I get my medical advice from Reddit
A few weeks ago, I gave a speech during the Sage Bionetworks Commons Congress discussing the importance of social media in health care (and not just having a Facebook page for your clinic). Below is the video and an approximate transcript:
When I finished grad school in Chicago a few years ago, I moved back home to Minneapolis and had pretty much everything anyone could ever wish for. I had a new job as an epidemiologist in a hospital. In addition, I spent some evenings working for a youth center as a counselor – I made some extra money, and was lucky to be involved in these kid’s lives. I was in a relationship, and we were pretty much inseparable. We found an agent and started looking at buying a house. After years of struggling to stop drinking soda, I had successfully quit and was even going to the gym a few times a week (on my way to losing that extra grad school weight). I fell asleep every night thinking I was the luckiest guy in the world.
So, I’m sure you can see where this is going. Life is filled with the highest highs and the lowest lows. So, naturally, everything began to unravel. I got laid off from my part-time position (the center lost some grants and donors, and was on its way to shutting down). There were management changes at work that were causing some serious headaches. My relationship ended abruptly with a job offer from some fruity little company in Cupertino. The second housing bubble was getting ready to burst, and home buying was nearly impossible (first world problem, I know).
I’m not looking for sympathy. You take the cards you’re dealt, and you handle it any way you can. In my case, I turn to Reddit, a social news site. I get my daily dose of tattoos-gone-wrong, huge spiders, and other mishaps to remind me that things can always be worse. On bad days, I look for pictures of kittens and puppies (nature’s SSRIs). And, of course, I look to the forums for information on how other people handle different situations – whether medical or mental health, or just everyday living.
I’m not alone. The average 24 year old will spend more time on facebook in the next week than they will with a physician in the next 20 years. Whether you like it or not, people (particularly teens and 20-somethings) are living their lives online. When good or bad times come, they play out online both actively and passively.
In my case, my problems came spewing out online. My employers on Facebook changed. My relationship status changed. I lost friends on Facebook as a result of the breakup, and I gained connections on LinkedIn as a result of leaving the job. I mostly stopped updating my status on Facebook and Twitter… and when I did, it was one of those obnoxious, ambiguous, needy updates (no judgment; we’ve all been there). My music listening, as measured by Last.fm, changed suddenly from hip-hop to emo-rock (and, really, just one or two songs on repeat for an entire summer). So, the internets knew that I was in the midst of a quarter-life crisis. My physician, however… well, let’s be honest, I hadn’t seen my physician in about 3 years.
And therein lies the problem with and solution for our healthcare system.
That average 24 year old – there’s a 1 in 3 chance that he’ll develop diabetes in his lifetime. There’s a 60% chance that he’s already overweight, and a ~30% chance that he’s prehypertensive.
If we want real change for our health care system, we need to be concerned about primary prevention efforts. We need to figure out ways to find signal from our everyday interactions, and build interventions that fit into the context that we actually live. Lucky for us, we’re now living in a world where a substantial amount of this information exists about us online.
So, in my little crisis, I started drinking soda and stopped going to the gym. It wasn’t that I didn’t want to be healthier, it’s just that I had other more pressing issues to focus on. However, if there was a way to alert someone on my care team to call me to help identify a plan to ameliorate my situation; that could have helped keep me on a healthy path and potentially mitigate health problems decades before they emerge.
That’s exactly what we’re working on at Epi.md, a medical informatics company currently in the Rock Health incubator. Ultimately, something needs to be done because, while it’s not ideal, patients are increasingly turning to services like Reddit, Google, and Facebook for information and support. That means they’re leaving a trail of data about their needs, and are perfectly susceptible to intervention. And public health, research, and clinical medicine will have limited success if they don’t acknowledge and utilize this fact.