Naren Arulrajah

As we entered the year 2020, life in North America seemed quite normal and unlikely to change. In January, COVID-19 was a newly emerging, yet-unnamed disease in a far away place. Many people were unaware of it, and few considered it a potential local threat.

One of the first warnings to garner public interest came in the form of a now-deleted tweet from 

, an epidemiologist who had approximately 2,000 followers on Twitter. In a matter of months, his audience increased tenfold, and he has been quoted in national media sources including 

. How this happened is both a social media success story, and a cautionary tale about content creation in the age of coronavirus.

You have probably read the standard social media marketing advice: create sharable content. Many doctors ask exactly what that means, and there is no single right answer. However, there are a few common guidelines. The tweet that landed Feigl-Ding squarely in the spotlight checks all the boxes:

Include images – Visual content tends to perform best on most social networks. The tweet included graphs, which may have been too technical for the layperson to understand, but they were visually appealing.

Provide value – People tend to share content that they find informative, entertaining, or otherwise useful. Feigl-Ding was issuing a warning, something people felt that others needed to know about.

Use a catchy intro – Social media users tend to scan their feeds, and you need to grab their interest right away or they will keep scrolling. The infamous coronavirus tweet began “HOLY MOTHER OF GOD” in all capitals. It was a dramatic, possibly alarmist statement – and it was attention catching.

Establish credibility – With the plethora of misinformation on the internet, people are sceptical of vague statements. Links, statistics, expert quotes, or facts and figures lend credibility to education content. Feigl-Ding’s 

 a link to a scientific paper, and described the new coronavirus having a R0 of 3.8, making it as eight times as contagious as SARS. He had made an error in the comparison to SARS. By the time he published the tweet, researchers decreased the R0 estimate for this new virus. At the moment, he was unaware of those facts, as were his followers. It appeared to be proven facts and science.

Be social – If social media were a physical place, it would be the casual coffee shop on the corner or the roadside diner. Dull, dry content is boring, and an overly formal tone seems out of place. Feigl-Ding’s tweets are mostly written in non-clinical (some would say unprofessional) terms and liberally sprinkled with emoticons, slang, and personal commentary. It is relatable.

How to avoid the follies of social media success

The core of Feigl-Ding’s message was correct and important. This strain of coronavirus did indeed become a pandemic, the likes of which we have not seen in recent history. Yet, it also included misinformation, outdated figures, and a flamboyant style that does not convey professionalism. Throughout the pandemic he has continued tweeting in similar style. As a result, he has gained a reputation as a

This is the unfortunate downside to social media success. A mistake is unlikely to haunt you if only ten people see it. However, it may become fodder for local or national media if tens of thousands see it. Unless you wish to cultivate a controversial image, it is good practice to double-check facts and avoid sensationalist statements. Furthermore, the unprecedented nature of the pandemic presents unique challenges. For example:

Facts can change – The tweet discussed above included outdated facts, even though Feigl-Ding posted it immediately after reading the paper. Many months later, the latest information is still evolving at lightning speed. Verify statistics immediately before posting and remove or update old material to avoid causing confusion.

Best practices change – Early on, Feigl-Ding had supported the idea that facemasks were useless. Within weeks, he changed course and embraced mask-wearing. His advice was in line with official recommendations, but it was often presented as his own opinion, making the sudden change seem self-contradictory. Be clear and concise in your public messaging.

Remember your audience is not clinicians –The secret ingredient in Feigl-Ding’s remarkable social media popularity is likely his relatable tone and style. He puts complex information in terms the average layperson can understand and relate to. However, there is a danger in over simplifying. People may take your statements too literally or misinterpret your words. Choose your words carefully and avoid generalizations or out-of-context comments.

Eric Feigl-Ding is just one example. Jeffrey VanWingen, gained unexpected fame for making a 

. Unfortunately, he is a family physician, not a food safety expert. Therefore, he included advice such as washing vegetables with soap, which is considered unsafe because it can leave a residue. He also made a general statement about leaving groceries in the garage for days, without stipulating to exclude perishables.

 of medical professionals successfully using social media to provide valuable, beneficial, important information to the public – and simultaneously building an excellent reputation. The key is a combination of meticulous fact-checking and a keen awareness of your reader’s mindset.

, has been a leader in medical marketing for over a decade. Ekwa provides comprehensive marketing solutions for busy doctors, with a team of more than 180 full time professionals, providing web design, hosting, content creation, social media, reputation management, SEO, and more. 

