In PM360’s March 2014 Digital Compendium, I wrote about the power of a single patient’s online negative comments to ruin your business. Now I want to explore the incomparable power of an online patient to affect decision points, behaviors and the health outcomes of other patients. Specifically, how do they do that?
Let’s explore the dynamics and psychological influences of online patient to patient support.
Someone Just Like Me
I am very vocal, self-disclosing and physically exposed on social media as an obesity health advocate. With great frequency, I receive messages both publicly and privately from patients who tell me what a pivotal difference I have made in their lives. Indeed, my shared experiences have proven to be the turning point for others to take control of their health and their lives. Many who want to achieve what I have achieved do exactly what I have done to get here.
In turn, the positive feedback I receive not only inspires me to continually contribute to the community but it also motivates me to be diligent in continuing along my healthy pathways. Often, those patients who have learned from my experiences then go on to inspire me and others in the community with their individual shared experiences.
In other words, we click. We connect. We fit well together. And we energize each other to reach our potential and succeed in our health goals.
That’s not so unusual. Most of us have experienced that sense of instant rapport with a stranger. It can be love at first sight with someone you meet at a party, a colleague with whom you instantly bond at the start of a project, or a miserable fellow customer waiting in the long supermarket checkout lane just before Thanksgiving.
We often click with people who have similar interests or experiences. And when that happens in the context of healthcare, the effect can be extraordinary.
What Makes Us Click?
Social media fosters an environment in which patients can click (identify and engage) with other patients who then shape our thinking, behavior, emotions and actions. Authors Rom and Ori Brafman study the science of click in their book, Click: The Magic of Instant Connections. They identify five “accelerators” that increase the likelihood of these kinds of magic connections in our relationships. These are: vulnerability, proximity, resonance, similarity and environment. The authors claim that these factors show up time and again across different contexts. For the purpose of this article, I will explore the context of online patient to patient relationships.
Vulnerability: The anonymity offered by the Internet through constructs such as avatars, private messaging and nameless email addresses, allows us to more easily open up. We pass through the intimacy barrier and communicate on a deeper level about ourselves. This in turn increases the online patient community’s perception of our trustworthiness.
Proximity: The closer the physical proximity, the emotionally closer people are likely to become. However, the digital connectivity through online patient communities does create very powerful connections. Time and again, patients who have never met me do amazing things for me. And I have done amazing things to help online patients, often never knowing their faces or their real names. Exceptional compassion and loyalty mark these relationships.
Resonance: Patients who interact online tend to match the emotional expression of the community. They tend to face the same set of challenges and successes concerning their health condition and the emotions surrounding them.
Similarity: Patients affect and appeal to each other in a very personal and emotional way, which anyone outside the community—including their caregivers and healthcare professionals—simply cannot. There is an “us” and “them” mentality.
Environment: An online community is so much more than a website with good content and graphics. It is patients’ shared experiences that create the sense of community. Community is a source of similarity.
These factors, or chemistry, create what the Brafmans term “quickset intimacy” and change the balance of power in the patient-physician relationship by inserting a new paradigm into healthcare: The patient-patient relationship.
But why is it that patients listen to advice just because it came from another online patient? It defies conventional wisdom that when making such important, if not life changing decisions around health, a patient will turn to a lay person who they have never met rather than an authoritative source. Many would call this behavior irrational. But with increasing likeliness, online patients will be swayed by the words of another online patient even over the advice of their physicians.
An influential online patient can have big effects. Author Malcolm Gladwell’s thesis that ideas, messages, behaviors and products “spread just like viruses” is a metaphor for the spread of what I call “word-of-mouth health.” When the opinions and experiences of an online patient cause small numbers of patients to start behaving differently, that behavior can ripple outward until a critical mass or a “tipping point” is reached.
In his book, The Tipping Point: How Little Things Can Make a Big Difference, Gladwell defines three pivotal types of powerful influencers: Connectors, sociable personalities who bring people together; Mavens, who like to pass along knowledge; and Salesmen, adept at persuading the unenlightened. So if we apply Gladwell’s “tipping point” concept to the current phenomena of empowered patients who leverage social media to reach other patients, then we can begin to understand how those e-patients who are one or more of these archetypes can be extraordinary change agents for patient health.
The Bottom Line
Whether rating a physician, giving an opinion on a prescription drug, advising patients on their treatment choices, or blogging about their condition experience, online patients have changed—and will continue to transform—the way people around the world manage their health. The traditional practice of paternal medicine in which patients were kept in virtual ignorance is dead and the emerging model looks something like this:
The patients research and discuss their condition and treatment options online. Patients read online reviews before selecting their doctor. An informed patient goes to a doctor visit prepared with questions—and a preferred treatment option in mind. The disparity gap in terms of information about their condition and treatment options is narrowed and the doctor and patient have a productive dialogue, negotiate and agree on a treatment approach.
The patient goes back online to research the things the doctor said and confirms these with online patients and sometimes with online physicians. Discrepancies are redirected to the doctor for further discussion and clarification and a shared decision is reached. The patient continues along his/her journey in this continued research, validation and decision cycle until satisfaction is reached and health goals are achieved.