Topol, 'Mama Doc' on Social Media, Vaccines, and Disease Prevention

Topol, Mama Doc on Social Media's Power, Vaccines, and Disease Prevention

; Wendy Sue L. Swanson, MD, MBE

Disclosures

March 17, 2015

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Leading a Health Social Media Revolution

Eric J. Topol, MD: This is Dr Eric Topol, editor-in-chief of Medscape. This is Medscape One-on-One—interviews with some of the most interesting people in medicine. Today I am thrilled to have with me Dr Wendy Sue Swanson from Seattle Children's Hospital, certainly one of the most interesting people in the field of medicine. We are going to be talking about her role in social media in medicine, the recent measles outbreak, and other topics.

Wendy Sue studied psychology at Kenyon College in Ohio and then went on to the University of Pennsylvania Medical School where she completed her MD, as well as a master's degree in bioethics (MBE). Before medical school, she taught for a couple of years, which had an impact on her career.

After medical school she went to Seattle for her residency, and she has been at Seattle Children's Hospital for a good part of her career. She published a book last year, Mama Doc Medicine (2014; American Academy of Pediatrics), which was a great resource for my daughter and my wife in regard to our 1-year-old grandchild.

You are one of the leaders in the healthcare social media revolution. Could you tell us how you got into that, and about your blog and social media portfolio?

Wendy Sue Swanson, MD, MBE: Social media auspiciously landed on my lap at the right time. I finished my training in 2006 and went into full-time practice in the community. It was obvious to me from the very beginning that people were starting to consume health information outside the pediatric office and were starting to make decisions based on what they were finding. This was a boon for parents who were raising young children and making decisions. As I began my practice I was fortunate to become a mom myself. With my second pregnancy I was on bed rest, and one of my friends said, "You have to get on Facebook." I joined Facebook while on bed rest and started to recognize that I could broadcast out to people who were interested in what was happening with my own health, and I could start to listen to all of these different voices.

As I moved along in practice and back, vaccine hesitancy continued and perpetuated in primary care. All of a sudden, moms and dads were coming into the clinic, bringing all sorts of stories, evidence, metaphors, and anecdotes that they were learning as healthcare consumers. It became clear to me that not only was science losing its voice, but I had only a precious15 minutes with families at the 6-month visit to talk about five vaccines, influenza, developmental milestones, sleep, and a whole laundry list of other topics, not to mention doing a complete physical examination. If I was going to fulfill my oath to reach patients and families and connect them with the science (and be a good storyteller so that the science was helpful), I wasn't going to be able to do it in the exam room.

Translating Science, Reaching Parents

Dr Swanson: I started to think about sharing messages about vaccines, and about championing the science, safety, and profound impact that vaccines have had on health and our lives. I began to tinker with a blog. I approached Children's Hospital, because although I knew I could just start my own personal blog, it was very important for families to have a place to go that they could trust. Seattle Children's is a great place with a repository of compassionate experts, and as a general pediatrician, I could potentially start translating some of that science for patients. Organically, my Facebook experience grew into my blogging experience and then into Twitter. It turned into a new career. I started out thinking that I would share what I know and tell it as a story. I wasn't going to do it with an ivory tower tone but would tell my journey of being a pediatrician married to a subspecialist and raising children. I wanted to tell "the real story" and wed evidence and anecdote.

As I got more and more into it, I started to learn that it wasn't what I was saying that was so profound; it was what I was hearing in the comments and the responses that I was getting to questions I asked on Twitter. For example, I remember the issue of contamination of baby formula with beetle parts. I went on Twitter and searched for the brand of formula and then "beetles parts," and I began creating content around this possible concern. I talked to a gastroenterologist who said that the stomach pH is so low that the beetle parts would not be harmful. When I went online and started searching on Twitter, I could see what moms were doing to each other. All of a sudden, the breastfeeding moms and the formula-feeding moms were arguing, and people were getting tense.

