Results from two recent surveys reaffirm longstanding trends in the ways patients of different ages use social media and the internet to access health information and communicate with physicians. The surveys' findings also illustrate the growing importance of social media in the doctor-patient relationship and underscore the communication challenges family physicians face while trying to meet the needs of a diverse patient base.

Social Media: To Friend or Not to Friend?

The first survey,(www.osteopathic.org) conducted on behalf of the American Osteopathic Association (AOA), asked questions about social media use and the sharing of health information. Of the 2,204 U.S. adults surveyed, 551 were ages 18 to 34 and were categorized as millennials by the AOA.

Among the results:

• 54 percent of millennials and 42 percent of all adults either are or would like to be friends with or follow their health care professional on social media.
• 65 percent of millennials and 43 percent of all adults think it is appropriate to use social media to contact their physician about a health issue, either by posting a message on the physician's web page or via direct message.
• 32 percent of those surveyed have taken a health-related action such as modifying their diet, taking a dietary supplement, changing their exercise routine or trying an alternative treatment based on information they read on social media. (The survey did not indicate whether adults consulted with their physician before taking a health action.)
• 15 percent of parents with children younger than 18 have self-diagnosed a health concern based on information they read on social media.

Communication and Access

The second survey,(www.healthyagingpoll.org) part of the National Poll on Healthy Aging, asked a group of 2,013 older adults ages 50 to 80 about their experiences using secure online patient portals to obtain and exchange health information.

Among the findings:

• Only 51 percent of those surveyed have actually set up an account on a patient portal. Higher rates were seen in women (56 percent compared to 45 percent for men) and adults with more education (59 percent for those with some college versus 40 percent for those who graduated from high school only).
• When asked why they had not set up a patient portal account, 40 percent of respondents said they did not like communicating about their health by computer; 38 percent didn't think it was necessary to set up a portal account; and 26 percent said they were not comfortable with technology.
• Among those who had set up an online portal account, 84 percent used it to view test results, 43 percent used it to refill a prescription, 37 percent used it to schedule an appointment, and 26 percent used it to get advice about a health problem.

Although online portals may solve some communication issues, many older adults appear to be more comfortable contacting their physician's office and speaking with the physician or a staff member. Poll results showed that under some circumstances, older patients thought that talking by phone was more effective than using a patient portal.

Specifically,

• 47 percent of patients rated the phone as a better way of communicating in terms of having the ability to explain their request to a health care professional, compared to 21 percent who rated the portal as better.
• 36 percent of patients said the phone is better with regard to how long it takes to get a response, compared to 34 percent for the portal.
• 30 percent of patients rated the portal as better in helping them understand the information received from their health care professional, compared to 27 percent who said the phone was better and 43 percent who rated them as about the same.

In addition, some adults who had not set up a patient portal account cited specific concerns about doing so:

• 26 percent reported being very concerned about a greater chance of error with a portal compared with talking to a health care professional in person or by phone.
• 18 percent were very concerned that they would not know who was answering their questions.
• 16 percent were very concerned that it would take a long time to receive a response.

"Many older adults still prefer telephone contact with their providers," explained Preeti Malani, M.D.,(www.upi.com) a professor of medicine at the University of Michigan in Ann Arbor and the poll's director. "We hope providers, and health systems, will take these findings into consideration when designing the ways patients can interact with them," she told HealthDay News.

Putting Online Communication in Perspective

Although people who use social media to speak with their physician or obtain health information make up only a fraction of the total number of people who use social media, it's important to see how those numbers stack up with the general population.

According to the Pew Research Center's Social Media Use in 2018 survey,(www.pewinternet.org) 88 percent of American adults ages 18 to 29 use some form of social media. That share drops with age, falling to 78 percent among adults 30 to 49, 64 percent among those 50 to 64, and 37 percent among those 65 and older. The most popular platforms among all adults are YouTube (73 percent) and Facebook (68 percent). However, more than half of young adults also use Snapchat and Instagram (68 percent and 64 percent, respectively).

In many instances, people are accessing social media throughout the day. Seventy-four percent of Facebook users, 63 percent of Snapchat users and 60 percent of Instagram users visit those sites one or more times per day.

And people aren't restricting their social media use to just one platform. The survey found considerable overlap between users of different services. For example, the survey results showed that 87 percent of people who use Facebook also use YouTube, and 90 percent of people with a LinkedIn account also use Facebook. As with overall use, the average number of social media platforms used was highest among adults 18 to 29 (four), decreasing to three platforms among adults 30 to 49, two among those 50 to 64, and one among those 65 and older.

How Family Physicians Are Meeting the Challenge

Family medicine is sometimes referred to as a "cradle-to-grave" specialty. At a given moment, the typical family physician's waiting room may contain patients of virtually any age. This diverse mix can make it difficult for FPs to find ways to effectively communicate with their patients on social media without overstepping the bounds of privacy and confidentiality.(www.hhs.gov)  

Fortunately, evidence from the latest AAFP Member Profile(14 MB PDF) suggests that family physicians are already stepping up to meet the challenges in communication that come with treating such a diverse group of patients. Profile survey results indicate that:

• 69 percent of active AAFP members have a web portal that allows for secure messaging;
• 57 percent have a web portal for prescription refills;
• 51 percent communicate with patients via e-mail;
• 44 percent have a web portal to schedule appointments and share health information; and
• 12 percent offer direct text communication with patients.

In addition, 20 percent of AAFP members report using telehealth services in their practices. The two main reasons for implementing these services are to improve patients' access to care (78 percent) and to provide more convenience and flexibility for physicians and office staff (61 percent).

Significant numbers of AAFP members also report using a phone or mobile device regularly for direct messaging (81 percent), checking e-mail (78 percent), going online (76 percent), and accessing social media (45 percent).

The Bottom Line

As these surveys show, the way patients and physicians interact has forever changed as increasing numbers of patients communicate using e-mail, a social media platform or a web portal. Younger patients -- in particular, those under 30 -- are far more comfortable texting or e-mailing their physician; they also are more comfortable looking up health information online. Older patients, although willing to use online portals for some services, nevertheless remain satisfied with more traditional methods of communication.

Family physicians are responding to these trends by adjusting their own communication methods to best address the needs of their patients. As patient demographics shift, FPs will want to continue to take these considerations into account and plan their communication and patient outreach strategies accordingly.