(X% Body) + (Y% Words) + (Z% Pheromones) = The Enigma of Social Media

One of the most common (egregious?) misunderstandings concerning social media interactions is that they’re simply no different from face-to-face.

Although there are urban understandings of how body language and words contribute to communications, we really don’t know for sure. (See Misinterpretation of Mehrabian’s Rule.)

Not to mention pheromones, and who else knows what tiny subtle mechanisms at play in human inter-connectivity and communications.

We must understand what’s going on here. Why? Because you and I and everybody else are connecting less and less personally, and more and more via electronic telepathy.

Ergo: what happens via social media is different from face-to-face.

Now, this difference has down-sides.

But…but this difference has upsides as well. Think of Twitter’s value-extraction mechanism – tiny pearls of wisdom secreted though the tyrannical pressure of 140 characters as an instance.

Furthermore: there are inter-plays between the down-sides and up-sides of this differential.

The more you peel away, the more you peel away. Crazy, huh?

Crazy as it is, we must keep peeling away and plumbing the breadth and depths of how the presence of today’s technologies enhance, obsolesce, retrieve and flip the media of communication and other forms of human contact. See the pic below:


When thinking about Healthcare – how nurses, physicians and other HCPs aught to explore their personal/professional rights/responsibilities – it’s critical that we return to a media-analysis of what’s going on. We are moving towards a strange chimera of technology, psychology, ethics, communication, economics, politics and professional work.

^ What therapeutic communications do social media enhance?

^ What patient-provider relationships do social media obsolesce?

^ What practical wisdom do social media retrieve from the ancient past?

^ How far can we bend social media in Healthcare and what happens when they flip as a result?

That’s why I offer the quirky equation as the title of this post: we don’t know enough, but we can start with a framework. What I offer is just an intuition pump, not to be taken literally.

There is an enigma to social media.

We know some of the variables that compose this enigma, but not all. Not by worlds.

Let’s work out the algebraic topology that is the enigma of social friken media.





Great Hospitals Enable Consumers To Rip Them Into Shreds

The operating system of all hospitals is information. Information powers decisions. Decisions guide care.

The way hospitals can improve, then, is to ceaselessly generate and acquire better information.

Consumers may not always know what they want, but once they’re your customers they often know a lot more about your operations than you do.

The gut reaction of almost all hospitals is to fear negative feedback. This is not a rational stance. Why? Because negative feedback is information – negative feedback loops keep the furnace from overheating.

Great hospitals understand this: that negative feedback offers more potent information than positive feedback.

Smart hospitals, then, would be wise to enable consumers to connect – right on their property! This is what today’s technologies enable.

Kevin Kelly states the premise well over here.

So many organizations pay huge sums to consulting providers, but then panic over the free knowledge from consumers.

The business of business is business.

The business of business is not fear nor avoiding bruised egos.

Hospitals are businesses – and the business they are in is caring.

You cannot care if you do not listen.

The best way hospitals can prove that they are “The Best” is to build platforms right on their front porch that connect and enable consumers to trade stories, kvetch, point out flaws, hash out their collective problems and…to praise quality care.

Bad hospitals cower and hide and silence.

Great hospitals enable consumers to rip them into shreds.

Phil Baumann




Should You Monitor the Word Suicide on Twitter?

Ashley Billasano was an eighteen year old who cried for helped many times. Apparently, Twitter may have been the last place she voiced her pleas and frustrations (not only did Twitter (metaphorically) ignore her, so did the very people she entrusted with her accusations of rape and other abuse).

Either nobody was paying any attention to her Twitter stream or nobody knew how to respond or just didn’t care (in this society, that seems to be an emerging trend). Not a single one of her tweets received a reply.

This is remarkable.

It’s an instance of why I continue my own plea to Healthcare Social Media hand-wavers to plumb deeper the ethical ramification of social media.

We can’t prevent all suicides. I get that.

But if nobody was paying attention to her tweets, then one question is: Who should, if not her followers?

Should agencies specialized to handle suicides monitor the public stream for mentions of “suicide” and related keywords? And not just Twitter, but elsewhere?

There’s no linear answer, of course: if you say “Yes”, then there are new arcs of questions which need answering: Is this an invasion of privacy (not in a legal, but ethical sense)?

Another question: what if you are a Healthcare professional or organization and your account follows someone who starts a clearly apparent plea for help (bearing in mind that suicidal pleas take different forms)?

