Jamin Brahmbhatt, MD

Two alternative therapies for the treatment of men with orchialgia showed positive results in studies presented at the AUA annual meeting in San Francisco. A third study on another pain-related condition in men found that the addition of low-dose tadalafil (Cialis) to levofloxacin (Levaquin) is well tolerated and significantly improved chronic prostatitis/chronic pelvic pain syndrome symptoms.

An AUA press briefing on the studies was moderated by Jamin Brahmbhatt, MD, of Orlando Health in Clermont, FL. The studies examining orchialgia treatment demonstrated improved symptoms with physical therapy in men who have undergone previous medical and surgical interventions and with the use of trigger point dry needling as a component of physical therapy.

“Dry needling, which has already been used for patients with other forms of chronic pain, including interstitial cystitis, is now being used in men with chronic testicular pain or orchialgia. The study found that there were definitely benefits” when dry needling was added to physical therapy, Dr. Brahmbhatt said in a 

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In this interview, Jamin Brahmbhatt, MD, gives his take on several studies of orchialgia and chronic prostatitis/chronic pelvic pain syndrome presented at the 2018 AUA annual meeting.

Multiple approaches show benefit in treating orchialgia

From surgical robots to the latest lasers, urologists love new technology. In health care, we tend to be the 1% driving innovation. Medical apps, health trackers, social media, and the ability to ask Siri (or for Amazon fans, Alexa) health-related questions have changed the entire landscape of how information is distributed. This is why urologists should be 100% at the forefront of digital platforms; this is where our patients are now socializing.

Here are some statistics to digest on the current impact of the Internet on our habits (courtesy of the Pew Research Center’s “Social Media Fact Sheet” and “Social Media and Health” report and the Health Research Institute’s “Social media ‘likes’ healthcare”):

1 out of 4 minutes in the U.S. are spent online.

80% of adults have looked online for health information, with 40% of these individuals looking specifically for a doctor by name or specialty.

165,000 (and growing) unregulated health apps are now available, of which 50% are free downloads.

1 out of 3 U.S. adults use social media for health discussions.

88% of physicians have used the Internet or social media for research on drugs or medical devices.

Before moving on with our discussion, it is important to remember that social media can be equally as bad as it can be good. Negative experiences can be filmed and made viral in a matter of seconds online. Patients can post as many bad reviews as good reviews. We have to be just as careful online as we are in our offices, especially when it comes to patient confidentiality.

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In my opinion, professionally, it is safer to not engage patients on their individual medical problems on social media. However, discussing general medical topics should not be a problem. If someone comments or asks more questions, I tend to keep my discussions broad and general. I always add the tag line, “This is general information. For more specifics about your condition, please see your medical provider.” I recommend all physicians to stick this rule to avoid any HIPAA violations.

In today’s digital world, having an active professional presence online has become a must. Your digital presence can then be used to supplement your personal/professional or office marketing strategy. The reality is that the average patient no longer reads the newspaper or local lifestyle magazine, where we can appear on the cover for $1,000. For that amount, you can achieve a better return on investment online. You may not get that pretty picture you can frame on your wall, but you can get positive press and referrals. If cost is an issue, you can actually grow your practice on social media by simply having a presence.

Next - Your online identity: Where to start

Social media can be overwhelming at times. There are some simple things you can start with and then build on with little effort. The first few steps are not to start any Facebook pages or Twitter accounts but to actually recognize your online presence.

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 The first step is to take control of your online identity. When was the last time you searched your name online with a search engine like Google? What you find is exactly what your patients will find when they search your name. Look at all the search tabs, including news and images. You may be surprised by what you find from your long-forgotten college days. I recommend searching your name at least once a month.

Also on Google, you can set up alerts that monitor the Internet for any mentions of your name online, and an email will be sent to you. Alerts will not capture everything, but they will help save you time.

 The next step in taking over your online identity is to search for yourself (and your competition if you’re interested) on the leading physician review sites. Currently the top review sites are RateMDs, Healthgrades, Vitals, and Yelp (yes, the same site that reviews restaurants). On these sites you can claim your online profile and keep your listed information up to date.

Claiming your profile will also allow you to dispute negative reviews. There is no guarantee negative reviews will be deleted, but it may motivate you to get the patients to post positive reviews to outnumber the negatives.

 Next, make sure your practice has a website that is up to date. You may be the best surgeon in the world, but a poorly designed and outdated website may not get that digitally savvy patient into your office. I would leave the website’s management to the experts. You or your staff should make sure information, including your address, contact numbers, profile pictures, and services offered, is updated.

Most hospital systems have their own websites that allow them to create a profile for you (or even expand the profile that may already exist for your name or practice). Make sure to check your hospital pages to make sure the information listed under you is accurate and up to date. If you prefer having your own website and you are in an employed model, make sure it’s OK for you to create your own site and content.

Only after the steps above are taken is it time to venture into social media. (Also see, 

 There are hundreds of social media platforms. If you had to choose one, I recommend Facebook. There are currently 2 billion monthly active users on Facebook. Within Facebook, there are thousands of active private and open health forums where patients are actively discussing their health. It’s good to know what forums are out there for your expertise, but I wouldn’t recommend actively recruiting or engaging patients on these forums.

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I do recommend having a business or professional page on Facebook for you or your practice. If patients are checking into your location, Facebook will create a page for your office (whether you want one or not), allowing patients to leave comments or ratings. Therefore, it is important to claim your business name and page on Facebook. On this page, patients can send you messages, write reviews, or learn from information you may share. If you have a personal Facebook page, make sure you check your privacy settings to see what is open versus private. I keep my personal Facebook page private and do not accept friend requests from patients.

I believe the next best social media platform, and another one I keep updated, is LinkedIn, which has over 467 million active users. Linked-

In should be thought of as your online resume. It ranks high on Google searches and may be the first thing patients see when they search your name. LinkedIn is also a great way to network with like-minded individuals in your field of interest.

The next most popular social media platform for urologists is Twitter, which has 328 million active users. Twitter is a great way to read and share medical news, engage in journal clubs, or stay up to date during conferences. Most conferences, including the AUA annual meeting, have hashtags (eg, #AUA18) that can be followed on Twitter. Conference attendees will use the hashtag to post comments or share news from the meeting. Twitter, like LinkedIn, can also rank high on Google searches.

Growing a following on Twitter is difficult if you are not actively using the platform all the time. My best recommendation is to use Twitter to learn and share information when you have time. Then, during conferences or journal clubs, increase your activity to help expand your stable of followers.

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Instagram today is the fastest growing social media platform. It allows you to post pictures with comments. Several doctors are using Instagram to post interesting cases and selfies from their recent travels. To avoid feeling overwhelmed on social media, I would recommend devoting your efforts to the big three: Facebook, LinkedIn, and Twitter.

Want to see some examples social media profiles to help you with setup or the type of content to post? Check out Dr. Brahmbhatt’s social media profiles:

https://www.linkedin.com/in/jaminbrahmbhatt

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is assistant professor of surgery (urology) at the Center for Reconstructive Urology and Men's Health, University of Utah, Salt Lake City, and 

is professor of urology, Icahn School of Medicine at Mount Sinai, New York.

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In today’s digital world, having an active professional presence online has become a must.

Author | Jamin Brahmbhatt, MD

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