing.

People do not come to Instagram to for entertainment. Aesthetically unappealing photographs, photographs of patients during surgery or scary stuff related to the clinical practice should better be avoided. What might be okay for a doctor may simply be scary for a normal person.

1 : Promotion

Instagram the words do not mind continuous bombardment of advertisement after advertisement. As long as you can ensure that the post is visually appealing and can draw the attention of someone scrolling Instagram feed it is ok.

There are very limited options for the user in form of buttons to be distracted cluster post are displayed one by one. This is the reason why the conversion rate of the ads posted on Instagram is highest all social media. If user like the post, he or she explores it, and gets converted into a customer. As the description section does not allow you to add link, user has to actively check your profile to get converted, whatever you’re right in description must have clear call to action. 

2 : Type of post

  1. Informational/ motivational post for patients having images along with bold text on the image.
  2. Images of your facility oblique clinic or hospital.
  3. Avoid the photographs of the patients as it might disclose his/her identity, which is ethically wrong.

Conclusion:

For practicing doctors , social media offers immense opportunities to show case their skills to a larger audience. what matters is how well you use it?

Share your experience in promoting your practice on the social media. Let us know what issues are you facing in this regard. Share this post with others if you find it useful.

Scientific studies report that most individuals (81%) say that they “learned something new” regarding their health, the last time they went online. The majority (80%) of people found the information through a search engine as reliable.

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Cataract Surgery

How much a Cataract surgery cost in India?

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Credit : Pixabay

Cataract surgery has no fixed formula to calculate a cost, but there are few rules which worth to be mentioned to help decide right place get operated. Having a relative getting operated is often a ‘once in a lifetime’ experience, and biggest question is how much is it going to cost. Am I been quoted a fair price or I am getting fooled. 

Surgery packages:

Most of the cataract surgeons in India practice what they call as surgical packages for what they charge for doing cataract surgeries. It is mainly limited to uncomplicated age related cataract done under without giving the general anesthesia.

The” Package” include, pre-operative examination, surgeons fee, surgery charges, anesthesia charges, medication given during and before surgery, cost implant (Lens) and hospital stay. it varies from, hospital to hospital , surgeon to surgeon, city to city, type of surgery ( SICS> Phaco> Femto Laser) , type of lens ( Indian Mono-Focal > Indian Multifocal> Multifocal )  and so on. Cost may vary from 10k -150k depending on the combination of doctor, hospital, surgery, lens you have chosen for you.

Cost of the post-operative drugs and additional intervention after the surgery are usually separate.

How to confirm that you have got what you have promised?

At the time of discharge, patient gets the discharge and treatment summary, which mentions name of surgeon, anesthesia, details of surgery and details (name and brand of lens) implanted in the eye. Brakes down of the charges for each item are usually not provided.

Can you bring the lens of your own and hospital to implant it?

Most of the hospital gives a fairly long list of Lens to choose from. One can choose from the available options. Hospitals usually do not allow surgical implants and disposables from outside. It is because hospital has to maintain a huge inventory of each and every disposable and lens in different sizes and numbers and often in multiple numbers as the backup. If a lens or any disposable gets damaged or contaminated while handling it during implantation, hospitals have multiple similar pieces in back up. It is not possible if patients bring a single piece from outside.

More over surgeons often have expertise and a certain comfort level with certain brands of lens, which they implant daily. Most of the surgeons have serious reservations against trying a new lens, in that event of stress of doing a surgery. So they usually do not agree for this.

Brands of Lens

There are many different types of intra-ocular lenses available in India. Most surgeon/hospitals offer surgical packages based on Indian (cheap) and imported (expensive) lenses. Imported lens are costlier than their Indian counterpart and are preferred by both patients (rich) and doctors alike. There are no scientific studies which validate the difference in the quality of the two, this notion continue due the common perception that imported goods are superior in quality.

Indian versus imported lenses

In eighties and nineties, when ophthalmologist began to switch to lens implantation (rather than leaving the eye without the lens and giving the patient thick glasses). At that time the lens needed to be imported from US and Europe, as there were no lens manufacturers in India. Though the imported lens were of good quality but were very expensive. In nineties some Indian companies started manufacturing lens in India. The lens manufactured were quite cheap, but the quality wan not as good as those of the imported once.