Would a hospital be held legally responsible if it failed to take action (how would the hospital “prove” that it didn’t see the tweet))?

If you set up an alert for suicide keywords (from any or all social media platforms), do you then put yourself in a position of *some* responsibility?

Years ago I asked these sorts of questions – long before there was even the phrase “Healthcare Social Media”. You should raise these questions too if you’re truly passionate about this stuff. (I was more optimistic then. I still am – but I’m not convinced enough people are taking these questions seriously enough.)

At conferences where so many people praise Twitter – especially marketers – I often counter with my own snarky (but closer-the-truth) aphorism: “Nobody reads your tweets.”

Now that I know my sarcastic insights into the marketing potential of Twitter are far clearer and more realistic than most marketers’, I’m heartbroken.

I wish I was wrong.

Phil Baumann




The Klout Trap – It’s Unhealthy

Klout isn’t healthy.

Klout represents the pathway which social media can take into narcissism.

It’s also dumb. Just dumb. I’ve noticed lately that some friends in the #HCSM domain are in awe of Klout – and specific hospitals have boasted about their scores.

This is unfortunate.

To me, such boasting suggests a complete lack of any understanding of how to get things done – in Healthcare or Marketing.

I am Phil Baumann. I influence what I influence. If I decide I want to be heard – believe me, I’m heard. If I decide to clear a way to new land in a new century, I clear the land.

That’s Phil Baumann doing all the work – not his Klout score.

Are you a soldier? Or are you an army of potters, sculptors and blacksmiths going into battle with no idea on how to fight?

You either have presence or you don’t. You either have brilliance or you don’t. You either know how to lead community or you don’t. You either know how to use social media and other technologies artfully or you don’t. You either have a fight worthy of fighting or you don’t. You either have passion to fight or you don’t.

Numbers crunched by a stupid company have nothing to do with it.

Discipline. Fidelity. Intelligence. Those matter.

Klout? You must be kidding.

[Oh, and if you haven’t thought about all of the implications, read this. Yes, you do have to think about this stuff – and not be superficial.]

Related Link

Phil Baumann



Finally, A Social Media Platform for Healthcare!

You’re going to hear that a lot – either as part of vendors’ claims, or as a hope from consumers.

Unfortunately, such a stance is the result of a fundamental misunderstanding about networks in general and digital networks in particular.

There is no Web. There is no “social medium”. Those are illusions.

There is no final destination.

There is no final product.

There is no final platform.

There is, however, evolution.

There are complex systems.

There are opportunities.

Gone are the days of stability.

Gone are the days of insular authority.

Sorry to disappoint: there is no social media platform for Healthcare.

And there never will be.

That’s a bad thing.

It’s also a good thing.

The trick is to know when it’s bad, and when it’s good.

Phil Baumann


Death of My Blog

This blog, Health Is Social, was once read by a decently large sized audience. It got RTs and comments.

Today, not so much.

Reasons: the content, the frequency, the rare link-back commenting on others’ posts, the low-rate of any promotion…

Also, I decided not to write “How To…” or “Top Ten…” posts – the reliable parlor trick of link-baiting.

I used to believe with a passion that Healthcare and Social Media would rally deep discourse.

But it’s become a promotional world. A world of links and pats-on-backs – in short, a world of belief-reinforcement.

It’s become a place where people say things that sound wonderful. And maybe they are.

But there’s little anger. Little understanding of the danger of today’s technologies. It’s become like some weird version of the Positive Imagery movement.

And now, I’m pretty close to giving up.

I love writing and speaking about Healthcare.

But mine is a lone voice. And you can cry out so much until you lose energy.

I felt the same way when I was a bedside nurse: I worked my butt off for my patients…but in the end, I couldn’t stand having to fight wars with administrators who saw themselves as healthcare experts but were almost absolutely clueless. All talk, no do. (You can spot them: they’re the ones who never ask the docs and nurses “Need a help lifting?”)

Maybe these feelings were seeded earlier this year: I was asked to speak at a conference. A representative from a Pharmaceutical company introduced herself to some of us. As we talked, I told her what I did and that I used to practice nursing. She said “Oh, you’re a nurse? That’s wonderful. Nurses are so important.” You know what said next? “I’m going to talk to Dr. ___ because those are the insights I need to hear about.”

It wasn’t the words she said. I understood utterly that the physician view is key to Pharma. But it was her body language. The way her eyes subtly shifted the moment she learned I was a nurse and not a physician.

