Monday, January 6, 2014

#Affordable_Care?: It Costs What! Why so much?


Event:  SMBS Intersession 2014 (#UBSMBS2015, #Affordable Care?)

 
Date:  January 8th or 9th, 2013 (1/2 #UBSMBS2015 class each day)

 
Time:  11 AM to 12 noon

 
Location:  Farber 144

 
Title: #Affordable_Care?:  It Costs What! Why so much? How this will Effect You, Your Training (#ACGME,  #GME), Your Career (#CiM) & Your Patients (#HCR)

 
Instructor:      Philip L. Glick, MD, MBA, FACS, FAAP, FRCS (Eng)

Vice Chairman, Department of Surgery
Professor of Surgery, Pediatrics, OB/GYN, and Management,
            SUNY @ Buffalo

E-mail:glicklab@buffalo.edu

Twitter: @glicklab    


www:  http://www.buffalo.edu/~glicklab

 
Introductory Paragraph: #Affordable_Care?:  It Costs What! Why so much? How this will Effect You, Your Training (#ACGME,  #GME), Your Career (#CiM) & Your Patients (#HCR).  Using recent publications, real time resources, and social networking, we will discuss how healthcare’s costs will affect the students’ professional lives (training experience, career choices, personal finance, access to patients, etc.) and your patients’ lives in the next 3 to 5 years.  This will be a full participatory educational experience.  Students (#UBSMBS2015) will be expected to familiarize themselves with the reading materials in advance;  sorry for the short notice, but this will give you something to do during the snow!  Tweets (@glicklab) will be used prior to, during and after the intersession class to help the attendees inform themselves, their peers and their followers to better understand the effects of the on various aspects of their professional lives.  Attendee diversity, i.e., cognitives à proceduralists, primary care advocates à specialty care advocates,  federalists à libertarians, liberal à conservatives,  Twitter savvy à Twitter novice,  academic career bound à hospitalists à private practice bound, NYS residents à non-residents, etc., is encouraged and will make the educational experience richer. All opinions will be valued, and professionalism and ethics will be emphasized.  Your IQ will be helpful, but your EQ will serve you better.  If you want to reinforce your adult learning skills and have some fun doing it, this intersession course is highly recommended.

 

 
Learning Objectives:

 
At the end of this session, you should:

 

  • Understand the cost structure of healthcare and how the Affordable Care Act (#ACA) may or may not improve this.  Additionally,  how #Affordable_Care?  will affect your training, your career choices, your practice environment, your personal finances and your patients.
  • Have better insight into your professional metamorphosis from a student-doctor to a physician-healer, from trainee to practicing doctor, from healthcare user to healthcare provider and from citizen to tax payer.
  • Understand the basic information for the  meaningful use of  Social Media (Twitter, FaceBook, & YouTube) for their personal and profession needs and the risks, benefits, and alternatives of  this state of the art technology (#HCSM, #SoMe, #SoMed).

 
Required Reading:

 
Affordable_Care?:

 
- Brill S  Bitter Pill: Why Medical Bills Are Killing Us. Time Magazine 2013

http://healthland.time.com/2013/02/20/bitter-pill-why-medical-bills-are-killing-us/print/[2/26/2013 7:31:26 AM]

 

Lazarus S.  How a cat bite cost one man $55,000 LATimes 2013

http://www.marketplace.org/topics/economy/health-care/how-cat-bite-cost-one-man-55000

 

Cox R, Healthcare $avy.  Out of Network care

Out-of-network Medical Costs Affect Everyone | Healthcare Savvy

 

Rosenthal E.  Health care’s road to ruin, NY Times 12/22/13

http://www.nytimes.com/2013/12/22/sunday-review/health-cares-road-to-ruin.html

 

Rosenthal E. American Way of Birth, Costliest in the World .  NY Times 6/30/13

http://www.nytimes.com/2013/07/01/health/american-way-of-birth-costliest-in-the-world.html?pagewanted=all

 