Now days there are many Indian companies who are manufacturing the lenses in India, and also exporting it to many other countries, which include US and Europe. Since they have to meet stringent FDA and EC guidelines for that, overall quality of lens manufactures in India matches with any of the manufacturers from abroad.

So in my view, it as far as the  quality  of the comparable lens (similar lens material and design) is concerned, there is no difference.  The imported Lens usually cost 3 to 5 times as much as an Indian lens. Various government bodies are raising concern of this pricing of the lens in India. Quite likely, we may have some government regulation on price control of lens, in day to come.

Imported: Alcon, AMO, Zeiss, Bausch & Lomb, Hoya.

Indian companies: Appasamy, Omni, Aurolabs, Biotech, Care,

Foldable lens versus non foldable (rigid) lens?

Foldable lenses are more popular and expensive that their non-foldable (rigid) counterparts if all other parameters are same (design, brand, country of origin). There are only two scientific studies (one from Thailand, other from France ) which were designed to see the difference  in the vision and other outcomes after the surgery, among these type of lenses. Neither of the two studies reported any difference among the two.

Tips regarding selecting lens packages in cataract surgery.

  • Surgery packages: 10K-150K INR chose as per your budget.
  • How to confirm that you have got what you have promised?  Discharge Summary 
  • Can you bring the lens by your own ? No 
  • Which Brands of Lens is better? All are same. 
  • Indian versus imported lenses, which are better? All are same
  • Fold-able lens versus non-fold-able (rigid) lens, which one is better? All are same

Also read

Scientific studies report that most individuals (81%) say that they “learned something new” regarding their health, the last time they went online. The majority (80%) of people found the information through a search engine as reliable.

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Cataract

Inappropriate cataract surgery: is it a myth or reality ?

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Credit: Pixabay

There have been media reports in which the doctors and the hospitals have been accused of performing cataract surgeries when these are not actually required. The question is, are these really fake news or are actually happening?

Media reports a recent media report, attributed rapid rise in the number of certain type surgeries being done at various hospitals , to the fact that some of these surgeries are been done for economic reasons only. The patient may not have actually needed one. Among the many surgical procedure, the cataract was reported to be the commonest.

Targets to meet: News report say that in corporate hospitals, the doctors are pressurized to perform more surgeries to increase the corporate profits as surgeries offer greater financial return in shorter time. Consequently some of the patients are advised to undergo cataract surgery in spite of the fact the patient can manage without it. It further suggested that those who are advised to undergo surgery should better have a second opinion, which is very much concerning. Similar concern are also been reported from advanced counties as well.

The Optometric-Ophthalmic Kickback Scheme: Dr Robert P. Gervais reported the arrangement of kick back system practiced in US, in which patients are predominantly operated to make money, by ophthalmologist in cooperation with optometrist. It is surprising that it is practiced in a country like US where documentation and other regulations are so diligent followed. The scenario could be much worse in India where it is difficult to enforce government regulations.

Also read: 

cataract surgery : an ultimate patients guide
How much a Cataract surgery cost in India?

 

Scientific reports: a number of scientific publications have reported the documentation of performing unnecessary surgeries to be as high as 30 percent for certain type of surgeries. Practices of unnecessary surgical procedures in Indian scenario are been well documented in case of caesarean deliveries and hysterectomies under government insurance schemes .

Government stand: a senior government minister have expressed concern on this issue and share the perception that kick back, cut and commission is prevalent in some segment of practice. They have also ” considering to bring some type of oversight for pathological laboratories and diagnostic centers to end the corrupt practices including possible nexus between doctors and the laboratories, and cartelization among diagnostic centers

Doctors and representative medical bodies: They largely dismissed the concerns over profit-driven tests and procedures as a “perception,” saying corruption is less widespread than the media would have it appear. “The medical profession is noble and will remain noble,” “There are people who are corrupt, they are facing charges and they are being punished.”

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Credit: Pixabay

Conclusion: Though the actual figures may actually be debated as what percentage of doctors are indulging in these kind of practices but these reports certainly points to the maligning of reputation of whole profession. These will only add to stricter government regulation and legal scrutiny of clinical practice and practitioners.