Think about that. Think of the opportunity she lost there. And she just walked away from it because she inherited stereotypes of nurses and doctors – as if what we do are completely unrelated.

This idiotic and ignorant cultural behavior needs to stop.

Since I’ve been around the country speaking and trying to elucidate and question the possibilities before us, I don’t know if I can stand doing it anymore.

I have my community over on RNchat and MDchat – two populations who can make the biggest differences. If you’d like to be a part of leading them, let me know.

It’s a tough decision to put a blog down.

I added my voice, my ideas, my passion.

I think I may be more useful working at Starbucks or Wholefoods. No joke.

Phil Baumann



We’re Wrong About Healthcare Social Media

There’s a misunderstanding about “social media in Healthcare. This misunderstanding explains why discussions and applications have been going around in circles. Let me explain (I may expand my thoughts in a future post.)

Social Media (versus social media – lower case) is the amalgamation of: Technology, Ideology, Culture, Psychology, History, Philosophy, Science, Humanity, and Stupidity. (Yes, it’s ok the say Stupidity.)

When asking, for instance, “how can we use social media in healthcare”, we’re asking a Technological question. Technique. (Google “Techne”.)

But we’re not just dealing with Technology. And we’re not just talking about “the conversation” and “being social”.

No, we’re dealing with the wide and deep and ramifying consequences of a whole new layer encapsulating our world. We are dealing with a moment in geological time where the entire spectrum of History – social eruptions, wars, cultural shifts, etc. – are going to transpire within a single loci: a kind of strangulation of selective pressures. A new bottleneck – and we may not get through it. If we do, we will reach a new level of the ascent of the human being.

Healthcare Social Media, therefore, requires an apprehension of sociological dynamics, business re-thinking, the nature of revolutions and the consequences of momentous change.

None of us will grasp these in their full. Some of us get it more than others, but no single individual or group will acquire complete gnosis.

The crowning achievement of our species is the Question Mark.

If you care about health and it’s progress, you’re wise to spend less time figuring out how to use Twitter or Google fricken Plus and a whole lot more time questioning the living hell out of our world.

Phil Baumann


Questioning the Limits of Healthcare Social Media

Joseph Stalin

How far can the use of social media in the context of Healthcare be pushed?

Should a rape victim live-tweet his psychotherapy sessions?

Is it safe for the victim of “domestic” violence and abusive control to use social media?

Is the privacy-is-dead ideology a liberation, or a dangerous caving-in to misguided ideologues?

We are at a point in civilization where the choices we make today – right now – will be lock-in for future generations.

There was a time – thousands of years ago perhaps – when there were no cruel paternal nor maternal inequalities. Then: something happend, perhaps something to do with technology: a cultural lock-in that brought forth power-dominance and prejudice and suffering. A lock-in we are still trying to break.

When the Old Powers of Europe collapsed after World War I, new ideologies contended and the wrong gods where chosen and worshiped: Tsarist Russia was replaced with Stalinist Nightmare.

Today’s Old Powers – the Corporation, the Medical Profession, the TV – face needed revolutions.

Today’s Question: which revolutionaries win the lock-in? The Digital Utopians? The Dystopians?

For the cost of utopian vision is blindness to danger and the cost of dystopian fear is regression and stagnation.

Social media now have everything to do with Health Care – from the dopamine alterations in your brain to the social relationships made and destroyed by how we use these technologies.

How far we push social media, therefore, determines how far we push our health.

How the doctor tells you that you’re going to die determines how you die.

Who knew that a tweet could kill human being?

@PhilBaumann – @HealthIsSocial – Newsletter





The High Cost Of Low Quality Social Media

My old man once told me: whatever you do, don’t get dirty unless you know how to garden.

It’s tempting for brands to go for the lowest common attention-denominator in today’s world of tweets and pings and quickie YouTube hits. After all, the cost of attention goes up every single day.

But the cost of getting dirty for attention goes up too. See this post on how low brands might go – tnw.to/19H7A and then bounce back here.

Now that Healthcare organizations are “getting” the need to pay attention to the web, there is the chance that we’ll see marketing campaigns and social media efforts go for the “hot” shot…the viral YouTube video, the magical tweet that gets featured on Mashable or NYT.

It won’t take much to go from that to using cheap means to meet expensive needs: like reaching and engaging and educating the right people.