If you’re looking for ways to boost your marketing results, call 855-598-3320 for a free strategy session with Naren.

Articles

What we can learn from an epidemiologist’s rise to social media stardom.

Content Creation in the Age of COVID-19

Whether by shelter-in-place mandates or personal choice, people are staying off the streets and on the computer in record numbers. Many aspects of life are moving online, and that includes healthcare. 

For doctors who previously resisted technology, the adjustment can be daunting. This article covers some of the basics that you should know if you are new to telemedicine.

Is telemedicine a good fit for your practice?

Yes. The options are extensive and rapidly growing, making telemedicine a good fit for nearly any practice:

Virtual consultations – This is usually in the form of a video chat, with real-time communication, also known as synchronous telemedicine. It may be used for preliminary diagnostics based on symptoms, post-treatment follow-ups, treatment planning, and other non-contact care.

Store and forward – Data is collected and sent for review. This can range from medical records transferred from another physician, to a photo taken by a patient and emailed. It allows you to source multiple types of data, if needed.

Remote monitoring – Medical devices or even apps on a patient’s mobile phone can record and transmit information ranging from blood pressure and heart rate to essential biometric data.

Enhanced patient communication – From simple secure messaging apps to full featured online portals, you have a wide range of options to connect with patients. These tools can help you perform post-treatment check-ups, allow patients to ask questions, monitor healing, refill prescriptions, and much more.

The first thing to consider is insurance. Find out if your malpractice coverage includes telemedicine. If not, you will need to update your policy before beginning. Next is services and pricing. Decide what you will offer, which clinicians will participate, how much you will charge, and how billing will be handled. Aside from these preliminary considerations, there is little stopping you from implementing telemedicine immediately.

Currently, you can conduct virtual consultations with nearly any private messaging or video app, including Skype, Facetime, and Google Hangouts. Since your clinicians and patients probably already use these technologies, implementation is incredibly simple. That is by design – and it is 

In response to COVID-19, HHS Office for Civil Rights (OCR) issued a 

, which essentially loosened HIPAA requirements relating to telemedicine. When they deem it appropriate, they will rescind the notice, and full enforcement will resume. Therefore, even if you start with a familiar app, you should upgrade to HIPAA compliant software as soon as possible.

It is called by many names including telemedicine, telehealth, mHealth, eHealth, and more. The first question many doctors ask is exactly what these terms mean, and how they are different. As this is an emerging part of the healthcare field, the answers are not clear.

eHealth (electronic health)– This is the broadest term, and it is used globally. Although it has not yet made its way to most dictionaries, 

 defines eHealth as the use of information and communication technologies (ICT) for health.

Telemedicine – This is probably the most widely accepted term, with listings in both 

dictionaries. It is described as the practice of medicine remotely using communication technology, a definition echoed by the 

United States Health Resources Services Administration

Telehealth – This might be the most familiar term to patients, who likely use interchangeably with telemedicine. However, some organizations make a distinction between the terms, and there are widely varying definitions. Most notably, 

uses telehealth to describe only real-time (live) audio and video communication between the clinician and patient, whereas telemedicine also encompasses store-and forward technologies, remote monitors, and other technology. The 

, on the other hand, considers telehealth a much broader term, encompassing telemedicine as well as non-clinical technologies such as remote training.

 explains mHealth as “medical and public health practice supported by mobile devices,” while noting that there is not a standardized definition. This characterization is mirrored by the 

Why does the terminology matter? There are two primary reasons. First is clarity of communication. If a vendor offers “mHealth software,” it is probably limited to mobile devices, and if they offer a “complete telehealth solution,” it might not have the full scope of features you expect.

The other reason you need to know these terms is marketing, especially SEO (search engine optimization). All these terms are potential keywords, and good starting points for keyword research. However, a quick look at 

 will show that interest increased dramatically, coinciding with the emergence of COVID-19. You will also see that telehealth is the most popular search term followed closely by telemedicine, and far fewer people querying eHealth or mHealth.

Do not think of telemedicine as a fad that will pass when life returns to normal. It is a natural evolution of healthcare, and it is here to stay. Modern life is infused with technology, a trend that has been developing for years and was rapidly accelerated by COVID-19. For obvious reasons, healthcare will never move entirely to the digital space. However, some aspects of it can, and patients are eager to see this happen.

In regions with pandemic-related lockdowns, telemedicine proved to be the lifeline for many practices. When people cannot leave home, they lack access to important services. However, that problem existed in smaller scale long before coronavirus.