Please share your comments below.

Dengue

Dengue: Patient’s guide for Dengue fever

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At times when newspapers are filed with headlines of Dengue cases,  and its complications , how should one decide what to do when one develops fever. Its a step wise patient guide to take a informed decision at every cross road.

CREDIT: DengueInfo

Step one : DO NOT PANIC

  1. Every fever is not dengue. Even in the season when lots of Dengue cases are reported, it is not the only cause for fever. Fever is one of the most perplexing clinical signs which is seen in diverse clinical conditions  from infections, malignancy ,drug effect  to environmental toxicity. In many cases, cause of fever could not be established even after   after intensive search. So do not presume that you have Dengue, just because few other cases are been reported it.
  2. Every patient of dengue is not at risk of serious illnessDengue fever is a severe  and flu-like illness but seldom causes death. India in year 2017 a total of seen 28,702  cases of dengue  were reported  out of which  46 patients succumbed . It is less that 2  per one thousand patients.
  3. High risk patients
    1. Children
    2. Elderly ,
    3. Patients presenting with hemorrhagic manifestations.
    4. Patients presenting with altered sensorium / disorientation.
    5. Patients with associated diseases,  diabetes mellitus , hypertension, chronic anemia, congestive heart failure, other cardiovascular diseases,
      chronic obstructive pulmonary disease, asthma, renal disease .

Step two: Medical consultation with nearest health facility.

Dengue infection has no specific treatment, but it does not mean that consultation with the nearest health facility is not required. One must consult the nearest health facility available.

Clinical course

Dengue infection is dynamic disease involving whole of the body. It has a wide clinical spectrum that includes both severe and non-severe clinical manifestations .

  1. Phase of fever when patient typically develop high-grade fever suddenly usually last for 2-7 days.
  2. Critical phase when the temperature drops to 37.5–38 degree  C or less usually on days 3–7 of illness. During this period the decrease in platelet count is noticed.
  3. Recovery phase If the patient survives the 24–48 hour critical phase, patient slowly recovers in the following 48–72 hours.

Severe dengue  If one or more of the following is present: (i) plasma leakage (ii) severe bleeding, and/or (iii) severe organ impairment.

Step three:  Selecting correct health facility for management :

Since there is no specific treatment of Dengue, the only way to prevent death in  a case of Dengue is  early recognition of the disease, and its management by the health care personal. When it is not possible to manage that patients, than the referral to a higher center.

Step four: Prevention is better than cure. Ensure that other family members are protected from mosquitoes so that further spread of disease can be avoided.

Best Mosquito control methods for your home.

key points are

  1. Prevention is better than cure.

  2. Most dengue patients recover without requiring hospital admission.

  3. Only some may progress to severe disease.

  4. Patient with severe disease need hospitalization and/or  critical care management.

Also read

Scientific studies report that most individuals (81%) say that they “learned something new” regarding their health, the last time they went online. The majority (80%) of people found the information through a search engine as reliable.

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doctor discovery website

Online doctor search websites: risks for associated doctors.

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india-1034843__340 (2)Online doctor search websites offers the doctor good online visibility and availability, just like other streams; are there any risks associated with these kind of associations for doctors? I think risks are real and multiple.

I was looking for a dermatologist in the city, and i thought of giving a popular Online doctor search website   a trail. I typed initial alphabets of the word “dermatology”, it showed the list of 30 dermatologists in the city. In spite of the living in the city for 15 years, i could not identify most of them.

Most of the information was expected from Online doctor search website like fee, location, schedule and profile of the listed doctors.  There was enough information available online to actually decide who should be consulted. It has details of ones qualifications, affiliation of present and past and of course, the patient’s reviews. Plus it also had the assurance that if i am not been satisfies by the experience, i can at least write a negative review.

But there were some facts which actually drew my attention. The first 10 dermatologists had almost similar qualification (10 yes post MD) , fee ( 400-600 INR) and reviewer’s ratings (90-100%) and exactly same profile as there was no options of customization of profile for the doctor .

