Citizen Patient: Empowered and Unempowered

Empowered. Unempowered.

Engaged. Disengaged.

Educated. Uneducated.

Enlightened. Unenlightened.

Electronic (digital). Analog.

Words. Words matter. Words matter because they have the power to do completely different things, like: clarify and confuse.

Does it matter what we call human beings who have medical conditions? Are they patients? Do we use qualifying words to describe them? Empowered patient? Unempowered patient?

Lately there’s been words about the word ‘e-patient’. “Should we use this word?” “Shouldn’t we use this word?”

Does it all matter? I think it all depends on who you are.

If you’re my provider, you can call me a muther effer – I don’t care, as long as you know what you’re doing, assess me appropriately, answer my questions or point me to reliable resources, educate me…But that’s me. Not you. Or him. Or her.

Recent discussions and the meta-discussions about them have raised questions about the appropriateness and necessity of words like ‘e-patient‘. Susannah Fox proclaims:

New concepts need gimmicks. Proven concepts do not.

An eternal truth, with one exception: a proven concept without an audience might still need a gimmick. And perhaps all the discussion about these words comes down to the desire for a noble gimmick. Not an easy desire to satisfy. It’s a tenuous endeavor, a marketing problem really – one which can be brilliantly executed…sadly, more often botched.

Here are two other voices – read their stuff and you’ll be able to follow all the necessary links.

Bryan Vartabedian (@Doctor_Vasks if the e-patient revolution is over. I didn’t know there was a revolution but he makes a solid point about the commonness of analog and the perils of the proverbial echo chamber. He also notes that many patients aren’t using electronic resources – we could call them Analog Patients I suppose.

In a French-roasted post, Daphne Swancutt of HealthIntel, makes the case for not euthanizing the ‘epatient’. In it, Daphne may have identified the key pivot in the chatter over words:

One day, we’ll get to a point when all patients are e-patients. Perhaps then, we go back to the future and begin anew with “patient,” which will implicitly suggest e-patient. But, we’re not there, yet. Not today. Not tomorrow. Likely not next year.

That’s it: she’s acknowledged that ‘epatient’ isn’t ideal but that perhaps – for now – we do need some convenient call-bell to signify and communicate where we’re coming from so that providers and others invested in our well-being can take the most appropriate courses of action with us.

Now I don’t know if ‘epatient’ is that bell (you can read my preliminary views on what I coined the fPatient here), but her argument seems to be at the crux of the matter. The trick lies in how proliferative the word becomes – and if the sender and receiver are on the same page of meaning.

Ideally, healthcare professionals should have the training and experience and therapeutic communication expertise to treat their patients in accordance with their unique array of characteristics – we all have different communication styles, personalities, levels of passivity or activity.

Unfortunately, when they don’t, patients (my God -what word do I use in this post?!) are left to their own resources. And that’s where adjectives and letters might make a difference: those with the resources can ring their call-bell to others – to rally support, seek curated information, learn more about their condition, etc.


There is no right or wrong answer here. What matters is meaning and communication and citizenry (more on that word in a moment). Perhaps an amusing moment from Through the Looking Glass is worth invoking:

`When I use a word’, Humpty Dumpty said, in rather a scornful tone, ‘it means just what I choose it to mean – neither more nor less.’

In its simplest abstraction, seeking and receiving healthcare is about finding and getting solutions to problems.

Some people are actively engaged in their healthcare. Other’s aren’t. Engaged versus disengaged.

Some people use digital technologies. Others: not so much. Electronic (digital) versus analog.

But here’s the thing: regardless of your empowerment today, it might be lessened or taken away tomorrow. You might be Humpty Dumpty – and all you can hope for is that either you’ll be put back together again or change your world-view and find liberation in dignified acceptance.

When you become an unempowered patient, you are no less human than before. You do, however, become dependent on others to impute empowerment onto your person and to confer onto you the full rights of dignity and care and technical expertise which any true civilization labors to bring forth into a world of chaos.

We’re not always empowered, regardless of what we do. There are times when we are varyingly unempowered. What happens when you become unempowered?

Who takes care of you? Who speaks for you? Who breaks their back to rescue your dignity from death?

Regardless of what words we use, the fact is: we ultimately depend on professionals who manifest their oaths everyday – from their care to their research findings. We need cultures of caring that lessen the need for linguistic work-arounds. The Empowered Healthcare Culture.


If you asked me what word I might prefer that we call patients, I’d say: citizen. Neither more nor less.

A citizen has rights and responsibilities. A healthcare culture that encourages citizens to exercise the former and assume the later, engenders a more optimal environment of communication and healing.

