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The older generation of physicians may disapprove of social media

| Social media | July 6, 2011

In the last three years, less than fifteen minutes of the formal medical school curriculum at my school has been dedicated to social media.

During our orientation, a faculty member showed us a series of images that she had found online, publicly available on Facebook, that showed what she considered to be inappropriate behavior: students drinking, dancing and in revealing clothing. She warned us about the impact that images like these could have on our careers and told us that our professional duty was to behave ourselves. It was a message meant to scare us into conservative behavior and away from social media sites.

I have sincere doubts about the faculty member’s assumption that the images were unprofessional, but she was right that they are dangerous, especially when an older generation of physicians may be looking at the use of social media disapprovingly. There’s no doubt that discussing “online professionalism” is currently in vogue among medical educators. Personally, I have a difficult time reconciling this introspective worrying about social media with the news online everyday: more and more people are seeking health information on the web, patients are finding support on social media sites and there is a growing expectation among patients that they be able to interact with healthcare providers online.

This will surely change the doctor-patient relationship, reshape ideas about privacy and, hopefully, make healthcare more patient-centered. Given the difficulty that doctors have had adjusting to patients who Google their symptoms, I suspect that we’re unprepared for people who have heard a range of nuanced opinions from their social network. Our schools are not teaching about how to engage this trend constructively, instead we’re getting blanket warnings about social media and the risks of the internet. I’d like our medical schools to spend less time lecturing about what pictures to post online and more time helping us learn to doctor there.

Nathan Favini is a medical student who blogs at A Stranger in this World, and can be reached on Twitter @natefavini.

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  • http://lucidicus.org Jared

    At The Lucidicus Project, we give away books to medical students who are interested in learning about ethics and economics, specifically with regard to market-based approaches to health reform. We post photos and the first names of students who are awarded our kit of books on the topic. Visitors can see all the recipients here:

    http://lucidicus.org/recipients.php

    I am sure that in some academic communities it would be considered less controversial to post a photo of oneself publicly drunk than to indicate an interest in the writings of Frederic Bastiat or Ayn Rand. However, I am glad to say that we have not heard of any such problems yet. (As you can see from the link above, some recipients of the books do opt for full or semi-anonymity.)

  • solo fp

    It is amazing how many docs do not email their patients, do not have web sites, and do not have an internet prescence. My practice really took off, as I am one of the less than 10% local docs who has electronic media available to the patients. Online handouts are open to all, and new patient forms are available to all. My cost to maintain a web site is only $10 a monthy, and daily I bring in hundreds of dollars of business. Many docs hide from telephone calls and email, but open communication builds a stronger practice. The older docs are losing potential new patients to the younger docs with an internet prescence.

  • Brian

    Personally, I think you’re way off base here. The faculty member probably wasn’t trying to scare you “away from social media sites”, but rather to use them responsibly. I find it ridiculous when people expect to be taken seriously yet seem completely unable to manage their online presence. Yes, patients are online more. Don’t you think it behooves future physicians to either A) not act like imbeciles, or B) at the very least have the brains not to post pictures of it?

    • DanP

      I wholeheartedly agree! A medical student who is upset that the curriculum does not have more social media content! How precious! As if the curriculum is not already diluted with non-medical, non-scienific junk already.

      Maybe he can post to Facebook while he visualizes the vocal cords during an intubation.

      Seriously, professionalis counts. All the Professor was doing was giving practical advised to students whose reputations can be marred by a photograph of themselves blowing up a condom over one’s head.

  • http://offwhitecoat.wordpress.com The Scrivener

    Brian has it right. There’s a big difference between posting drunk photos and using social media wisely, as solofp does. Part of being a professional means knowing how to conduct yourself even without your white coat.

    I do agree, however, that more positive role models, showing us good ways to integrate social media into practice, would be great.

  • saynotosocialmedicine

    So you want us to give away more free services? Isn’t being on call 24/7 for free enough? Add to that free phone consults, free prescription refills, free form completeion, free review of all the crap sent to us by insurers.On top of all that, we have to pay a biller 8 % of collections to get paid then wait three months. I love tech but if a patient wants my opinions, let her make an appointment for a face to face encounter, the only thing for which I can get paid. It’s bad enought the snail mail and faxes I get from insurers that I have to review for free.
    Social medicine is another free ride for patients and insurance companies. This old but tech savy doc (I’ve had an EMR for 8 years, thank you) will tweet with patients and insurers after I start getting paid for the phone calls and 24/7 call. Good luck defending that post/tweet in court, too.

  • buzzkillersmith

    Do you want pictures of the local judge drunk on Facebook? How about a high-ranking military officer? The local high school principal?
    Having a position of trust and authority in society means showing self-restraint in public. Med student, you’re not a kid anymore.

  • http://www.npr.org/blogs/health/2011/07/06/137655269/to-friend-or-not-the-facebook-challenge-for-doctors?ft=1&f=1001 todd

    On NPR today: “So last year, he (Dr.) and colleagues mailed surveys to more than 3,000 doctors, residents and med students around the country to gauge their attitudes toward online social networks.”…

    …”Some 455 people responded, and the results revealed that a majority of them found it “ethically unacceptable to visit the profiles of patients” or interact with patients on social networks for either social or professional reasons…”

  • Sharon Bass

    I agree with being responsible for what you post online. I also think if a patient wants to talk to me or get medical advice they should make an appointment. There are already too many things I am required (by insurance and the government) to do for which not only am I not paid but must do to get the pittance that they will pay. I have about had it and am this close to becoming a cash only office. I could have so much less over head by not having to jump through the hoops of managed( read mismanaged) care, Medicare and Medicaid. I practice in a rural area and am nearing retirement so it would not be cost effective for me to get an EHR system at this point.

  • http://clinicallibrarian.wordpress.com/wiki/ Catherine Voutier

    I would suggest that clincians point patients to public libraries and hospitals that have consumer health libraries. Librarians are highly experienced in teaching how to find reputable resources online and in print, and how to assess the veracity of the information source. RMH and the State Library of Victoria have been running free health information workshops for the public which have been very successful and we are now developing an electronic e-learning package. If information continues to be easily accessible as it is now, the public will continue to look for it. As for online reputation, private corporations have been hiring people to seek what others are saying about them online. It is not just what you put up about yourself online, it is also what others say about you. This is nothing new anyway, gossip has just expanded to include the online media.

  • http://natefavini.com Nate Favini

    Hello-

    Thank you all for the interesting comments. I have posted a response on my blog.

    http://natefavini.com/post/7459887843/responding-to-comments-about-social-media-and-medical

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