Modern Health Care in the Age of the Internet and Social Medicine

Are we are all “medical citizens,” embedded as potential or actual patients, with our physicians, insurer’s, pharmaceutical companies, government bodies and others in a system of societal, moral and organizational stakeholders?

Today, with the advent of the Internet, High Speed Bandwidth, Social Media, Support Groups and Self Care Protocols, patients for the first time in the history of medicine have the ability to alter the outcome of disease and illness for themselves, family members, friends and significant others.

This essay attempts to address a most compelling issue of our time. Are medical self-help groups and self-care methods helpful or are they challenges to the delivery of traditional medical care? How do they differ and what consequences arise from this debate?

Also, how has the advent of the Internet and Social media transformed the landscape of medicine? What limitations may exist in this new era of information technology and social communication? And to what degree do they challenge traditional care models? Can a patient or their advocate become more of an expert on their own medical conditions than their own physicians? The answer to this question is a resounding yes, if the patient uses all the tools now available to them.

Various published estimates unanimously indicate that hundreds of thousands of patients die and millions more are injured by medical procedures gone wrong, medication errors or their side effects and by medications improperly prescribed or not taken as directed by patients. And it is not just the infirm that suffer, but their families, their loved one’s, friends and employer’s who must suffer with the grief and change of lifestyle that so often comes with these mistakes.

Furthermore, on May 8, 2013 National Center for Policy Analysis, in a release, stated that first diagnosis error rates are increasing at an alarming rate:

• An estimated 10 percent to 20 percent of cases are misdiagnosed, which exceeds drug errors, and surgery on the wrong patient or body part, both of which receive considerably more attention.

• One report found that 28 percent of 583 diagnostic mistakes were life threatening or had resulted in death or permanent disability.

• Another study estimated that fatal diagnostic errors in United States intensive care units equal the number of breast cancer deaths each year — 40,500.

Therefore, second opinions are often necessary precautions, as are third opinions when the first two differ. In fact, Medicare and insurers often pay for third opinions under these circumstances as it saves them billions in the long run.

Prudence dictates that the “medical citizen” must beware of these pitfalls, as their lives may depend on it.

Also, with patient reviews and rating systems available right on our own smartphones, we must question whether or not physician decision making is being compromised as well. For instance, a surgeon knows that his or her treatment decisions can possibly either result in either saving a life or ending it resulting in damning social media judgements, whether legitimate or not, which can then hurt their medical practices? Does this introduce a bias that may alter or cloud a doctor’s judgement? There is no data to provide an answer as of yet.

So, are doctors becoming more risk adverse as a result of this new landscape? Physicians are now being compensated more and more based on better outcomes, lower costs, reduced re-admission rates and other variables – not staff friendliness or less waiting room times which many doctor review sites measure.

Often 5 star rating systems get few patient reviews despite the fact that the average doctor has some 2,000 patient charts (most healthy) and while it is human nature to complain when we don’t get the outcome we want, consumers are less likely to praise a positive experience because we naturally expect top service and thus neglect to post a positive patient review yet are rather far more likely to post a negative review to retaliate against the provider. So patient reviews are not a very good or objective source of fair and balanced overall rating of a doctor’s performance.

How can this dilemma be resolved especially when a surgeon does everything perfectly but the patient becomes a victim of medication errors, poor nursing compliance with medical orders or perhaps contracts a hospital born infection, or some other adverse event out of the doctor’s control even if the doctor’s work is excellent? Nevertheless these doctor review sites often blame the physician. So Patients need better tools to make judgements about their own healthcare whether it be which plan to select or which treatment option to go with given a choice.

If a patient does utilize a rating site, they should make sure it is a government site based on huge amounts of data or a private site wherein doctors nominate other doctors for their excellence and would use these “doctor’s doctors” to provide care for their very own friends and loved ones.

Doctor reviews by other sites using stupid criteria like waiting room times, friendliness of staff, waiting room decor and other questions that have nothing to do with best outcomes accomplish nothing but make money for their operators.

In modern day, it is not unusual for patients to challenge doctors when it comes to illness and disease. After all, according to Tejal Gandhi, MD, president of the National Patient Safety Foundation and associate professor of medicine, Harvard Medical School, “Preventable medical errors persist as the No. 3 killer in the U.S. – third only to heart disease and cancer – claiming the lives of some 400,000 people each year, at a cost of over a trillion dollars a year””.