Rosenthal E.  The $2.7T Medical Bill NY Times 6/1/13

http://www.nytimes.com/2013/06/02/health/colonoscopies-explain-why-us-leads-the-world-in-health-expenditures.html

 

Rosenthal E.  “Affordable care” or a rip-off? NY Times 9/28/13

http://www.nytimes.com/2013/09/29/sunday-review/affordable-care-or-a-rip-off.html?_r=0

 

Affordable Care Act:

 

Blendon, R. J., Benson, J. M., & Brulé, A. (2012). Implications of the 2012 Election for Health Care - The Voters' Perspective. The New England Journal of Medicine. doi:10.1056/NEJMsr1213905

 

Rosenbaum, S. (2012) Threading the needle -  Medicaid and the 113th Congress, The New England Journal of Medicine, December 5, 2012 DOI: 10.1056/NEJMp1213901


Oberlander, J The future of ObamaCare, The New England Journal of Medicine, December 6, 2012DOI: 10.1056/NEJMp1213674


 

Professionalism:

 
Rohrhoff, N. J. (2012). Becoming a physician. What life is like. The New England Journal of Medicine, 366(8), 683–685. doi:10.1056/NEJMp1112089


 

Social Media in Medicine:

 

Yamout, S. Z., Glick, P. L., Glick, Z., Lind, S., & Monson, R. A. Z. (2011). Using social media to enhance surgeon and patient education and communication. Bulletin of the American College of Surgeons, 96(7), 7–15

 

McGowan, B. S. (2012). Understanding the Factors That Influence the Adoption and Meaningful Use of Social Media by Physicians to Share Medical Information. J Med Internet Res, 1–11. doi:10.2196/jmir.2138

 

 

App | 140 Characters (available via iTunes or Amazon, optional)

 

Recommended Apps (Not Required for this course): (I’m an Apple junkie (Mac Book, iPhone, iPad), so my App recommendations are Apple-centric)

 


 

TwitterFall   TwitterFall

 


 


 


 


 


 


 

HUBNET HUBNET (web-based)

 

University of Buffalo Libraries E-Journals - Find Library Materials - University at Buffalo Libraries  (web-based)

 

People you might want to Follow:

 

@glicklab

@drMLB

@susannahfox

@atul_Gawande

@briansmcgowan

@CDCgov

@hhsgov

@@hjluks

@TedMed

@NEJM

@WSJHealth

 

Hashonomy you might want to use:

 

#UBSMBS2015 (this will be primary Hashtag for all tweets related to this class)

            #Affordable_Care?

#ObamaCare

#ACA

#ACGME

#GME

#CiM

#HCR

#HCSM

#SoMe

#SoMed

#advocacy

#UBSMBS

 

 

Technology Suggested: To optimize your educational experience, it is suggested that each attendee to the intersession class have real-time access (laptop or mobile device) to the internet and a twitter account (username).  Prior to the course, the students will begin a twitter thread following the Twitter handle @glicklab that will determine the content of the Grand Round discussion.  In addition, we will be using a real-time twitter feed for class participants to comment and ask questions.

 

Volunteer(s) Needed:  #UBSMBS2015 students (2 to 3 max) can volunteer to be the live Twitter Ombudsperson(s).   They will work with @glicklab prior to the Grand Rounds to prepare for live Twitter feed (“The Back Channel”) for discussion and Q and A sessions.  Please See below.

 

Guidelines for a Live Twitter Comments and Q and A (The Back Channel):

 

  • Our live Twitter audience ombudsperson is @TBD
  • Please be courteous to our front channel speakers, they can’t see the Twitter  feeds
  • Real-time comments are encouraged
  • Multitasking obviously is encouraged
  • The ombudsperson may interrupt the speaker for timely comments or questions or save them for the Q &A
  • The back channel activity should be constructive, synergistic, & value added!
  • Any comments or questions we can’t get to during the presentation will be responded to shortly after the session
  • Classmates or others not able to attend this Grand Rounds are encourage to comment or ask questions using hashtag #Affordable_Care or #ubsmbs2015
  • If you have a different interest or agenda than #Affordable_Care share it somewhere else

