Caroline McCarthy’s article today in her “department,” The Social, raises the question of whether or not social media can play a productive role in improving health care by providing richer opportunities for doctors to communicate with “the rest of the world.” It is a moderately long piece; and it should be, because ultimately the conclusion is that this is a very messy situation. Furthermore, the fourteen comments she had fielded by the time I read the piece indicate that at least a moderate number of her readers accept the complexity of the situation. What is missing from both article and comments, however, is an attempt to come to grips with why the situation is so complex.
As I see it, this article address a problem broader than the scope of either health care or the ways in which social media can work. There is a bigger picture that needs to be addressed; and this concerns the more general need for effective communication between service providers and their clients. After all, service activities take place in the social world, regardless of the service being provided; and, whatever technologies the Internet may offer, the primary medium of service is human communication in all of its rich social complexity. Like it or not, neither the Internet nor any of the software it supports is equipped to address those social complexities (nor was it ever designed to do so). This is particularly evident in the case of the overall social context of the health care industry (and I think we are still the only country that calls health care an "industry," rather than a public service) and the various ways in which it impedes even the best efforts at effective communication. Thus, the only way in which we are likely to make any progress towards using the Internet to support any form of service, health care or otherwise, is by beginning with accepting the premise that treating any service as a profit-driven industry does nothing more than preventing it from performing the services for which it was intended.