And as a citizen loses power – either by lack of resources or education or disease or despair – we are obligated to raise our voices. The provider becomes charged with empowerment. The Empowered Provider. (Laugh, but remember: when providers work with limited resources and loony policies, they become less empowered. The Unempowered Provider.)

But here’s an interesting example of the power of words: If I asked my providers to refer to me that way – citizen – I’m certain many would wince quizzically and maybe even become outright dismissive. Why would they do that? Because it sounds to some ears, well, kind of ridiculous. It’s totally out of place with what we’re used to hearing in the context of healthcare.

Institutional Habituation.

And therein lies a deep problem: if viewing me (the patient) as a citizen is the tiniest bit unsettling, that says something about the culture of healthcare.

Think about that: in a sane culture, citizen is a word that should never tempt dismissal.

So allow me to utter the ridiculous (‘cuz that’s what I do best):

The empowered patient is a citizen.

The semi-powered patient is a citizen.

The unempowered patient is a citizen.

We are not all patients…all the time.

We are all citizens…every moment, from birth to death, engaged or disengaged, educated or uneducated, electronic or analog, enlightened or unenlightened, empowered or unempowered.

@PhilBaumann –  @HealthIsSocial@RNchat

Coming in a few weeks: an introduction to social media for healthcare. Sign up for our Webinar here.

Hospitals Can Block Facebook But Not the 21st Century


Healthcare organizations – hospitals in particular – have a moral and fiduciary duty to understand, evaluate and intelligently adapt to the technological and communications conditions of today.

This is a public health matter. In a world where data flows at the speed of electrons, doctors and nurses and other providers have unprecedented access to new ways of getting information and providing care to patients.

The issue of hospitals blocking access to social media like Facebook and Twitter has been a topic of debate. It’s time we address this matter with open minds.

You can catch up on this story if you need to here:

Before discussing hospital blocking of social media, let’s take a quick look at some general observations about our world:

  • Rates of technological change always exceed rates of cultural change
  • Human and organizational psychologies often convert legitimate concerns into irrational fears
  • The Web is an unstoppable media-producing medium
  • Communication, social exchange and information are critical components of Healthcare

Do you see where I’m going with this?

I know about privacy. And HIPAA. And patient dignity. (In fact, I’ve even had to fight hospital administrators over that last part.)

What I’m saying is: I know how important and concerning these matters are to administrators. They’re not “wrong” in being concerned. It’s the fear which is a problem.

I also know what it’s like to work in an environment with horrible information systems – systems that are disconnected from a world – literally a world – of information, crowd-sourcing and expert curation.


Facebook is a security problem.

You know what’s a security problem in hospitals? Ignorance. Misinformation. Fear.

Facebook is a risk.

You know what’s risky? Surgery. Suction tubes. Insulin pumps. Hospital acquired infections.

Surgery can kill you with the wrong cut. Facebook can’t.

Suction tubes can tear your lung tissue. Facebook can’t.

Insulin pumps can shunt you into hypoglycemia and kill you. Facebook can’t.

Hospital acquired infections kill approximately 100,000 people admitted to hospitals per year (that’s practically genocidal). Facebook can’t.

Healthcare has always had to address risk. What makes Facebook so more frightening than a hospital admission?

You know what else is risky? As more of the world uses social media as the leading way to publish and consume breaking news, it becomes easier and easier to miss critical alerts if you’re not monitoring Twitter or Facebook or other media.

Imagine a national disaster and hospitals are asked to partake in efforts, some of which are conducted via Twitter or other public media. Do you want to be in a hospital that has to take last-minute measures with IT to get connected?

See where else I’m going?


I can’t speak for other Healthcare professionals about whether or not we have a duty to learn about the Web and 21st Century communications.

But I will speak for myself: I took an oath to protect patients. And even though I don’t practice at the bedside, I consider my work and opinions and evangelism of the dangers and opportunities of the Web as extensions of my oath. I consider it my public health duty to do my best to explore, learn and question as much I as can about the Web.

In other words, I’ve done my best to bring a nursing perspective of the human condition to our understanding and use of the Web. And I have online colleagues who are doing that everyday.


Should Hospitals block Facebook?

That’s not really the question. Here’s the question:

Should hospitals block the 21st Century?

If they can, then that means they have access to technologies which can also probably cure all disease from the face of the earth.

Then they’d be out of business, and we wouldn’t have to fret about their policies over staples of mainstream communication like Facebook and Twitter. 🙂

And here’s the fiduciary responsibility part: the more comfortable a business is using social media internally, you know what happens? It becomes more proficient in marketing and public relations in our time.

Management is morally obligated to ensure the best care for patients. It’s also legally obligated to do what’s right for Investors.

They’re the ones with capital.

Which is to say: they are the ones who ultimately decide who keeps their job.