 

Contact information: 

 

Philip L. Glick, MD, MBA, FACS, FAAP, FRCS (Eng)
Voice:    716 859-3371   
Fax:       716 859-1354 (confidential fax line)  
E-mail:   glicklab@buffalo.edu  

Blog:  http://glicklab.blogspot.com/
LinkedIn: http://www.linkedin.com/in/philiplglickmdmba

Tuesday, January 22, 2013

@UBSurgery #ObamaCare: How Will #ACA Effect U?

Event:  Department of Surgery (UBSurgery) Grand Rounds (#UBSurgery)

Date:  February 14, 2013 

Time:  6:45AM to 8AM

Location:  Swift Auditorium, Buffalo General Medical Center

Parking:  Chair's fund will reimburse Attendees (Faculty)

Title:  #ObamaCare: How Will the Affordable Care Act (#ACA) Effect You, Your Training (#ACGME, #GME), Your Career (#CiM), and Your Patients (#HCR)?

Instructor:      Philip L. Glick, MD, MBA, FACS, FAAP, FRCS (Eng)
Vice Chairman, Department of Surgery
Professor of Surgery, Pediatrics, OB/GYN, and Management,
            SUNY @ Buffalo
Twitter: @glicklab    
Blog: http://glicklab.blogspot.com/

Introductory Paragraph: How will #ObamaCare aka the Affordable Care Act (#ACA) Effect You, Your Training (#ACGME, #GME), Your Career (#CiM), and Your Patients (#HCR)?  Using recent publications, real time resources, and social networking, we will discuss how the ACA’s implementation will effect the residents’ and faculty’s  professional lives (training experience, career choices, personal finance, access to patients, etc) in the next 3 to 5 years.  This will be a full participatory educational experience.  Students, Residents, and Faculty will be expected to familiarize themselves with the reading materials in advance.  Tweets (@UBSurgery) will be used prior to, during and after the scheduled Grand Rounds to help the attnedees inform themselves, their peers and their followers to better understand the effects of the #ACA on various aspects of their professional lives.  Attendee diversity, i.e., cognitives à proceduralists, primary care advocates à specialty care advocates,  federalists à libertarians, liberal à conservatives,  Twitter savvy à Twitter novice,  academic career bound à hospitalists à private practice bound, NYS residents à non-residents, trainee --> master surgeon, etc., is encouraged and will make the educational experience richer. All opinions will be valued, and professionalism and ethics will be emphasized.  Your IQ will be helpful, but your EQ will serve you better.  If you want to reinforce your adult learning skills and have some fun doing it, this Grand Rounds course is highly recommended.


Learning Objectives:

At the end of this session, you should:

  • Understand the pros and cons of the #ACA and how it will affect your training, your career choices, your practice environment, and your personal finances.
  • Have better insight into your professional metamorphosis from a student-doctor to a physician-healer, from surgical trainee to practicing surgeon, from faculty member to surgical leader.
  • Understand the basic information for the  meaningful use of  Social Media (Twitter, FaceBook, & YouTube) for their personal and profession needs and the risks, benefits, and alternatives of  this state of the art technology (#HCSM, #SoMe, #SoMed).

Required Reading:

Affordable Care Act:

Afendulis, C. C., Landrum, M. B., & Chernew, M. E. (2012). The Impact of the Affordable Care Act on Medicare Advantage Plan Availability and Enrollment. Health Services Research, 47(6), 2339–2352. doi:10.1111/j.1475-6773.2012.01426.x

Blendon, R. J., Benson, J. M., & Brulé, A. (2012). Implications of the 2012 Election for Health Care - The Voters' Perspective. The New England Journal of Medicine. doi:10.1056/NEJMsr1213905

Romney, M. (2012). Replacing ObamaCare with real health care reform. The New England Journal of Medicine, 367(15), 1377–1381. doi:10.1056/NEJMp1211516