Online doctor search websites: Stay close and be cheap 

adventure-2178442__340Clinical practice has always been different from the online sales of the movie tickets. It’s never actually about the number, though  a good practice is always reflected in patients count. Patient comes to you with a medical issue, often in distress. You establish an emotional rapport and trust with him, and treat him.

A satisfied patient shares that emotional connection and trust with other people which help a doctor to build the reputation in the community.  New patients coming to him are often refereed by older patients.

He/she is already primed about the doctor’s capabilities and knows what to expect. Slowly but steadily doctor build a follower ship of these satisfied patients which maintains a steady flow of new patients and is called a practice.

These Online doctor search websites reduces a doctor to a commodity, presented in a grid fashion, where all are more or less same and meant to be chosen on who is cheaper and conveniently available. Patient has to give star rating about how he felt about the experience. Patient can have hundred reasons why he/she gave a particular review or star rating and the next user has hundred different interpretations of the same review and rating.

There is no room for standing out of the lot, and if you want yourself to be featured ahead of others, than you pay for it. Practice is all about establishing your distinct identity among your colleagues with a separate patient base. You do not compete with your colleagues; you complement them in areas of weakness.

Online doctor search websites are designed so that patients develop loyalty with the site and a long term patient doctor relation could not be established.  If the doctor’s clinic is at a distance, select closer one. If time is not convenient, select some one more convenient to you. If you are not willing to move out, get an online consultation. You cannot contact with the doctor directly, by any means.

 

Also read:

Must know facts for online doctor search.

Medical Tourism : Trends, reasons, and a lesson.

 

Online doctor search websites :Patient inflow

india-1723464__340Very design is such that is redistribute the users among the service provider. So if there are 1000 dermatology patients in a city with   30 registered dermatologists, site will ensure a distribution of these patients among the available doctors, is a way which is cost effective to the users. And how will the service providers compete with each other to increase the patient inflow.

You are available for longer hours and cheaper rates. Those who doubt it can have a lesson from recent OLA and UBER drivers’ strike. People initially joined these companies because they can get customers easily, but soon the number of drivers associated with the network sky rocketed without an associated increase in the number of customers. It forces the company to frame the policies so as equability distribute customers among the associated drives, significantly bringing down the monthly earning, making it non-viable indian-318643__340option for some.

Patient’s personal and health related data 

As of now there were no clear cut guidelines. With drafting of Digital Information Security in Health Care Act.(DISHA), government has defined the policies clearly. It says that Protected Health Information (PHI) includes individually identifiable information which in-turn includes ‘sensitive personal data or information’ (SPI).

The new guidelines state that Protected Health Information (PHI) is owned by the patients and it the duty of the doctor to protect and secure the stored health information on patient’s behalf. Individually identifiable information not only includes name, contact number and Adhar but also the voice recordings of communication between doctor and patient that are non-clinical in nature. The  policies of every doctor search and appointment site clearly state that they are not a party in the doctor-patients relations , which leaves doctor squarely responsible to every contact or communication that happen  between doctor and  patients.

Online doctor search websites :Medico-legal responsibilities

holi-2198066__340There are no legal agreement between Online doctor search websites and doctor regarding the distribution/sharing of the duties/role and information disclosure policies. Online doctor search websites do not take the responsibilities regarding verification of patient identity and obviously take no measures to ensure that.

Some clearly state that they are not responsible if the user provided the incorrect information regarding personal identity. This put the doctor at serious long term medical-legal risks. Most of the websites have the stated policy of sharing patients contact details to third parties, (health information providers, drug supplying companies, investigations labs, taxi companies and so on) or have sister concerns engaged in these business.

Some of the companies encourage doctors to give online consultations on phone, mail, whatapp or similar applications. New regulations clearly state the doctor’s responsibility of ensuring privacy and data protection of patients consulted as these website are clear that they are not a party in doctor – patient contract you are entering in, with the patients.

Online doctor search websites : What happens in developed countries?

This concept of Online doctor search websites, is been there in US and there are few popular websites as well ( zocdoc). HIPPA (1996) clearly define a set of national standards for the protection of health information in US. All the site providing online doctor search and appointment are supposed to be HIPPA compliant. A lack of similar regulation in India could be attributed to proliferation such websites in India, which provide single stop solution for getting everything, from consultation with a doctor to ordering medication and gym membership, and from a single window. A similar lack of awareness among doctors could be a reason for doctors joining them.