It’s a rough economy. Attention is a scarce resource.

Doing your best to know what century you’re in is never a bad career move.

by @PhilBaumann – @RNchat@HealthIsSocial

Recommended post: Inteview by @MarkRaganCEO on Executive Fear of Social Media

Find out more about healthcare and social media in our upcoming Webinar. Find out more and sign up here!

Webinar – Healthcare Social Media: Perspectives in Practice

Health Is Social is excited to deliver its first Webinar on Thursday, August 26, 2010 at 1:00pm – 3:pm EST, 10:00am – 12:oopm PST, 6:00pm – 8:00pm London:

Healthcare Social Media: Perspectives in Practice will showcase the practical perspectives of four pioneers in healthcare social media.


If you’ve decided that Social Media is here to stay and you’re either planning or implementing your social media strategies and presence, but are still figuring out what to do or what more you can do, then you’ll want to attend this Webinar.

The purpose of the Webinar is to expand on the theoretical bases of healthcare social media with specific examples and views. Health Is Social believes that social media offers a robust array of possibilities within healthcare, requiring different perspectives on what can be done.

In this Webinar, we cover four of these perspectives: the patient’s, the provider’s, the healthcare organization’s and the professional’s (internal staff):

Hospitals, healthcare associations, practitioners interested in developing their online presence are encouraged to attend the Webinar. We believe Social Media goes deeper than just public relations – these new media offer opportunities to improve collaboration, help redesign internal processes and provide novel ways of adding value to all of an organization’s information customers.


We have four terrific presenters whose collective knowledge and experience offer a unifying blend of themes in healthcare social media:

Dave deBronkart – Patient Perspective

Dave deBronkart

Dave deBronkart, author of Laugh, Sing and Eat Like a Pig, will provide the Patient Perspective.

An accomplished speaker and writer in his professional life before his illness, today Dave is actively engaged in opening health care information directly to patients on an unprecedented level, thus creating a new dynamic in how information is delivered, accessed and used by the patient. This is revolutionizing the relationship between patient and health care providers, which in turn will impact insurance, careers/jobs, quality of life and the distribution of finances across the entire spectrum of health care.

Dave blogs regularly at and actively participates in community discussions on empowering patients. You can follow his wisdom on Twitter by following @ePatientDave.

Bryan Vartabedian, MD, FAAP – Provider Perspective

Bryan Vartabedian, MD

Dr. Vartabedian is Assistant Professor of Pediatrics at Baylor College of Medicine in Houston, Texas and attending physician at Texas Children’s Hospital, America’s largest children’s hospital.

Beyond practicing as a pediatric gastroenterologist, he has an interest in the evolving role of social media in health care.  Since 2006 he has been active in the health blogosphere and currently blogs at 33 Charts.  As an active speaker, he has addressed the AMA, American Telemedicine Association and the Texas Medical Association on the issue of MDs in social media.  He maintains an active presence on a variety of social media platforms and in between patients you can find him on Twitter.  In his free time, he serves as a strategic thinker for the next-generation physician social network, iMedExchange.

Erin Macartney : Healthcare Organization Perspective on Partnering Patients with Healthcare Team

Erin Macartney

Erin is a public affairs specialist at the Palo Alto Medical Foundation, where she coordinates the social media program, and is responsible for PAMF’s Facebook and Twitter accounts and online newsroom. She is also a regular contributor to Ragan’s HealthCare Marketing and Communications News. PAMF uses a variety of communications tools to create relationships with patients and further health education – helping people become active partners in their own health and health care team.

Previously, Erin was corporate communications manager at Quintiles, an international bio and pharmaceutical services provider; worked in corporate communications at Amgen, a pioneer and leading company in the biotechnology industry; and as a freelance writer and communications consultant. Erin is active in the #hcsm community and co-founder of HCSM Silicon Valley (@hcsmSV). You can follow her on Twitter at @emacartney.

Angela Dunn, Odom Lewis – Professional Development Perspective

Odom Lewis

Angela Dunn, Dir. of Social Media & Recruiting for Odom Lewis, helps you navigate social media for your personal and professional brand in healthcare and pharma marketing.  Angela has more than twenty years of experience in marketing communications.

In addition to helping place top leadership in healthcare and pharma marketing communications, Angela also helps coach CEOs and senior leadership on social media. She was recently featured on the American Express OPEN forum and interviewed by MSNBC at TWTRCON in NYC.

Angela was also among the top 12 bloggers asked to participate in “Best Strategic Learning Investment for 2010” for pharma and healthcare marketers. Angela blogs for Odom Lewis and is responsible for their Twitter account @OdomLewis and their newly developed Resource Hub for Healthcare and Social Media professionals on Facebook.


Order tickets below or visit the event page here.