Obama, B.  (2012) Securing the future of American Health Care, 367(15), 1377-1381 DOI: 10.1056/NEJMp1211514

Rosenbaum, S. (2012) Threading the needle -  Medicaid and the 113th Congress, The New England Journal of Medicine, December 5, 2012 DOI: 10.1056/NEJMp1213901
Oberlander, J The future of ObamaCare, The New England Journal of Medicine, December 6, 2012DOI: 10.1056/NEJMp1213674

Professionalism:

Rohrhoff, N. J. (2012). Becoming a physician. What life is like. The New England Journal of Medicine, 366(8), 683–685. doi:10.1056/NEJMp1112089

Social Media in Medicine:

Yamout, S. Z., Glick, P. L., Glick, Z., Lind, S., & Monson, R. A. Z. (2011). Using social media to enhance surgeon and patient education and communication. Bulletin of the American College of Surgeons, 96(7), 7–15

McGowan, B. S. (2012). Understanding the Factors That Influence the Adoption and Meaningful Use of Social Media by Physicians to Share Medical Information. J Med Internet Res, 1–11. doi:10.2196/jmir.2138
 

App | 140 Characters (available via iTunes or Amazon, optional)

Recommended Apps (Not Required for this Grand Rounds): (I’m an Apple junkie (Mac Book, iPhone, iPad), so my App recommendations are Apple-centric)


TwitterFall   TwitterFall







HUBNET HUBNET (web-based)

University of Buffalo Libraries E-Journals - Find Library Materials - University at Buffalo Libraries  (web-based)

People you might want to Follow:

@UBSurgery
@glicklab
@drMLB
@susannahfox
@atul_Gawande
@briansmcgowan
@CDCgov
@hhsgov
@@hjluks
@TedMed
@NEJM
@WSJHealth

Hashonomy you might want to use:

#UBSurgery (this will be primary Hashtag for all tweets related to this Grand Rounds)
#ObamaCare
#ACA
#ACGME
#GME
#CiM
#HCR
#HCSM
#SoMe
#SoMed
#advocacy
#UBSMBS
#UBSurgery


Technology Suggested: To optimize your educational experience, it is suggested that each attendee to Grand Rounds have real-time access (laptop or mobile device) to the internet and a twitter account (username).  Prior to the course, the attendees will begin a twitter thread following the Twitter handle @UBSurgery that will determine the content of the Grand Round discussion.  In addition, we will be using a real-time twitter feed for Grand Round participants to comment and ask questions.

Volunteer(s) Needed:  An individual (MS3’s, residents or faculty) or group (2 to 3 max) will be asked to be the live Twitter Ombudsperson(s).   They will work with @glicklab prior to the Grand Rounds to prepare for live Twitter feed (“The Back Channel”) for discussion and Q and A sessions.  Please see contact informatio below.

Guidelines for a Live Twitter Comments and Q and A (The Back Channel):

  • Our live Twitter audience ombudsperson is guest celebrity
  • Please be courteous to our front channel speakers, they can’t see the Twitter  feeds
  • Real-time comments are encouraged
  • Multitasking obviously is encouraged
  • The ombudsperson may interrupt the speaker for timely comments or questions or save them for the Q &A
  • The back channel activity should be constructive, synergistic, & value added!
  • Any comments or questions we can’t get to during the presentation will be responded to shortly after the session
  • Classmates or others not able to attend this Grand Rounds are encourage to comment or ask questions using hashtag #UBSurgery
  • If you have a different interest or agenda than #UBSurgery share it somewhere else

Contact information: 

Philip L. Glick, MD, MBA, FACS, FAAP, FRCS (Eng)
Voice:    716 859-3371   
Fax:       716 859-1354 (confidential fax line)  
E-mail:   glicklab@aol.com   
Blog:  http://glicklab.blogspot.com/LinkedIn: http://www.linkedin.com/in/philiplglickmdmba