Rural populations, shut-ins, people with no transportation, and disabled individuals without caregivers are just a few examples of those who routinely lack access to medical care. There are also many uninsured people seeking affordable options, and those who simply want the convenience of virtual visits. Technology offers a variety of ways to connect with these patients, as well as improving the quality of care for current patients. Furthermore, it offers an opportunity to expand your practice and revenue without the expense of additional office space.

COVID-19 has changed life as we know it in many ways, some temporary and some long-lasting. Telemedicine, along with other accelerated digital trends, are likely to be some of the most enduring impacts. Embracing the digital side of healthcare is not just about getting through this crisis. It is about improving and future-proofing your practice.

For doctors who previously resisted technology, the adjustment can be daunting.

Going Digital: The Essential Guide to Getting Started in Telemedicine

Never before have we faced such an extensive global health risk and economic disruption. Amid stay at home orders, social distancing guidelines, and overwhelming fear, countless businesses are closing, including many medical practices. Some do not know when or if they will reopen.

Keeping the doors open: is it possible and feasible?

There is no question that the crisis will affect your practice. The question is how severe the impact will be, and how you can stay afloat in these uncertain times.

To some extent, the decision may be out of your hands. At the time of this writing, cosmetic, elective, and non-urgent medical treatments are currently prohibited in many areas across North America. However, some remain open and restrictions are expected to ease in coming weeks.

The situation is fluid, so it is essential that you stay up to date on the latest requirements and recommendations. Beyond legalities, there are several things to consider before deciding to (or not to) close your practice:

Assess the health risk: Can you reasonably protect clinicians, other staff members, and patients? This depends on your location, patient demographic, type of services you offer, and even the layout of your office. It will also change over time, as the rate of spread increases and decreases in your locality, so you should constantly re-assess.

Determine the need for services: It might not be financially feasible to keep your office open and staffed for emergencies if they are rare in your specialty. On the other hand, if you are likely to see a lot of emergency patients, it may be profitable to remain open, and it may alleviate some of the burden on local ER facilities.

Review your insurance: Of course, your policy will not explicitly say whether you are covered for Covid 19 related liability, because the disease did not exist when you purchased insurance. It will be included under some policies, but not all. If you are not sure, contact your insurance company or talk to your lawyer. You need to understand your liability before deciding.

Maybe you have decided to stay open, but it certainly is not business as usual. The situation can change on a daily — sometimes hourly – basis. Do not let your office devolve into chaos!

Instead, expect the unexpected. Be prepared and keep your team prepared:

Take stock of supplies: The worldwide shortage of personal protective equipment (PPE) and other medical supplies is unprecedented. What is available today might not be tomorrow. Take inventory of what you have in your office and estimate how long it will last. If you expect to run out quickly, it may be prudent to limit services to the most serious emergencies. Some practices have been forced to close due to lack of supplies.

 what to expect, but we can make a good guess, at least for the immediate future. Rather than postponing decisions until you have solid answers, make a detailed plan based on current information. It can be adjusted as things change, but at least you will have a starting point. Also try to anticipate possible “what if” scenarios. What if a clinician or staff member contacts Covid 19? What if a patient displayed possible symptoms? What if you run low on PPE supplies?

Establish a clear chain of command: Despite your best efforts, unexpected issues can and probably will arise. Who has the final word in important decisions? What if that person is not available and the situation is urgent? Do several people need to discuss important matters? If so, how will you call a virtual meeting? You want to answer these and similar questions before they arise.

Keep staff informed: Do not just plan ahead in your mind. Document the appropriate process for handling various situations and discuss your plans with your team. Make sure everyone knows the chain of command, and that they have applicable contact information. The last thing you want is an employee faced with an unexpected problem and no idea what to do or who to call.

Unless you specialize in infectious diseases or operate an urgent care facility, you can expect a reduction in patients. That means a reduction in income, at a time when you and your employees can least afford it. However, there are steps you can take to minimize the impact:

Explore telehealth options: Online appointments are a great way to conduct post-treatment follow ups, initial consultations, discuss future elective treatments, and in some cases even preliminary visual diagnostics. This can expand your range of services, increase your income stream during the crisis, and reduce the number of people physically present in your office. Even if you must close your doors for a time, you can remain open for virtual business.

Consider alternate services: If your practice focuses on aesthetic or other “nonessential” services, you might have to close for a time. However, you may be able to temporarily transform into an essential facility. For example instead of smile makeovers, offer emergency dentistry. Instead of Botox, offer treatment for wounds, burns, and other dermatological emergencies.