My hope was that I could learn the science by talking to an expert and then listening online. The message I then crafted would hopefully do a better job reaching concerned parents. My hope is that by using these new tools, I will be more efficient and I will reach more people. I can potentially learn much more, so that as a spokesperson and general pediatrician who desperately cares about the population, I will be able to accomplish more.

Shifting Views on Social Media

Dr Topol: How is this being received by your colleagues—not just in pediatrics, but when you talk to physicians about your remarkable experiences, the reach and the impact that you have had? Is this starting to get traction among the physicians with whom you interact?

Dr Swanson: That question is momentous in my career in the sense that back in 2009, when I started this, I remember colleagues literally guffawing at me when I said I was going to "start a blog." It seemed to be a laughing matter that I was going to tackle public health problems this way. Their views have dramatically shifted. No one is laughing anymore when they realize that we can reach millions and listen to tens of thousands of people and filter information. Six to nine months after starting the blog, I began to get requests to speak. I started meeting people in the entrepreneurial space. I met patients and families, and I talked to empowered patients who were hacking solutions to get the expertise and information that they needed, and to those who desperately wanted to be at the helm of their own healthcare with their own data.

As I started to do more speaking and listening in the entrepreneurial space, I also started to become more savvy about the strategies with which to take a blog and a message—taking one channel of information and blasting it out—and start to build a better story about how this could augment what we have always done. Now I am asked to speak all over the country and around the world. I am running an innovation group at Seattle Children's called Digital Health. I have a small team and we are building new technologies. Not every doctor will get on Twitter and Facebook. Not every doctor has to create content, but every physician who cares for patients and who will ultimately be responsible in the future to care for populations in more savvy ways will have to curate health information. We need to have trusted tools with which we can champion—first and foremost—patient privacy when they want it, create navigation tools for them to share when they want to, and leverage that community-building and create repositories so we can bring down those silos.

For physicians who are extremely busy and who have so many inboxes to deal with, who have to document in the electronic health record, keep up with their colleagues, publish research, and dedicate their attention to patients and families, the holy grail will ultimately be making this a part of the regular workday. Those are the new tools that I am building at Seattle Children's Hospital now.

The Blog That Started It All

Dr Topol: Did you have to convince the hospital or was it a willing partner? I'm trying to figure out how you developed such a strong bond with the hospital. Many hospitals are not exactly "with the program."

Dr Swanson: In 2009, the hospital's vice president of communications, David Perry, had come from Microsoft and he was a big thinker. He had gone to Cranium [the toy and game company]. We had lunch and I said, "I think we can start to take care of people outside of the exam room. We can start to disseminate education asynchronously." He said, "I think we can too." I said we needed a blog. He was my dual champion. What started was an experiment, which was, "Can we hire this non-subspecialized pediatrician for a large successful academic center to translate the mommy story in a meaningful way?" It was an experiment that went very well.

The first post that I wrote that went viral was about rear-facing car seats. What I love about the story and what I learned from it was that I was starting to hear some chatter about the data in 12- to 24-month-old toddlers—that if they are rear-facing, they are 75% less likely to die in a car accident than if they are front-facing. I called up a couple of colleagues who sat on the task force of the national committee at the American Academy of Pediatrics (AAP) and I asked whether this was going to be a recommendation. They said yes but that they had to hold all of our committee meetings; it would be another year or so.

I connected with some experts, got the data, and created a post called "Two is the New One," in which I told people to keep their children facing the back of the car until they are 2 years of age. I just put it out there. In one night it bumped, which at that time was a big deal. It got 50,000 views overnight. It started getting picked up on BabyCenter and people were talking about it. For me, what was so exciting about it was that 15 months before the policy statement came out, the national media had picked it up. There was this blog sitting there that was being read 10,000 times a month. Families were learning that keeping their kids facing the back of the car was potentially safer, and that may have saved a child's life or saved a child from an injury that was unwarranted.

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