Monday, January 21, 2013

APSA 2013 Eucational III Session : #SoMed #eAPSA2013

Education Session III
Social Media
#eAPSA2013
Moderators:
Philip L. Glick, MD, MBA; Gretchen Jackson, MD, PhD

Learning Objectives:
At the completion of the session participants will be able to
·         Understand the basic information for the meaningful use of social media for their personal and professional needs
·         Understand the risks, benefits, and alternatives to this state of the art technology for the pediatric surgeon, their patients, and their patients families
·         Understand how social networking can be used for graduate medical education, continuing medical education, and patient education
·         Understand the legal ramifications of a pediatric surgeon using social media for GME, CME, and patient care

Please Note:  This session will include a live Twitter feed.  To optimize your educational experience, attendees, and non attendees, are encourage to have a working Twitter account (www.twitter.com) and to follow the hashtag “#eAPSA2013” (don’t include the quotation marks) before, during and after the educational program. 

To Tweet or Become Extinct: Why Pediatric Surgeons Need to Understand Social Networking
Philip L. Glick, MD, MBA @glicklab

To Twitter or Die: The ABC's of Surgical Social Networking and the XYZ’s of Cyber Security
Zachary A. Glick, MS @z1g1

Can Tweeting Make You Smarter or Dumber: Using Social Networking for GME, CME, and Patient Care?
Benedict C. Nwomeh, MD @bnwomeh

Oper @ ting Safely on Social Networks: Legal Do's and Don'ts v3.0
Rebekah A. Z. Monson, Esq. @razmonson

Meaningful Use: How Social Networking Can Make You A Better Surgeon –What Does the Data Show?  
Brian S. McGowan, PhD @briansmcgowan

#MedEd:  The Changing Face of Medical Education in the Era of Social Media
Mary L. Brandt, MD @drmlb

Concluding Remarks and Live/Online Panel Q and A via Twitter
Gretchen Purcell Jackson, MD, PHD gretchen.jackson@vanderbilt.edu, @pedssurgery, @gpurcelljackson

Live Social Media (Twitter) Ombudsperson
Danielle S. Walsh, MD @walshds

Wednesday, May 18, 2011

Getting to the Root of the Matter

Getting to the Root of the Matter
Kathleen Ang, BS       Charles W. Hartin, Jr, MD        Philip L. Glick, MD MBA
As pediatric surgeons, we never expected to be writing an article such as this, but the rash of skin infections related to shaving various parts of the body is reaching epidemic proportions. In the last decade, pubic hair removal has been on the rise amongst teenage boys and girls.  This practice can be traced back to ancient Egypt and Greece in the 17th century.  By the 1940s, female body shaving, especially in the underarm region and legs was established as the cultural norm, and pubic hair removal trailed closely behind, booming in popularity since the 1980s.  The reasons for shaving are vast and have been evolving since the practice first began.  First done to prevent parasite infestation,  it is now practiced to increase feelings of sexual attractiveness and the desire to feel “clean” and “neat” in the most intimate of body regions.
                As the incidence of pubic hair shaving has risen, so has the outbreak of infections caused by antibiotic resistant staph bacteria (MRSA), which thrive on normal skin in warm, moist places such as groin creases and armpits.  Improperly shaving these areas can cause small cuts in which the antibiotic resistant bacteria can invade, possibly leading to infection of the soft tissue around the area (cellulitis) or formation of pus pockets (abscess).  Over 1000 kids with skin infections are seen annually at Women and Children’s Hospital of Buffalo and approximately 20 percent of which are likely related to improper shaving of the groin, legs or armpit areas.
                To prevent or reduce such infections, we recommend using hair removal techniques that minimize skin damage or we suggest avoidance of shaving altogether. Tweezing, waxing, sugaring and epilation are all mechanical techniques to pull each hair from its root and are time consuming, painful, cause damage to the skin, and should generally be avoided.   Another method is chemical depilation, which works by dissolving the hair follicle so, it can then be wiped away providing a smooth result. Although inexpensive, depilation can result in a chemical irritation and cannot be used near the genitals.   Permanent methods of hair removal that destroy the hair follicle, e.g., lasers and electrolysis, have risen in popularity, but are expensive, time consuming and results vary.  Shaving is the most common method of hair removal but should be performed with electric razors, clippers or single use safety razors (on well lathered skin) designed specially for the armpits, legs and pubic region.  Trimming pubic hair using scissors and a comb to avoiding contacting the skin is the safest, cheapest, and least irritating of removal methods.  Adolescence is a very difficult stage of development.  Avoidance of complicating it with preventable skin infections seems prudent.
Ms Ang is a Medical Student at SMBS, SUNY@Buffalo.  Dr Hartin, Jr, is a Pediatric Surgical Fellow at WCHOB and Dr. Glick is a Professor of Surgery, Pediatrics, and OB/GYN, WCHOB and SMBS, Department of Surgery, SUNY@Buffalo