Yeah, sex sells. I’m sure some marketer will find a bright idea to connect a nice pair of legs with diabetes or cancer or bipolar affective disorder.

But Healthcare isn’t prostitution. And women aren’t objects. Neither are people with wellness needs or disease conditions.

My old man’s advice may be the best advice for this weird social media world we’re all being sucked into…or *down* into. You do have to dig into the dirt if you want to do social media “right”. It’s HARD work…really hard work

Being a gardener means being grounded, knowing the dark material you work with, and understanding the power of time and patience and persistence.

The work we do must be high quality.

When choosing what role to play in social media: decide between prostitution or gardening.

The web is a dirty world.

Make it beautiful or pay the high cost of selling your body to the lowest bidder.

@PhilBaumann – @HealthIsSocial


Ethics and Health in Social Media

We don’t talk much about the ethics involved with social media, especially in Healthcare where it matters most.

Why not?

Is because everybody is so absorbed with “how to use social media to______”?” that ethics isn’t even a thought?

We developed schools of ethics because ethical issues can be hard to spot on the surface. A general “be kind, be good” doesn’t cut it. No matter how good we are, it can be easy for us to commit ethical slips.

What are the ethics of following patients on Foursquare (a geolocation service)? Yes, geolocation has it’s place in health care and crises. But isn’t it a bit weird that hospitals would follow people’s check-ins, especially when most check-ins have nothing to do with any kind of health care?

What are the ethics of scouring public posts, tweets, status updates, etc.? Can researchers mine public data without any ethical restraint just because that data are public?

We aught not carry a dismissive attitude about what doors social media are opening up.

Just because a tool creates a new opportunity for you, it doesn’t mean you have to use it.


The discourse and assumptions and philosophies we adopt right now – today, this very year, this very moment – will forever shape the kind of civilization we make. Let’s call it ethical lock-in.

Do you not realize how transformative this age – this momentous, changing-right-before-your-eyes age – we live in is becoming every day?

Do you not see how Twitter can be used by the charming Hitler’s of the world to lead us into destruction? Remember: evil empires always slip in theough the cracks unfilled by dismissive peoples. Tweet by Hilter:


Adolf Hitler


RT @.FDR The only thing we have to fear is fear itself. << Except…Adolf Hitler, bit*ches! LOL

March, 1933 via UberTwitter

The above tweet sounds absurd: but it’s physically possible – had Twitter been around in the 1930s, it would have shaped the course of history. I don’t mean any offense or lightening of history – the point is that a dictator could very easily use these media to exploit entertainment and spectacle to throw his evil into the shadows under the guise of “that whacky guy”. Would you follow Hitler on Twitter? It’s an ethical question: follow him and you help build his “following” and thus boost his ego and possible reach; block him and you might not see what he’s up to.

What are the ethics of a hospital following patients? No right or wrong answer per se. But there are ramifications to following on Twitter – I can use software to see who a hospital follows (and who follows a hospital), map out all the connections, mashup dashboards of content – metadata – and use that for purposes nobody even considered when they hit the follow button. Just a thought. What if an insurance company did exactly that?

Do you not see how boundaries on Facebook can be easily violated?

Do you not see that a conversation in an elevator is not the same thing as a tangle of @ replies on Twitter? We do not live in a linear universe – the online world is *not* necessarily a mirror of the offline one: to believe that is an error of logic –

Do you not see how geolocation services can open wide the chance for governments to achieve their long-dreamt hope of the perfect Security State?

Do you not see how the Facebook Wall might be like Plato’s Wall? This is important – for if we do not understand our reality, how can we form ethics?


I’m not saying these media are all bad.

I am saying that we owe it to ourselves to think critically.

But I suspect that our dopamine receptors may be getting too full to deal with the hard brain-work which all ethical discourses require.

Hurry – the window for us to create healthy and democratic spaces on the Web is fast-closing.

An unhealthy and unethical civilization creates unhealthy and unethical people until it vanishes.

Healthcare professionals (including marketers) have a duty – and a right – to scrutinize the ethics of how social media is used; how they influence our health; and how to ensure that social media’s deceptive simplicity ramifies and complexifies ethical matters we take for granted.

If you truly love social media and don’t think this is a big deal, then why would you be afraid to have your ideas filtered through the rigor of critical examination?

The question mark is the ultimate social medium.

@PhilBaumann – @HealthIsSocial – Newsletter