Self-help groups and self-care probably date back to the dawn of civilization when people lived cooperatively in tribal settings. These groups dealt with all life issues related to the survival and political stability of the group. The dawn of medical ethics probably dates back some 2300 years with the publication of the Hippocratic Oath.

But now the game has dramatically changed due to major technological advances in medicine and with the great advances of the Internet now being the primary source of medical information for medical consumers. And with the explosion in social media, people have the ability to communicate and share information on a scale never before foreseen or imagined.

Add to this all the new stakeholders that have entered the fray such as insurance companies, employers, managed care organizations, Obamacare, biotech companies, governments and, of course, pharmaceutical companies and healthcare policy makers. The challenges faced by the medical citizen and social policy planners have never been so daunting.

Visual Aesthetics Essay – Brands

Brand logos certainly do not reach the high intellectual and status of high art created by Michelangelo, David or De Vinci. For example a McDonald’s logo on a burger box could not be considered as high art.

However whilst the McDonald’s logo is not high art this is not to say that there is no value in the visual aesthetics of the branding of the McDonald’s Golden Arches Logo, whilst the burger box with the logo may only be worth a few pence. The McDonald’s way of branding itself costs millions, however it is worth it as the branding makes even more millions back in profit. In other words whilst a logo on a burger box may be worth a few pennies in material value, the brand itself if branded correctly like McDonald’s can make a serious amount of money. This is backed up by the BBC (2008) who mention “It has been rolling out new food items over the past three years, and saw revenues rise 6% to $5.1bn”.

Branding is all around us from the labels in our clothing, to the products advertised on television. From the daily paper to a trip round your local supermarket we are always surrounded by some form of branding permeating our everyday lives.

Branding is used to help encourage us to spend our money with whatever product is trying to promote itself. It does this through many different ways; one such example is through lifestyle association. This is where a brand will advertise itself as representing a certain type of lifestyle. The website Health Canada. (Date Unknown) mentions how tobacco marketing uses a positive lifestyle association. “Lifestyle” or “image” advertising is one of the primary tactics used to market tobacco. Marketing messages are crafted to show the product in situations depicting independence, virility, fun, and other positive self-image traits. Over time, through multiple exposures, the consumer develops a mental picture or “image” that associates tobacco use with these desirable situations”

Pepsi for example is always associated with health and fitness, for example in adverts showing people playing sports whilst drinking Pepsi. These adverts are aimed to promote the idea that if you drink Pepsi you too will be part of that energetic and healthy lifestyle. In my chosen example I found an advert (which I got from YouTube) which illustrates this point. It is called “Britney Spears FIFA Pepsi Commercial”. The advertisement features the typical theme for Pepsi of healthy and attractive people enjoying Pepsi. In this Pepsi advert Britney Spears and some well known footballers are getting active playing football, whilst she sings and does a bit of dancing.

This advert is trying to convey to the viewer that if you drink Pepsi, you too will be like the people in the advert, in other words you too will be a healthy and attractive young person.

By constantly portraying Pepsi with images of healthy people being active it constantly reinforces people’s belief in the brand association that Pepsi is good and healthy.

However the brand association that is portrayed in the adverts, is greatly different from reality, but these adverts are their just to encourage us buy into not just the product but the lifestyle it allegedly offers. If the brand was to truly show adverts deprecating who really buys into the branded products, chances are those people would be put of the branded product.

For example if the well branded empire of Kentucky Fried Chicken (now called KFC as it was shortened to give the brand a cooler and more “hip” name as part of rebranding), was to show the real type of people that eat in their restaurants, who in reality tend to be overweight. This is backed up by The Jon Garrido Network (Date Unknown), who describes fast food’s influence in the American obesity problem “research has shown that Americans currently eat out, or order in, more than ever before – fuelling the trend toward weight gain. Food-market researcher Technomic found in a 2005 survey that 69 percent of consumers described their diets when eating out as “fair to poor,” compared to 39 percent who said they eat “fair to poor” diets at home. Not surprisingly, a new study that followed Americans for three decades suggests that, over the long haul, 9 out of 10 men and 7 out of 10 women will become overweight. Published in the Oct. 4 issue of the Annals of Internal Medicine, the report shows obesity may be an even greater problem than indicated by other studies demonstrating that two-thirds of the U.S. population is already overweight or obese. “The health implications for the country are enormous,” says Ramachandran Vasan, an associate professor of medicine at Boston University and the new study’s lead author.” And also mentions an ideal quote about people that eat fast food “Clearly, the philosophy today is “obesity be damned.” Let the feasting begin.”