Monday, February 28, 2011

Gronkowski Rule: Fact or Fiction?

Gronkowski Rule:  Fact or Fiction?

I enjoyed Allen Wilson’s commentary about the success of the Gronkowski boys in the NFL  A dream comes true for Gronkowski - News - The Buffalo News http://www.buffalonews.com/incoming/article10937.ece.  A common thread throughout the article was the competition fostered by their dad.  Wilson’s only erratum was not giving equal credit for the boy’s success to their mom, Diane; as I recall, she was also a competitive collegiate athlete.  Most importantly, Gordie and Diane deserve much credit for emphasizing a balance between academics, citizenship and athletics;  They’ve raised 5 good boys.

Our family met the Gronk Nation via Amherst Hockey House League.  Our son Zack played on several teams with Chris or Dan.  In 1992-93 both boys were on the Penguins (mini mites) with Zack.  Although the house league rolled 3 lines (A, B, and C lines), when Dan and Chris were on the ice together (A line), they were a goal scoring machine and unstoppable; even at that age, they were men amongst boys.  Following that season , the two boys were never drafted onto the same team again, much to the protests of Diane who wanted the convenience of only having to drive to one practice or game, instead of two.  Although never officially stated, the Amherst Hockey Board of Directors were alleged to have passed the “Gronkowski Rule,”  which stated, that in  order to maintain competitive balance in the house league,  only one Gronkowski  per team.  FYI, in 95-96 Zack’s team, the Kings (squirts) won Super Sunday;  thanks Dan. 

Sunday, February 27, 2011

Unless there is reform of New York State government, the joke is on us!

Unless there is reform of New York State government, the joke is on us!


A funny thing happened on the way into a local store this week, I ran into a politician. He handed me a flyer, and said, “I’m Robin Schimminger, and I hope I can count on your vote.”  I took the leaflet, and then walked on.  In the check out line, I read the flyer.  The bullet point that caught my eye was “Reforming State Government.”   On my way, I introduced myself and asked him what he meant by “Reforming State Government” He said, “what do you mean?”

“What do I mean?”  Again pointing to his flyer I asked, “what are your plans for reforming state government?”   I explained to him, the NYS citizens are completely fed up with Albany politicians and the dysfunction of NYS government.  Why are our state budgets always so late?  Why is there no transparency to the budget process?  Why does our state spending exceed the state’s revenues?  How was he going to stop Sheldon Silver’s strangle hold on the government? Again, I asked him how he was going to “Reform State government?”  This was reminiscent of Abbot and Costello’s routine,  “Who's on First?”

He explained to me how he had the endorsements of  business councils and federations of NYS.  Again, I asked him how he was going to “Reform State government?”  He told me,  as an individual he was powerless to fix the problems I had asked him.  His faux smile was now glued on more tightly. And then like a good politician he asked me where I lived.  He realized I  didn’t live in his district and he stuck his hand out, said thank you and walked away.

