Mixing Social Media & Medicine Requires Caution, Professionalism

We spoke recently with Arthur R. Derse, MD, JD, Director of the Center for Bioethics and Medical Humanities, and professor of Bioethics and Emergency Medicine at the Medical College of Wisconsin.

Dr. Derse is a featured speaker at the Massachusetts Medical Society’s Ethics Forum, “Social Media and Medicine: the Impact on Your Patients, Your Practice, and You,” on Friday, Dec. 2, 2011, from 3:30 p.m. – 5:30 p.m.

MMS: Should physicians  embrace social media?

Dr. Derse: Social media can be a very good thing for doctors but can also pose some challenges.  There are many issues to think about, like professional image, privacy, and social barriers between doctors and patient. There are traditional boundaries that are set and respected.  Suddenly, your patient is seeing more of you than perhaps you want them to see.

If you are going to be online, and you want to convey trustworthiness and a professional demeanor, the material about your friends and family needs to stay elsewhere, and never the twain shall meet. If you don’t want to use social media, you can still practice good medicine.  But when you are ready to post online you have to have heightened caution.

MMS: What are some guidelines for physicians thinking about getting more active online?

Dr. Derse: Consider confidentiality first.  Social media offers incredibly effective one-to-many communication tools.  A danger is that once something is out in cyberspace, it’s out there.  You can take it down but you can’t take it back.  I think physicians have to be especially careful because there may be times they think they are online talking to colleagues, and they aren’t.

MMS: You sound cautious.

Dr. Derse: Consider that Facebook is a corporation there to make a profit. Nothing totally assures me that material that is confidential (on various social media) will stay that way forever. You really have to read the terms of service and be aware of the confidentiality settings and statements in any type of social medium. The companies own the playing field and can change the rules anytime.  Everything you put up there is being viewed and analyzed for commercial purposes.

MMS: Are you seeing many instances of doctors getting in trouble online?

Dr. Derse: Most violations are inadvertent.  But we have seen instances in the news of individuals disciplined for making snarky comments about a patient, or posting confidential information about patients, and one case (in England) of someone tweeting a picture of a patient during surgery.  Issues have also come up when people have disclosed things about their facility or organization.

MMS: One thing many physicians worry about is the breathtaking speed of social media.  There isn’t much time for careful consideration.

Dr. Derse: There are reasons why (medical) journals have a publication and vetting process.  The instantaneous aspect of the Internet and social media is powerful, but also has quite a downside. In the light of the next day, what you said may not be what you wanted to say. It can pose a challenge to professionalism, because part of professionalism is judgment and deliberation.

—          Erica Noonan

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