Social media AMA physician professionalism policy

AMA Policy – Professionalism in the Use of Social Media.

This was posted recently and it is a good piece of work that will promote physician (and patient) discussion about the professional role and use of social media.

I applaud the American Medical Association (of which I am not currently a member, but I am a member of Medical Society of District of Columbia) for recognizing that physicians are engaging in this communication and that it has benefits. The history of AMA with regard to electronic communication with patients is definitely changing for the better.

Opening paragraph:  It seems to refer to a “one way” dialogue with patients – “provide opportunity to widely disseminate public health messages and other health communication.” Question is, can physicians actually use the medium to reduce the separation between the profession and patients to promote quality, safety, affordability, to learn to be better doctors? My answer is yes.

(a) Don’t post patient-identifiable information online – We have to protect patients’ personal information. I think it’s important to differentiate “without their consent.”

Sometimes, they want us to share it, and we will do that with their consent. “This is important because it allows the patient story to come into our work. For example, on this blog, the stories of Regina Holliday (@ReginaHolliday) and ePatientDave (@epatientdave ) and Donna Cryer (@donnacryer ), are told with their consent. Because Regina is actually a member/patient in the health care system I work in, Kaiser Permanente, she has signed a HIPAA release document allowing us to tell her story.

In actuality, I have met patients who have gone through the HIPAA release process, and it is less “allow” and more a request to “promote,” so that other patients after them will have great health care. Perhaps an organization could post its HIPAA release process for others to use. Some useful guidance on what constitutes posting patient-identifiable information can be found here, at the Ohio State Medical Association Social Media Toolkit.

(b) Using privacy settings to safeguard personal information - Sensible, and supports the idea that some physicians may include personal information about themselves online.

(c) Interacting with patients on the Internet, maintain appropriate boundaries of the physician-patient relationship – This confuses me in the way it’s written, because I am coming from a place of interacting with patients, but not necessarily “my” patients. So perhaps for this audience, it’s understood that “patient” means “your patient?” Otherwise, a physician interacting with patients who are not theirs are not in a patient-physician relationship, correct? What do our patients think about this one?

(d) Separate personal and professional content online – I do this, and I also don’t do this, so my advice is to decide which blend makes sense, because it is a blend, we are people.

(e) Physicians have a responsibility to monitor other physicians and report them to the authorities if needed - I’ve never seen this before in a social media policy (feel free to point out other policies that have this clause, if you’ve seen it, in the comments).

This seems more of an “enforcement/policing” model than a “coaching/educational” model of learning to be better. Is this how physicians are instructed to engage in quality improvement with their colleagues in real life? And what’s the role of the patient, are we accountable to them and do they have the opportunity to help us be professional online? And what’s their (the patients’) definition of us being professional?

(f) Social Media can undermine public trust in the medical profession - This is really the only one that I am not on board with. It is a reminiscent of a less than optimistic approach that I’ve posted about here before. Take a look at this piece of data from the Digital Influence Index (pointed out to me by Social Media guru @vincegolla):

75 percent of consumers view companies with microblog accounts as more deserving of their trust than those without.

Is it possible that social media can improve trust in the medical profession, to enhance its reputation among the people it serves, to have consequences for medical careers that are transformational and supportive of lifelong learning?

See what you think, feel free to post your thoughts in the comments, and please welcome your physician in their professional use of social media to improve your health and health care.

Ted Eytan is a family physician who blogs at his self-titled site, Ted Eytan, MD.

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  • http://www.engagingthepatient.com Nick Lloyd, Emmi Solutions

    Great post Ted. Social Media and other forms of online communication are coming to health care. Here’s a great interview with Dr. Jennifer Shine Dyer, a physician who uses texts, facebook and twitter to get her teenage diabetes patients on track. http://wp.me/pAdE7-jT

  • http://www.drjshousecalls.blogspot.com Dr. Mary Johnson

    Social media could do a whole lot more.

    (e) is VERY troubling – because it sounds a lot like an intimidation tactic and/or censorship.

    You don’t like what a doctor is saying online? Don’t counter with facts. Brand him/her a “cyber-bully”. Sick the Medical Board – or worse – on him/her.

    Nice.

    It’s a lot like hospitals labelling medical whistle-blowers “disruptive”.

    The AMA still hasn’t gotten to that party yet.

  • http://obesefromtheheart.com Sara Stein MD

    Thank you for summarizing the salient points so clearly, Ted. I prefer the Ohio social med recommendations specifically because of the pejorative notion of monitoring/reporting other physicians in the AMA policy.

    I am a psychiatrist who uses social media extensively (Facebook, Twitter, blog) as well as traditional media (TV, radio, print) to educate people about my passions of obesity, depression, bullying. I am careful not to be argumentative or political in those sites, but on my personal sites (closed to the public), I speak openly to my family and friends. I give general medical advice at times, such as get your Vitamin D level checked, but I refer individuals to their own providers for questions about their own conditions. It does tend to be one-sided, although we do have discussion.

    I prefer to view social media in the “see one, do one, teach one” model of physician responsibility. If I have information that can possibly help another person, and I can give out that information for free in a public talk, a comment in a newspaper, or a tweet, I have done my third physician obligation of teaching. If I can teach another physician how to use soc med comfortably and effectively, even better to proliferate the method.

    If, like @endogoddess Dr Jen Dyer, I can actually use soc med to help patient compliance with diabetes, I have a slam dunk in great care and communication. I haven’t arrived there yet – I need to figure out how to do what Jen does with my topics of obesity and depression.

    Hopefully the AMA will learn from us.

    Best,
    Sara

  • Arthur Williams, MD

    There is a need for HIPAA-compliant social media. I know that the facebooks and myspaces have blanketed our cyber space and mental space, but that does not mean they are really suited to patient care.

  • http://emergewithus.com/ Kristen_at_emerge

    I enjoyed your blog and I think the guidelines are a step in the right direction. We have found that many healthcare providers are not getting online because they are concerned with legality of social media and violating HIPAA. We are hosting a free webinar to address some of these HIPAA issues on Dec 9. If you’d like to join us here is the link: http://emergewithus.com/upcoming-webinars/

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