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Social networking, once the domain of teenagers, is attracting physicians who want to connect with other people online for reasons from professional contact to dating.

Although Internet interactions can be freewheeling, certain rules of etiquette apply. As with most technology, early adopters tend to set the standards, and latecomers learn to adapt. So "netiquette" does vary, depending on the type of site -- general versus physician-specific, personal versus professional.

And there are a plethora of sites. Social networking no longer involves just a handful of general sites, such as Facebook and MySpace, but includes a network of sites specific to health care, physicians and even specialties.

The first step to social networking, experts say, is to decide what audiences you want to connect with, choose the most appropriate site for each purpose, and set clear boundaries between each one. But even if you opt for purely social networking, a stranger there potentially can become your employer, patient or colleague, and an etiquette blunder could be career-killing.

"There's no way people aren't going to Google a new contact," said Rusty Weston, chief blogger of the networking site My Global Career. "You have to be careful."

A recent survey conducted by Erika S. Fishman, director of research and client services for Manhattan Research, a marketing and research firm for health care and pharmaceutical companies, found nearly half of all physicians feel it is important to have a professional presence online.

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Direct-to-consumer marketing isn't only about enticing patients to ask for a specific prescription drug. It's also about pitching patients to ask their doctors how that prescription will be conveyed.

This patient-centered pitch on electronic prescribing is being made by SureScripts, the nation's largest provider of electronic prescribing services, joined by nearly all of the nation's largest pharmacy chains.

The hope is that patients who are educated about the benefits of e-prescribing will start to demand that their physicians use the technology.

SureScripts chief marketing officer and lead campaign organizer Tammy Lewis said the main objective is to let patients know that more than 70% of pharmacies have e-prescribing connectivity, and show how e-prescribing might benefit them.

Part of the campaign involves signage at more than 26,000 pharmacies saying, "ePrescriptions filled here." Other signs will direct consumers to a Web site where they can learn about the benefits of e-prescribing, find a doctor who has the technology, and print information to bring to physicians who don't (www.learnabouteprescriptions.com).

The printed materials include information about a Web site where physicians can assess their e-prescribing needs and learn about available systems. Five physician organizations and the Medical Group Management Assn started that site (www.getrxconnected.com).

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Kaiser Permanente and Health Net have agreed to offer coverage to hundreds of individuals whose policies the insurers had rescinded and to pay medical bills from before and after the rescissions.

The agreements between the state's Dept. of Managed Health Care and the insurers are the latest development in a crackdown on what authorities have called illegal policy rescissions.

"While it's obviously terrific for those particular patients, that this had to be done reflects that there is a pattern and practice of behavior from those big insurance companies, and it hurts people who need health care," said California Medical Assn. President Richard Frankenstein, MD, a pulmonologist from Garden Grove.

Dept. of Managed Health Care Director Cindy Ehnes said she expected the state's two largest insurers of individuals, Blue Cross of California and Blue Shield of California, to follow Kaiser and Health Net by agreeing to offer coverage to as many as 4,000 former members.

At a May 15 news conference announcing agreements with Kaiser and Health Net, Ehnes said doctors or hospitals who provided free or uncompensated care to the people regaining coverage have a right to collect from the health plans, but doctors and hospitals may have to go to the patient to ask for payment.

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Hospitals generally are well aware of what they have to do under the Health Insurance Portability and Accountability Act to ensure the security of patient data. They are also aware that their own employees might be the ones who breach that security.

However, hospitals generally underestimate the malicious intent and the financial damage involved in data breaches and are unaware they're being targeted by perpetrators wishing to commit identity theft or medical fraud.

That is the conclusion of a recent report by the Health Information and Management Systems Society. The report was based on responses to a January telephone survey from 263 hospital executives responsible for patient data.

"I think ... hospitals, they may stick their heads in the sand, and they don't want to acknowledge that people want to access people's data for personal gain," said Brian Lapidus, chief operating officer of Kroll Fraud Solutions. Kroll, which sells data protection and identity theft response solutions, commissioned the study by HIMSS.

The report did not look into breaches at physician practices. But some experts say physicians also underestimate their chances of being targeted.

Mike Spinney, spokesman for Ponemon Institute, a Traverse City, Mich.-based think tank that researches privacy and data security issues, said while breaches are commonly discovered at hospitals and large medical groups, too often physician practices adopt a mentality that they are too small to be targeted.

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An Ohio hospital is soliciting help from its patients in putting together a comparison shopping tool showing not just what competing hospitals charge, but also what insurers are paying them for care.

In exchange for submitting a copy of a bill from a competing hospital and the corresponding explanation of benefits form from certain insurers, Alliance Community Hospital will pay patients $100.

"We don't want any personal information -- only the costs of a medical procedure," a hospital ad announcing the program said. The ad said the hospital plans to post compiled prices and reimbursements on its Web site.

The offer of cash for EOB forms is the latest effort toward pricing and quality transparency at the Alliance, Ohio hospital.

A state law that took effect in November 2006 requires Ohio hospitals to post prices for common procedures on their Web sites and make hard copies of price lists available to patients, but Alliance CEO Stan Jonas wants to take things a step further.

"It's our belief that educating the public on how to comparison shop for health care services, as they do for other major life investments (i.e. cars, homes) will benefit them by helping to clarify their best choices for quality and value," Jonas wrote in an e-mail to AMNews.

"In our own interest, we hope that a majority of the consumers who do this research will ultimately wind up at our front door."

Because health plans negotiate discounts and keep reimbursements largely confidential, there is still an element of mystery to health care prices, said Ohio State Medical Assn. spokeswoman Lisa Hackley.

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