But doctors have yet to fully understand that less is more when it comes to social networking mediums, said Bretton Holmes, head of Holmes World Media, a healthcare consultancy. “The vast majority of them are under the impression that they ‘must’ have this as an aspect of their practice in order to flourish.”

According to Manhattan Research, <http://www.manhattanresearch.com/products/Strategic_Advisory/ttp/> about 99 percent of physicians are using the Internet today, including participating in physician-only social networks such as Sermo<http://www.sermo.com/> and Ozmosis, <https://www.ozmosis.com/home> which offers the opportunity to connect with peers in a protected community. On Pharma customer service portals, doctors can download drug samples, attend medical symposium Web casts, or have a live product discussion with a drug representative. And social media is changing medical journals, as physicians stay-up-to-date by not just reading content online but also having the ability to read and respond to posted medical cases, join in teleconferences about health debates, and use interactive graphs to view specific data. “As medicine continues to advance and physicians face increased demands on their time, they need a more effective way to collaborate and share knowledge with their peers,” said Joel B. Selzer, CEO of Ozmosis.

Using Facebook <http://content.nejm.org/cgi/content/full/361/7/649> and Twitter and having a commercial Web site is when many physicians wonder whether their time might be better spent elsewhere. Steven B. Siepser, a Wayne, Pa., optometrist, admits, “Facebook can eat you alive. One must remember your highest and best use.” Holmes cautions as well to be diligent about the “ingredients” that comprise social networking – “doctors need to cut the fat from these sites and make them worthy of a visit; not be sending out notices of new staff and the like, but make the information relative.”

Physicians also need to be aware of privacy, the lasting nature of these datasets, and the possible commercial use of Web sites, cautions Dr. Peter J. Smith, a director at the University of Chicago Medical Center. “Healthcare professionals often underestimate the potential professional conflicts that social networks introduce,” said Smith. Pho, the blogger, says he always keeps patient privacy paramount and always remains vigilant about HIPAA (Health Insurance Portability and Accountability Act), especially on Facebook and Twitter. “Once you hit ‘enter,’ it’s on cyberspace forever,” said Pho, who doesn’t give personal medical advice over the Web, but rather guides patients to reputable sources of information or links.

The new technologies allow physicians to actively engage patients online, <http://www.33charts.com/2009/10/9-things-to-consider-when-patients-contact-you-via-social-media.html> enhancing community reputation, and generating goodwill and business for a practice, a situation that Pho sees as win-win. “There seems is a growing demand for physicians who understand the Internet's role in patient health information today."

Bryan Vartabedian, a pediatrician at Texas Children’s Hospital who blogs frequently about the intersection of medicine, health, and social media on 33 Charts, <http://www.33charts.com/> offers these social media tips for physicians:

Listen before you start. For the fledgling physician looking to get into social media, the first step is to look and listen. Spend a solid three to four weeks studying the dialog underway on a variety of social media platforms. Choose a dozen or so physicians who are already there and see what they do and how they behave.

Decide where you may want to live. There lots of social media platforms, or places to hang out. Choose where you are going to live, whether it’s a blog, Twitter, or a site called Cinchcast that allows users to make mini-podcasts that people can listen to.

Set a social media budget. Just as you have to limit where you spend your time, you have to decide how much time you have to spend. While the most passionate among physicians might be spending up to a couple of hours a day reading, building and sharing, your schedule may only allow 30 minutes a day. This is not a problem. Just focus on the slow build of meaningful connections.

Think about what you might do with it? A lot of what you do as a physician on social media is dependent upon where you want to go. Are you looking to build a concierge practice or are you just looking to have a little dialog? Do you want to connect with potential patients? Are you building a side-business and want to connect with professionals in the pharmaceutical industry? And if you don’t know exactly where you’re headed, that’s okay. You can always develop some relationships, have fun and see what evolves.