It is clear to see that people that eat fast food tend to be overweight. If this true image of the average KFC customer was portrayed in an advert, these same obese fast food eating people would likely be put of from eating at KFC, as what they would see in a realistic advert depicting real people like themselves would not be appealing to them. Chances are if KFC did this it would it would cause a great reduction in customers, which would ultimately kill the brand.

So far I have given examples of older well established brands, however new brands are created all the time. The next example I will look is one of these brand new brands, its Levi Roots Reggae Reggae Sauce. I have chosen this as it is a great example of a new product that has based its brand on a person, but also more unusually used reality television to introduce the brand to the public.

Reggae Reggae sauce shot to fame on the BBC television show “Dragons Den” where the enthusiastic personality of Levi Roots, and the taste of the product won Levi Roots Financial assistance and business support from a two multi millionaires. It was not long after the screening of “Dragons Den” on television that other brand marketing came into play, positive television expose combined with newspaper stories as well as a charity single where Levi roots who wrote the theme tune for the Reggae Reggae Sauce which he also written. He even used the Destinations travel show in Earl’s Court to help promote his brand ( I still have the autographed bottle to prove it).

In other words, the advertising of the Reggae Reggae Sauce brand was on a wide range of media platforms. I myself have even seen adverts for it in Subway, where the sauce even has its own sandwich named after it. Unlike companies such as Dell or Sony that base their brand on product rather than personality. Reggae Reggae Sauce bases its brand on the charismatic personality of Levi Roots himself to sell the product, even using his name to introduce the sauce ( although his real name is far more boring than Levi roots) And it the branding makes a big deal of his Jamaican cultural roots, even using the Jamaican flag colours on the branding. All in all the branding and promotion of Reggae Reggae Sauce has been a success taking sales of the product from a couple of hundred bottles of sauce a year, to the vastly improved sales mentioned by Wikipedia (2008), which says, “A follow-up episode of Dragons’ Den aired on July 18, 2007 revealed that Sainsbury’s had expected the sauce to sell 50,000 bottles in its first year. It sold 40,000-50,000 bottles per week[4], and continued to be a high-selling product.”

So far the example I have looked at has been successful branding that has enhanced and improved sales. However it is prudent to highlight an example where branding has gone totally wrong, in fact has been a total unmitigated disaster. The case in question is British Airways who also had one of the most successful branding campaigns called “Bringing people together / Face” created in (1989). Whilst that brand campaign created business in 1997 the fortunes of British Airways where put firmly into reverse due to a unsuccessful rebranding. The cause of the dramatic slide in fortunes was due to “creative experts” who told British airways to ditch the long established overtly British theme of its brand. And instead make it all multicultural stripping away the britishness and replacing it with what they called “world images” which were meant to represent different parts of the world to make British Airways less imperialistic.

The Independent. (Date Unknown) mention the idea behind this.”The philosophy behind these tribal doodles was a simple one – British Airways could become a more effective global player by incorporating the merely geographic and historical Britain within a “Britain brand agenda”, a national-corporate mission. A successful re-branding exercise would, it was assumed, deliver BA the symbolic rights to the British concept.”

This proved to be a very stupid mistake for British Airways, this was due to the fact that it just confused everybody, no one was quite sure what was or was not a British Airways plane. It especially confused people from overseas who could not understand why British Airways had ditched its britishness, in favour of rebranding that ultimately meant nothing to anybody.

These messy brand inconsistent designs had no brand consistency, it baffled the customers and air traffic controllers, and ultimately left the British airways brand floundering. Wikipedia (2008) mentions the negative effect of the rebranding. “In 1999 British Airways reported a 50 percent slump in profits, its worst since privatisation. In March 2000 Bob Ayling was removed from his position. British Airways announced Rod Eddington”

It was only by rebranding back to a more British theme that profits began to rise for British Airways once more.

This is just one of many examples where ill chosen branding and rebranding have been disastrous, in some cases poor branding have completely killed of product. In some cases poor branding has not captured the public’s imagination, or has been outdone by a better branded product.

From this example it is clear that branding can drastically alter the fortunes of a product. If handled well it can make the product a highly recognisable household name. If however the branding is poor and does not suit or enhance the product then it may not even reach the public consensus and fade into obscurity.