But using social media also raises questions about doctor-patient boundaries, privacy laws and confidentiality. Should doctors "friend" young patients on Facebook? What rules should doctors establish about texting with teenagers: content, hours and expectations of speedy replies? How should doctors take into account the reality that teenagers' cellphones are often missing in action, only to be found — and pored over — by friends and parents?
For these reasons, many doctors stop short of texting. Because texting is not encrypted and does not comply with privacy laws, "my clinic rules forbid me," said Dr. Wendy Sue Swanson, a pediatrician who treats teenagers at the Everett Clinic, which is outside Seattle, and at Seattle Children's Hospital.
But teenagers follow her on Twitter and her Seattle Mama Doc blog, on which she writes commentary and posts health news and videos.
During visits, she will ask a teenager the safest way to pass along private information. For those on birth control, she'll say, "Take out your cellphone and put in a daily alarm about when to take your pill. Call it...'strawberry.' "
Dr. Swanson won't answer individual questions on her blog. "But if they ask a question in my office that I think a lot of teens would like to know about," she added, "I can put the content on the blog without identifying the patient."
In New York, Mount Sinai Hospital's Adolescent Health Center uses a program called Text in the City to send patients tips and reminders about medications and appointments. Patients can also text questions, understanding that answers may not arrive for 24 hours. Dr. Katie Malbon, who writes most of the responses, said she cautions: delete an answer after reading it....
....But many doctors cannot imagine adding social media responsibilities to an already exhausting practice. Dr. [Natasha] Burgert, 36, is a juggernaut: With two children, she has a busy practice, keeps a blog on her group's Web site, posts Twitter messages, texts her teenage patients and still sticks to an 8-to-5 workday.
She carries a paper notebook to jot reminders, and spends 15 minutes a day sending texts and e-mails. It saves her hours of phone tag with patients.
The teenagers don't overload her with exchanges, she said. "They understand it is a privilege, that not all physicians will do this. Actually, I have more problems with first-time parents."
Image: Doctor texting, via Shutterstock