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ealthcare has been changing in drifts and shifts over the past few

centuries.

The drift can possibly be pinned from 1600s when medicine

came to be widely accepted as an expertise separate from reli-

gion. The subsequent centuries saw us drifting into a scientific

understanding of disease and its causes. The first dramatic shift

came with the discovery of antibiotics in 1930s. We now had

pills which could cure giant killer diseases and this led to the

rise of a new behemoth, the Pharmaceutical industry. With regu-

lar discovery and later inventions of newer drugs, power seem-

ingly concentrated with the Physician- the drug dispenser. The

healthcare ecosystem settled into a physician centric system,

with the doctor exercising complete power over the patient and

all other stakeholders revolving around the doctor. This was

always an unstable ecosystem because of the power imbalance

among the stakeholders and the coming of internet has upset the

traditional positions irrevocably.

The internet was the second major shift. Tim Berners-Lee

(father of Internet) made the biggest financial sacrifice in recent

times when he refused to patent his hyper text transfer protocol

and instead threw it open for the Aam Aadmi. Ordinary people

used this new found power of instant low cost communication in

wonderfully diverse ways and healthcare social media was born.

People realized the power of information and sought more of it.

This new communication platform totally changed the way

healthcare stakeholders talked to each other. Lately, the patient

has taken his rightful place as the center of the new healthcare

ecosystem, with all other stakeholders working to woo that cus-

tomer. The recent regulations regarding generic medications will

only strengthen this new position. Since patient, and not the

doctor, will now make the purchasing decision, all stakeholders

in this ecosystem (Pharma, labs, hospitals) need to reconsider

their strategies and focus on the true consumer.

Many savvy entrepreneurs have already smelt the coffee.

Now, many stages of healthcare services can be accessed

online. You can track your health using Smartphone apps

and websites. When unwell, you can check your symptoms

to arrive at a presumptive diagnosis online. It‟s easy to

search for a suitable physician in your geographical area

who you might want to consult. Compare rates and services

at various hospitals. Book your appointments. Receive your

lab reports and prescriptions in the comfort of home. Join

social support groups and get information about alternate

treatments or therapies. Store all your health records digi-

tally and get second opinions from anywhere in the world.

Doctors can monitor their patients remotely and even tweak

treatments from a distance. They can discuss treatments and

obtain referrals in secure online platforms. The effect of

Internet and social media is just too huge to be ignored.

To borrow an analogy from Jed Weissberg, MD, Senior

Vice at Kaiser Permanente, the Choluteca Bridge is a meta-

phor for today's healthcare ecosystem. The Choluteca

Bridge was built by the U.S. Army Corps of Engineers in

1930 with design strength to withstand the worst of hurri-

canes that affected the area. When Hurricane Mitch came in

1998, it destroyed 150 Honduran bridges, but not the Cho-

luteca Bridge. Instead, the storm rerouted the Choluteca

River. This rendered the huge, strong and beautiful bridge

useless as it served no purpose in the changed environment.

The true potential of healthcare social media has not even

been scratched on its surface yet. The focus on cloud com-

puting and Big data can work wonders in the field of medi-

cal communications. At Digital MedCom solutions, we

currently tag 25,000 Indian physicians via weekly emails

and popular social media platforms. Our aim to have an

active social database of all 500,000 practicing Indian phy-

sicians (or at least the approx. 250,000 active onliners)

within the next 2 years is not as farfetched as it may seem.

All the stakeholders in healthcare, except the patient, seem

to be ignoring social media at present. Unless steps are tak-

en to remedy this inertia, traditional pharmaceutical indus-

try is destined to go the Choluteca Bridge way.▌

Medical Communication in the 21st Century

Dr. Neelesh Bhandari is the founder and Chief

consulting officer at Digital MedCom solutions,

India‟s first healthcare social media agency. You

can contact him via email (drneelesh@digmed.in)

or Twitter (@edrneelesh).

Dr. Neelesh Bhandari