When a patient sent her a medical question using Facebook, Schwartz says, she made a point not to answer it there.

At JFK Medical Center in Palm Beach County, Lesnikoski's inaugural tweets were designed to contrast the effect of breast cancer on a woman in her 40s and a woman in her 90s; she was operating on one of each that July day. The only information she revealed about the patients was their age.

Before the surgery, Lesnikoski prepared a series of facts about breast cancer that could be tweeted to her 70-plus followers, along with basic information about the surgery, from her account, drbethjfk.

Lesnikoski, who has a background as a medical educator, says every surgery is a highly prescribed process, so there are traditional stopping points that can be used to tweet without interrupting the operating team's concentration. She says the hospital is now looking into tweeting during surgery as a way to keep families informed about a patient's progress.

``Surgeries can last from 45 minutes to 2 ½ hours,'' Lesnikoski says. ``These families will get updates every 20 minutes. The patients we've done our focus groups with have loved this concept.''

BRIEF IS BETTER

Dr. Donna Bilu Martin of South Beach Dermatology has been sharing skin facts and product information this year with her Twitter account followers. It's a compressed version of information she might send out in an e-mail -- but tweets don't clog up someone's inbox or get stuck in a spam filter.

``We can do this without being annoying,'' says the dermatologist, who tweets under the user name drbilumartin.

``The risk of melanoma -- the most deadly form of skin cancer -- increased by 75 percent in people who started using sunbeds regularly before age 30,'' she tweeted last month.

In another post, she shared information about a drug recently approved to hide wrinkles.

While Twitter identities are the latest tool in some doctors' medical bags, Dr. Camil Sader now considers his iPhone a medical necessity.

Sader, who specializes in laparoscopic surgery in Broward and Palm Beach counties, sometimes visits 180 patients at four hospitals in a single week. Tracking which patients he saw, their prognosis and other details about their care had become a paperwork nightmare.

When Sader couldn't find a simple and secure database program, he created one. It's an iPhone app called ``Dr. Rounds'' and it debuted in July. The information now stored in it can be formatted into an e-mail and be sent to his office manager for billing. Or it can be sent to other physicians watching over Sader's patients.

``It makes all the difference. At the end of the week, I press a few buttons and I get a report of what I did rather than shuffle through seven to 12 pieces of paper to see `How many times did I see Mr. Smith?'' '' Sader says.

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