Read on Twitter
When social media was new, and its promise and peril were more hypothetical, a few wise mentors in my department and at SAEM encouraged me to read and talk about professionalism for #medtwitter and other platforms.
I think the powers that be recognized that social media could help with networking and knowledge translation. But they were also hearing about lives derailed - a student posting an insensitive joke, or a resident describing a case in a way that identified a patient.
They were terrified of social media. Tweets and Facebook posts and Instagram photos can be saved, and shared, and taken out of context in a way that terrified them.
It wasn& #39;t at all like the he said/she said issues they were used to adjudicating.
It wasn& #39;t at all like the he said/she said issues they were used to adjudicating.
I don& #39;t really consider myself a paragon of professionalism, but I started collecting examples of how social media posts led clinical staff into hot water.
There were a lot of click-baity headlines (even in academic journals) that conveyed the risk.
There were a lot of click-baity headlines (even in academic journals) that conveyed the risk.
And plenty of examples of physicians running afoul of patient privacy, even when discussing a tough case amongst a private group http://www.nbcnews.com/id/42652527/ns/technology_and_science-security/t/doctor-busted-patient-info-spill-facebook/#.Xxriwy05Qsw">https://www.nbcnews.com/id/426525...
As for peer-reviewed evidence, years ago it was meager but it already seemed clear - the online behaviors that really threatened a medical career were not photos or political opinions but rather, ethics violations. https://jamanetwork.com/journals/jama/fullarticle/1105088">https://jamanetwork.com/journals/...
Things like misrepresenting credentials. Harassing messages. Prescribing scheduled drugs via the web, without knowing the patient.
As for discipline, most state medical boards didn& #39;t have anything on file regarding doctors& #39; social media behavior. It just wasn& #39;t an issue.
As for discipline, most state medical boards didn& #39;t have anything on file regarding doctors& #39; social media behavior. It just wasn& #39;t an issue.
But of course, local disciplinary actions - schools, departments, hospitals - as well as hiring decisions - are harder to track.
But research here was also illuminating. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4899068/">https://www.ncbi.nlm.nih.gov/pmc/artic...
But research here was also illuminating. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4899068/">https://www.ncbi.nlm.nih.gov/pmc/artic...
As with so many things, the attitudes of the people in power made all the difference. What& #39;s "inappropriate" is left up to the director, the chair, the dean. And those people tended to be older, with a more conservative view of how a doctor should conduct themselves publicly.
To their credit, in my interactions with leadership on social media professionalism, the scenarios they most worry about are patient-centered:
A cool case described online, that ends up violating patient privacy.
Or residency colleagues "blowing off steam" on Twitter, after a tough shift, in a way that ends up making patients less likely to seek care.
Or residency colleagues "blowing off steam" on Twitter, after a tough shift, in a way that ends up making patients less likely to seek care.
And they wanted junior docs to know that anonymity online is often just wishful thinking.
http://archive.boston.com/news/local/articles/2007/05/31/blogger_unmasked_court_case_upended/">https://archive.boston.com/news/loca...
http://archive.boston.com/news/local/articles/2007/05/31/blogger_unmasked_court_case_upended/">https://archive.boston.com/news/loca...
But there& #39;s an unmistakeable concern in medicine about & #39;the brand& #39; - some hospitals social media guidelines, for instance, ask that staff not wear clothes with the hospital logo when posting photos of get-togethers.
So long as the people making hiring/firing decisions have a parochial view of doctor comportment in public, we& #39;re going to have docs penalized for photographing themselves in social settings, or arguing about healthcare and gun violence.
And some of these leaders will encourage & #39;research& #39; that reflects their conservative values, like this recent study: https://www.sciencedirect.com/science/article/abs/pii/S074152141932587X">https://www.sciencedirect.com/science/a...
This study has been thoroughly critiqued already - a testament to #MedTwitter& #39;s many strengths and benefits. https://twitter.com/RedStethoscope/status/1286476250408771585?s=20">https://twitter.com/RedStetho...
Here& #39;s another good take https://twitter.com/DrChowdharyMD/status/1286475918823825415?s=20">https://twitter.com/DrChowdha...
And it& #39;s always good to check the references for the methods.
Some of the foundation for this group& #39;s classifications of & #39;unprofessional& #39; conduct is rotten https://twitter.com/traependergrast/status/1286467558934286338?s=20">https://twitter.com/traepende...
Some of the foundation for this group& #39;s classifications of & #39;unprofessional& #39; conduct is rotten https://twitter.com/traependergrast/status/1286467558934286338?s=20">https://twitter.com/traepende...
It& #39;s telling that these authors view gun safety posts online as "potentially unprofessional" as well as bikinis or Halloween costumes.
They& #39;re specific about clothes & politics, but leave "offensive comments" vague - I& #39;d say the latter is a much bigger professionalism concern.
They& #39;re specific about clothes & politics, but leave "offensive comments" vague - I& #39;d say the latter is a much bigger professionalism concern.
These authors didn& #39;t seem at all concerned with doctors abusing their position to sell snake oil, another professionalism concern that seems more pressing than holding a glass of wine at a social event. https://www.orlandosentinel.com/news/os-ne-jay-feldman-adventhealth-social-media-posts-20191214-cjdkmjv3qbbv7hkt4gg43gbq6u-story.html">https://www.orlandosentinel.com/news/os-n...
When I was asked to write guidelines for social media professionalism in medicine, I borrowed from Hippocrates.
When posting: first, do no harm.
Don& #39;t harm your patients by violating their privacy, or taking advantage of their vulnerable state.
When posting: first, do no harm.
Don& #39;t harm your patients by violating their privacy, or taking advantage of their vulnerable state.
Don& #39;t harm your colleagues or employers by unfairly, publicly disparaging them, or revealing confidential information about them.
And don& #39;t harm yourself, or your future self, by putting out into the world some ill-considered ideas, drunk tweets, or anything else that doesn& #39;t reflect your real nature.
Years later, I still that that& #39;s a fair distillation of how doctors should conduct themselves online.
Years later, I still that that& #39;s a fair distillation of how doctors should conduct themselves online.
This study& #39;s debunking, and the #MedBikini trend in general, shows that today& #39;s doctors are ... comfortable in their skin, and with their online personas.
These posts aren& #39;t harming anyone. And their honesty and approachability is probably helping.
These posts aren& #39;t harming anyone. And their honesty and approachability is probably helping.
These doctors are redefining professionalism. Hopefully they will end up judging the current system as harshly as they& #39;ve been judged.
@threadreaderapp unroll please (thank you for suggestion @DrCJohns)
