Are you sure about that, Dr? Health care Transparency and SocNet Pervasiveness

A 2009 incident reported by an IT blogger ("How I tweeted my way out of spinal surgery") involved a woman who suffered a spinal injury while in rural Pennsylvania. According to patient and IT specialist Sarah Cortez, the rural hospital's staff involved attempted to persuade Ms. Cortez to undergo back surgery -- she believes at least in part because of her appealing top tier health insurance coverage.

ZDNet's Michael Krigsman looked into the facts surrounding the case and cited the patient's assertion that in addition to serving as a revenue enhancer, the case might boost the hospital's accreditation statistics. Ms. Cortez resisted the staff's attempts at what she believed to be intimidation and reached out to Twitter followers to provide names of neurosurgeons in Boston where she lived. She was successful in this attempt while still hospitalized and despite the obvious difficulties in reaching knowledgeable practitioners on short notice.

Krigsman concludes that the incident reflects two emerging trends relevant to enterprise transparency:

1. That "social networking causes a balance of power to shift from the enterprise to its customers. Customers don't care about an organization's internal communication hierarchies. . ." Twitter allows customers to use alternate channels to test or even contest judgments offered by house experts whose authority was previously difficult to question.
2. Krigsman believes transparency is "inevitable" as "ad hoc collaboration groups" and "transient social collaboration" urge enterprises toward more responsive processes.

The motivations for the enterprise may be defensive. Krigsman reminds his readers that "every customer is a potential broadcaster reporter."

The implications for the professions -- physicians, attorneys, and accountants take note -- are unmistakable. Whatever the privacy, public policy, professional practice and public ignorance considerations that may cloud any given decision, be prepared for some patients to question, "Are you sure about that, Doctor?"

For a more nuanced view of web enabled health content, its publishers and information consumers, research such as this study by J. Segal may demonstrate some intrinsic limits on transparency. Some limits may be imposed by weaknesses in communications that underlie such attempts.