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Defining Online Physician Conduct

This week a reporter cornered me on the issue of professional behavior in the social space. How is it defined? I didn’t have an answer. But it’s something that I think about.

Perhaps there isn’t much to think about. As a “representative” of my hospital and a physician to the children in my community, how I behave in public isn’t any different than a decade ago. Social media is just another public space. Sometimes it’s easy to forget that we’re in public. When I’m wrapped up in a Twitter thread it’s easy to forget that the world is watching. But the solution is simple: Always remember that the world is watching.

On Twitter I think and behave as I do in public: Very much myself but considerate of those around me. I always think about how I might be perceived.

Here’s a better question, online or off: What is professional behavior? I have a pediatrician friend who, along with the rest of his staff, wears polo shirts and khaki shorts in the summer. The kids love it.  One of my buttoned-down colleagues suggested that this type of dress is “unprofessional.” Or take a handful of physicians and ask them to review a year of my blog posts and my Twitter feed. I can assure you that some will identify elements that they find “unprofessional.” I believe I keep things above board.

This is all so subjective.

The reporter was also interested in how I separate my professional and personal identities in the online space. I’m not sure the two can be properly divided. The line is increasingly smudged. I try to keep Facebook as something of a personal space. I think it was Charlene Li who suggested that she only “friends” people she knows well enough to have over for dinner. That’s evolving as my rule as well. But independent of how I define “well enough,” Facebook is still a public space. My comments and photos can be copied to just about anywhere.

Social media has not forced the need for new standards of physician conduct. We just need to be smarter than we were before. Everyone’s watching.

*This blog post was originally published at 33 Charts*

Two Docs Who’ve Passed: They Might’ve Been Social Media Giants

This year I learned about the death of two physicians that were pretty important to me.

The first was my pathology teacher, Dr. Guido Majno. In addition to being a tremendously kind and curious person, he and his wife wrote the best textbook I’ve ever read.

The second death was that of my pediatrician growing up, Dr. Thomas Peebles. Funny, although he followed me from birth to high school, my family never knew about his incredible research background. We learned it in the many obituaries.

It’s worth reflecting on their accomplishments and the manner in which they conducted their lives and practice — especially in this era, when doctors are encouraged to develop their social media presence and be proactive about online reviews.

Would they have used these new tools? Would they even have needed them? Would they have found the idea of trading links to medical stories on Twitter to be interesting? Stimulating? Or maybe distressing or distasteful?

I never thought to ask them.

*This blog post was originally published at Blogborygmi*

Are Doctors Afraid Of Social Media?

We sometimes forget that public transparency can be scary. I’ve found this particularly true for doctors. And they tell me so. This tweet from MD Anderson’s Dr. Garcia-Manero hints that the daily digital repartee that I take for granted isn’t so easy for the newbie:

And this comment came in today from a rheumatologist, Dr. Irwin Lim of BJC Health. It illustrates nicely the hesitancy physicians sometimes feel:

Our clinic’s business manager was pushing me to blog as a means to improve the profile of our group musculoskeletal clinic. I found myself quite afraid of this, as I had not previously participated in social media. I was also wary that I could not control patient comments. Eventually, I tiptoed into LinkedIn. I then started reading blogs and came across yours. Your posts have been very useful and have improved my resolve. A few days ago, I posted my first blog, and have since written a total of 6. It’s been quite enjoyable so far. The social media consultant engaged by the clinic wants me to now create content for YouTube. Some fear has returned, but I’ll hopefully be able to get over this, too.

Is fear specific to doctors? No, but I think the issues are magnified with medical professionals. Image, social voice/personality, permanency, and fear of legal repercussions are among concerns that are disproportionately felt by doctors. So can we mitigate this fear in any way and break the barriers to entry for doctors? Read more »

*This blog post was originally published at 33 Charts*

Social Networks For Doctors: One Place At A Time

I suspect that in the next couple of years we’ll see the emergence of a viable social network for physicians. It hasn’t happened yet, but I suspect that we’re getting close. Physicians are increasingly dabbling in mainstream social sites.

But maybe that’s a problem. After all, a doctor can only hang in so many places. If you have “The Facebook for Doctors,” do you expect us to spend our time there instead of on Facebook itself? Maybe we will, and maybe we won’t.

Beyond the obvious requirement of a network to deliver value, I think the rate-limiting factor is old-fashioned bandwidth. You can only be one place at a time. If I spend my days on Twitter, I’m not likely to spend my days on said doctor’s network. I will go there for particular things and to talk to certain people about specific issues, but like most doctors I’m not sure I can tell you exactly what I want. I’ll know it when I see it. (Actually I do, but I’m keeping it tip-top secret.) Read more »

*This blog post was originally published at 33 Charts*

Newt Gingrich’s Take On Facebook Saving A Woman’s Life

I’ve seen at least half a dozen links to the op-ed coauthored by Newt Gingrich and neurosurgeon Kamal Thapar about how the doctor used information on Facebook to save a woman’s life. (It was published by AOL News. Really.)

In brief, a woman who had been to see a number of different health care providers without getting a clear diagnosis showed up in an emergency room, went into a coma and nearly died. She was saved by a doctor’s review of the detailed notes she kept about her symptoms, etc., which she posted on Facebook. The story is vague on the details, but apparently her son facilitated getting the doc access to her Facebook page, and the details posted there allowed him to diagnose and treat her condition. She recovered fully.

Newt and Dr. Thapar wax rhapsodic about how Facebook saved a life, and sing the praises of social media’s role in modern medicine. (I’m not sure how this really fits in with Newt’s stance on health reform, within his 12-step program to achieve the total replacement of the Left…but, hey, nobody has the patience these days for so many details anyway.)

Regular readers of HealthBlawg know that I would perhaps be the last to challenge the proposition that social media has a role to play in health care. However, I think Newt got it wrong here. Read more »

*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*

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