I didn’t write this to be specifically critical of Mr. Schimminger, but as an incumbent, he is part of the problem.  I would ask the same questions to my NYS Senator Mike Razenhofer or NYS Assembly person Jim Hayes, but his obvious fumbling around the giant elephant in the room is emblematic of the problems in NYS. 

My wife and I are transplants to WNY.  Our family has thrived here.  However, since our arrival we have seen the state’s death spiral increasing its velocity.  Our kids, like many, move away for college, graduate school and permanently relocate.   We’ve watched the population of WNY shrink; not an insignificant concern for 2 pediatric doctors, let alone the future of WNY.  As SUNY@Buffalo faculty, we feel the bite of Albany’s budget tardiness and contraction.  Albany’s failure to pass UB 2020 legislation was pathetic; I understand why President Simpson has decided to “retire.”  Our taxes are too high, our infrastructure is crumbling, and the down state political machine is strangulating WNY’s ability to fix itself.

Clearly Mr. Schimminger and the remainder of his Albany incumbent cronies just “don’t get it.”   His campaign motto, “promises are easy to make, performance takes hard work” is disingenuous.  If there were qualified people to replace all the incumbents, it would be an admirable goal. Our current state legislature environment is polarizing.  Will they be able to “reform state government?”  If significant NYS Government Reform does not happen, the joke will be on us!   Governor Cuomo we need your help; keep your boot to their necks.

Wednesday, February 23, 2011

Is it a right, privilege, or a necessity to communicate via social networking with my doctor?

Is it  a right, privilege, or a necessity to communicate via social networking with my doctor?

The question I (http://twitter.com/glicklab (@glicklab)) recently posed to a 3rd year medical student was,:  "Is it  a right, privilege, or a necessity to communicate via social networking with my doctor?" 
I'd love to hear what you (@Susannahfox) and your followers at e-Patients.net have to say about this.  any primary sources you could recommend to us would be greatly appreciated.
As some back ground information:
    - By social networking I'm not referring to emailing with your doctor.  Which, BTW, email is an avenue of communication underutilized by  physicians.   But in some highly integrated environments, i.e., Kaiser Permanente,  has been shown to be efficient, effective at disease management, and accepted by both the patients and the medical staff.
    -  By "a right" I'm referring to the Consumer Bill of Rights and Responsibilities that was adopted by the US Advisory Commission on Consumer Protection and Quality in the Health Care Industry in 1998. In it, patients have the right to accurate and easily-understood information about their health plan, health care professionals, and health care facilities. Also, patients have the right to know their treatment options and take part in decisions about your care. Parents, guardians, family members, or others that they  choose can speak for them if they cannot make your own decisions.  But currently no where does it state how this information is communicated.  Traditionally, >99% of this is done face to face, physician to patient or to their health care proxy.  But does, the option of communication via social networking need to be added to future versions of the  Consumer Bill of Rights and Responsibilities in the future? 
    - By "a privilege" I'm suggesting that at this moment, 2011, physicians are in a voluntary "op-in"  mode to participate in social networking.  In a recent American College of Surgeons Survey as high as 80% of surgeons have visited a social networking site, but most use if for personal reasons only.  Only a small percentage of us, early adaptors,  have recognized the power of social networking for patient related matters and we need to help move our colleagues from awareness and understanding to adoption and institutionalization. 
    -By "necessity" I'm asking, can we afford to miss this opportunity?  Our health care system is severely broken.   We need to get in on the proper trajectory or system will collapse because of excessive cost and less than satisfactory results.  Many solutions have been suggested and recently legislated;  time will tell if these "fixes" will work.  However, social networking may be another tool to help us control costs, improve disease management (especially chronic diseases), improve patient satisfaction, improve physician satisfaction, decrease excess utilization of services, empower patients with shared decision making, improve health literacy, and/or to help to level the playing field with information transparency to shift us from a fee for service health care market to a pay for performance health care market at both the physician and hospital levels. 
Again, I'd love to hear what doctors, patients, and  the e-pt community have to say about this.  any primary sources you could recommend to us would be greatly appreciated.