One does not need to be a lawyer to negotiate through these offers. The important of being aware of once professional responsibilities cannot be emphasized more. There are two simple rules which can save anyone from landing in any of these risky associations.

  1. Never associate with any online site without diligently reading and understanding the privacy policy and terms and conditions of the site. Later can easily be found on the header or footer section of the site.
  2. Be aware of you responsibilities for patient’s privacy and protection of health information. Complete information is available at  information at the website of ministry of health family welfare, govt of India.
Medical practice

Medical tourism: trends, reasons, and a lesson.

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Are the issue of cost and quality the only parameter which decides where a patient will go medical tourism? Are these trends of medical tourism, more universal ? Is there any lesson to be learned ?

I recent came across a YouTube video appreciating the health facilities in India, and discussing the difficulty faced by former Pakistan hokey player Mansoor Ahmed to come to India for treatment. It brought me to questions, why had he chose India and what other options he had beside India. A recent report points to the fact large numbers of medical tourists care coming to Asian countries for the treatment , due to cheaper costs and high-quality healthcare services. India holds the second place, after Thailand which is at first.

Regional trend of medical tourism.

International medical tourism: 

We all have heard politicians and film stars going abroad for medical treatment. For last two decades it has become a industry with an estimated business of 50 B US dollars. Americans, Canadians and Europeans are the mostly the patients who travel to India , Thailand, Singapore and other south east Asian countries. Bumrungrad International Hospital , in Thailand is world largest international. It see more than a million patients a year , half of them are foreigners coming from more than 190 countries.India mostly receives patients from Africa and middle east countries. Affluent people from across the world flock to US for treatment as the its standards of healthcare are still the bench mark.

Medical tourism in India:

New Delhi is an epicenter of the healthcare for people residing in north and central Indian states.similarly Hyderabad and Chennai act as similar epicenter for southern states. it is not uncommon to see people coming from Bihar and West Bengal , to AIIMS New Delhi for cardiac and paediatric surgeries.

Medical tourism within states 

people from far off districts commonly come to the hospitals in state capitals for surgeries and other modern medical treatment often not available in peripheral districts of a state. all highways coming to any capital cities have clusters of private hospitals in the periphery of cities limits , most of which primarily cater to peripheral patients only.

Specialty destinations of medical tourism.

The movement also follows a trend in the form of the destinations becoming popular for certain type of specialised medical care. Isreal is popular for in-vitro fertilization , Thailand for sex reassignment surgeryand India for bariatric surgery and cancer treatments . For cosmetic surgery popular destinations are ArgentinaBrazilCosta RicaCubaEcuadorMexicoTurkeyThailand and Ukraine. In India we all know that Chennai, New Delhi and Hyderabad are very popular destinations for Eye surgeries. Similarly New Delhi and Banguluru are for cardiac surgeries. This pattern of specialty destinations could also be witnessed at state level as well.

Shri Sadguru Seva Sangh Trust, a charity hospital located at a small town named Chitrakoot, in Madhya Pradesh, India is known to operate 1,43724 cataract patients in the year 2015-16. It attract lot of patients from many adjoining district of Uttar Pradesh and Madhya Pradesh and Rajasthan. Similar example can also be seen elsewhere in the country.

Reasons for Migration Of Patients

Cost of treatment of medical tourism.

Probably the most important reason for the international medical tourism is the difference in the cost of the treatment for the similar or comparable quality. It is well known that cost of treatment is very high in US. It is often higher than the combined of traveling and receiving medical care abroad. For example hip replacement surgery cost $40,000 to $65,000 in the USA, whereas it costs about $8,000 to $18,000, abroad, which is including traveling expenses. This is the main reason why patients come to countries like India and south East Asian countries. The comparable prices in India usually vary from 0.25 to one 0.1 of the price of a similar medical procedure in the USA.

Quality of services in medical tourism.