Be financially proactive: Do not wait until you are confronted with a bill you cannot pay. Crunch the numbers. See what your projected revenue looks like and compare that to your financial obligations. Start contacting vendors to inquire about potential discounts or options for delayed payment. Look into loans. Explore ways to reduce expenses if needed. Make a contingency plan and be prepared.

Adjust your marketing strategy: First and foremost, if you are limited to emergency patients make sure you have paused any advertisements for elective procedures. Running these ads is not only a waste of money but it will give people the impression that you are not following local mandates. Secondly, optimize your marketing for emergency services, post on social media to let people know you are available, and use other applicable channels to get the word out.

The loss of human life is unquestionably the greatest tragedy of this pandemic. However, it is far from the only effect. An unknown number of businesses will not recover, and countless jobs will be lost. With some careful planning and smart decisions, you can make sure that your practice does not succumb to the economic fallout.

, has been a leader in medical marketing for over a decade. Ekwa provides comprehensive marketing solutions for busy doctors, with a team of more than 180 full time professionals, providing web design, hosting, content creation, social media, reputation management, SEO, and more. If you’re looking for ways to boost your marketing results, call 855-598-3320 for a free strategy session with Naren.

To some extent, the decision may be out of your hands. But what about the decisions that are still yours to make?

Can, and Should, You Keep Your Practice Open Through the Pandemic?

In Google’s infancy, a local doctor’s office didn’t have much chance of topping search results for most queries. You were competing with the entire internet for those top spots. Today, Google’s algorithm is smart enough to know when searchers are looking for a local business, and results are filtered accordingly. That means you don’t need to dominate the internet, just your service area. It also means you need to understand the rules of local SEO (Search Engine Optimization).

Think of it this way. Classic SEO is about optimizing your website. Local SEO revolves around optimizing your practice’s online presence, including the website and beyond. The most glaring difference between the two is demonstrated by citations and links.

In classic SEO, the general goal is to acquire inbound links from the most authoritative, highest-ranking domains possible. The general theory is the more links the better, providing they are from quality websites. A link from a small, low-traffic website is virtually useless; a mention (citation) without a link is completely useless. However, in local SEO, both of those can be valuable.

A citation is essentially a mention of your practice, somewhere on the internet. In many ways, SEO citations are akin to those found in the footnotes of a research paper. When you see the same study or expert cited repeatedly on various papers, you probably assume that the source is credible. Similarly, references to a business help Google confirm its validity.

Google uses citations to gather details about local businesses. When it finds matching information on multiple quality sites, it has a high degree of confidence in the accuracy of that data. A business with few to no citations might not even exist. If there are multiple listings with variations in NAP (name, address, phone number) they might be different businesses, or the details might be wrong. Therefore, inadequate or inconsistent citations can keep your medical practice out of the top spot on local search results.

There are two basic types of citations, structured and unstructured. Both are important.

These have specific fields for name, address, services offered, and other types of information, which makes it much easier for Google to find specific data. This helps validate your NAP.

Structured citations are often found on directories and similar websites where you can add a business profile and update information as needed. Start by claiming and optimizing your Google My Business profile, if you haven’t already done so. The next step is adding your practice to other local business listings, review platforms, and healthcare provider directories.

This is a less formal type of citation, which doesn’t follow a specific format or have data fields. Unstructured citations might be mentions of your practice in blog posts (not your own blog), news articles, or patient information websites. They can be more difficult to acquire and manage because they often come from earned media. For the same reason, they can be helpful in building authority.

Sometimes you can get local links simply by asking. For example, if your practice donates to a local charity, ask to be listed as a sponsor on their website. Always make yourself available to local health reporters, who often seek expert commentary. Additionally, hosting events and community involvement are great ways to gain local media attention.

Standard SEO best practices are just one aspect of local search marketing. As brick and mortar businesses, medical practices need more than domain authority. They also need local authority and credibility, and they need citations to prove it.

, has been a leader in medical marketing for over a decade. Ekwa provides comprehensive marketing solutions for busy doctors, with a team of more than 180 full-time professionals, providing web design, hosting, content creation, social media, reputation management, SEO, and more. If you’re looking for ways to boost your marketing results, call 855-598-3320 for a free strategy session with Naren.

Advice from the CEO and President of Ekwa Marketing on how to improve SEO ranking. 