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The AMA’s Policy On Professionalism In The Use Of Social Media

A new policy on professionalism in the use of social media was [recently] adopted by the American Medical Association (AMA). The AMA Office of Media Relations was kind enough to share a copy of the policy:

The Internet has created the ability for medical students and physicians to communicate and share information quickly and to reach millions of people easily. Participating in social networking and other similar Internet opportunities can support physicians’ personal expression, enable individual physicians to have a professional presence online, foster collegiality and camaraderie within the profession, provide opportunity to widely disseminate public health messages and other health communication. Social networks, blogs, and other forms of communication online also create new challenges to the patient-physician relationship. Physicians should weigh a number of considerations when maintaining a presence online:

(a)  Physicians should be cognizant of standards of patient privacy and confidentiality that must be maintained in all environments, including online, and must refrain from posting identifiable patient information online.

(b)  When using the Internet for social networking, physicians should use privacy settings to safeguard personal information and content to the extent possible, but should realize that privacy settings are not absolute and that once on the Internet, content is likely there permanently. Thus, physicians should routinely monitor their own Internet presence to ensure that the personal and professional information on their own sites and, to the extent possible, content posted about them by others, is accurate and appropriate. Read more »

*This blog post was originally published at 33 Charts*

When A Patient Contacts A Doctor On Twitter

When perusing my Twitter feed [one] morning, I stumbled onto this post directed to me:

Patients reaching me in public social spaces is becoming a regular thing. I’ve discussed this in the past, but I think it bears repeating. So here’s what I did:

I understood the mom’s needs. Patients resort to “nontraditional” means of communication when the traditional channels fail to meet their needs. Recognize that these patients (or parents in my case) are simply advocating for themselves. My specialty struggles with a shortage of physicians, so we’re dependent upon phone triage to sort out the really sick from the less-than-sick. It’s an imperfect system and consequently parents find themselves having to speak up when the gravity of their child’s condition hasn’t been properly appreciated.

I took the conversation offline. I don’t discuss patient problems in places where others can see, so my first order of business in this case was to get the conversation to a place where it can be private. I called the mom, found out what was going on, and rearranged her appointment to a time appropriate to the child’s problem. Read more »

*This blog post was originally published at 33 Charts*

The “e-Patient” Revolution: Is It Over?

There’s a conversation brewing over use of the term “e-patient.” The online health revolution is over, it’s been suggested. Web use, after all, has become so widely adopted  that the term “e-patient” may have more historical meaning.

Dropping the “e” might indicate that we’ve arrived. I’m not so sure. Perhaps the revolution we thought was going on never entirely took off. Or maybe it’s all about how you define the revolution.

Here’s what I see: Day in and day out, over weeks and months, hundreds of patients visit my clinic. I talk to them candidly about the tools they use and how technology and community is changing how they see their problems. I do the same with friends and family members. And like it or not, they’re a lot closer to “e-Patient 1.0″ than many of us would like to think. Read more »

*This blog post was originally published at 33 Charts*

Luddism And Internet-Based Medicine

My recent post on the subject of email from patients raised more eyebrows than I expected. It also put me in a position I’m unfamiliar with: Looking like a luddite.

Perhaps I’m not forward-thinking enough in my reluctance to embrace this advance. Perhaps I’ve gotten conservative as I’ve grown grey. Electronic communication is a great idea (I’m doing it right now), so why not apply it to my medical practice? Has Ned Lud gotten into my circle of influence?

This is, of course, extremely ironic. I lived so much on the cutting edge that my butt developed calluses. The calluses, however, were not just put there by the edge, they also came from occasional kicking.

The problem is I have an addiction: I’m addicted to change. I’m constantly looking for new and perhaps better ways to do things, then impatiently going after anything new and shiny. This served us well in the sense that I got us on EMR, got it working well, and have continued to keep us away from repeating mistakes too often. If something doesn’t work, I’m quick to look for the cause, and more importantly, how to fix it. Read more »

*This blog post was originally published at Musings of a Distractible Mind*

Patient-Doctor Facebook “Friends” Could Be A HIPAA Violation

Should you friend your doctor on Facebook? It’s a question that’s gaining increasing relevance as Facebook increases its social networking dominance. I’ve touched upon the issue in the past. So has the New England Journal of Medicine.

Washington, DC, physician Katherine Chretian gives her take on the issue in a recent USA Today op-ed. She is an expert of the Facebook-medicine intersection, having authored a JAMA study on the issue.

She says, no, doctors should not be friending their patients:

Having a so-called dual relationship with a patient — that is, a financial, social or professional relationship in addition to the therapeutic relationship — can lead to serious ethical issues and potentially impair professional judgment. We need professional boundaries to do our job well.

Furthermore, there’s the little matter of patient privacy and HIPAA. I wasn’t aware of this, but simply becoming Facebook friends with patients can infringe upon uncertain ground. Read more »

*This blog post was originally published at*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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