Many of the specialized medical centers which are popular among patients have developed state-of-the-art facilities that use cutting edge technology and equipment. The doctors in these facilities are trained in good institutions and have excellent skills because of large patient inflow. Bumrungrad International Hospital has 39 speciality subcentre and provide services using cutting technologies like Robotic assisted spine surgery. Shri Sadguru Seva Sangh Trust, has fully developed sub specialies of eye and has Operation Theater Complex having 25 modular OT and a LASIK LASER suite.

Patient’s affordability in medical tourism

The number of American people seeking treatment abroad is increasing because 1 out of six American is uninsured and there are many medical conditions which are not covered by the medical insurance. It is these types of people who make the bulk of those who travel abroad for treatment and hospitals like Bumrungrad International Hospital offers a good bargain. Shri Sadguru Seva Sangh Trust, offers services to the poor people living in adjoining area and most of the surgeries are done free of cost. Even those opting for the paid services, the rates are very affordable.

Superior brand value in medical tourism

Majority of foreign patients come to hospitals which have a great reputation in the their field. Bumrungrad International Hospital is the first hospital in Asia to be accredited by the American-based Joint Commission International (JCI), one of the groups providing international healthcare accreditation services. For consecutive three years, from 2004 to 2006, it was featured on CBS’s 60 Minutes and NBC’s Today Show as a leader in medical tourism and International hospitals. Among the patients which receive the treatment there, Shri Sadguru Seva Sangh Trust, enjoys the reputation second to none. The Lion Club International Humanitarian Award, 1993 is to name a one, the actual list is a page long. Former president of india, A P J Abdul kalam has written a testimonial of their mission.

Patient care in medical tourism

At Bumrungrad International Hospital they take care of each and every possible issue one can face if one is travelling to another place for treatment. That include, food, language, stay before and after hospital, finance, insurance, airport transfer etc. If their website is to be believed they provide cultural support services in as many as 18 languages. Shri Sadguru Seva Sangh Trust, provide free cataract surgical services through eye camps. Obviously the services may not actually match a corporate hospital, but it include transport to and fro from the home, lodging and boarding , food, surgery and post-operative medication. Even those opting for the paid services, patient has to arrange his/her own transport, and pay for the surgery and treatment, which a very much subsided. Services are appreciated by all.

Connectivity and outreach in medical tourism

 Bumrungrad International Hospital has its international offices in 22 counties across the world, even in Iraq and Pakistan. The website of the hospital is comparable to amazon.com in functionality and details. Thailand is a major international tourist destination, which gives it an additional advantageShri Sadguru Seva Sangh Trust has simple but functional website which provide all the relevant information. One can have an online appointment. It even provides a contact number for patients to contact in emergency, something amazing for a charity eye hospital. They have 26 visions Centre, in 12 adjoining districts which is the main drainage area for the hospital. Plus it organizes 1500-2000 free screening eye camps to identify patients. Chitrakoot is an important religious tourist destination for adjoining Hindu population.

Lesson from medical tourism.

These migration pattern and underlying reasons offer insight in the way the health services delivery models should be planned. With increasing internet penetration , increasing disposable income , decreasing travel cost and free information flow, physical proximity of the services is not the actual criteria on which a patient access a health facility. This seems to be more valid in case of the public funded health care facilities. Majority of investment goes into construction of facility , manpower hiring and equipment purchase. The intangible qualities like patient care , connectivity , out reach and brand building are often ignored. I could not find a single government funded hospital in UP, in the list of NABH accredited hospitals. It is uncommon to see government hospital having a functional website. If at all there are one, it mostly displays the achievements of the office bearers rather that the services and contact details. It is very difficult to locate the facilities, services and service providers as most of the government hospital do not have anything like patients reception and information system. The patients care is unsatisfactory. All these services and accreditation do warrant an additional financial resources. These facilities continues to be underutilised in spite of significant budgetary outlay. Facilities lacking result oriented corporate work environment could not deliver the services demanded by the patients. Health care being very labour intensive , is difficult to manage in government setting because of administrative inertia.

A health facility is rated not by what it has, but by what it delivers.

What are the issue I failed to identify . Please share your views in the comments below.

Also read

Scientific studies report that most individuals (81%) say that they “learned something new” regarding their health, the last time they went online. The majority (80%) of people found the information through a search engine as reliable.

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