The medical residents starting their training today belong to a generation that 
doesn’t think twice about broadcasting even intimate details of their lives via texts, Twitter and other social media.
That can get tricky when those doctors’ lives begin to include patients.
To help spark discussions of how residents can negotiate this new ground, the folks at the Mayo Clinic Center for Social Media have put together a video with advice from doctors who are active on Twitter, blogs, Facebook or other forms of social media.
The project “was born from this idea that there are currently no well-defined guidelines about digital behavior” for physicians, says Bryan Vartabedian, a pediatric gastroenterologist at Texas Children’s Hospital in Houston who appears on the video and who blogs at 33 Charts. “Our initial goal is to initiate a dialogue about professionalism by physicians” who have an online presence he tells the Health Blog.
Privacy violations are one big pitfall. While it’s desirable for physicians to discuss patient cases, when they do so on Twitter or Facebook they have to “recognize that they are having a conversation in a hallway, not in a conference room with the door closed,” says Victor Montori, a Mayo endocrinologist and medical director of the clinic’s social media center.
Even discussing patient cases without using names or identifying details is troublesome, says Vartabedian, because patients may see a post or Tweet and recognize themselves, particularly if it’s a rare or embarrassing condition. (He recently blogged about just such a case.) Not only might those details violate patient confidentiality, they erode trust and professionalism, he says.
Broadcasting purely personal activities can also affect a doctor’s professional image. Would you be totally confident in the ICU physician who just talked to you about your ailing mother if the first page of a Google search features a photo of him doing a keg stand?
Those hazards aside, it’s important for physicians to use Twitter and other online tools, the video emphasizes. Vartabedian says he uses Twitter to gather information, and that social media is also a valuable way of disseminating general information to patients.
Montori says institutions and practitioners can raise awareness about conditions or available treatments, and also to counteract misinformation floating around online. “A lot of my colleagues say they don’t have time for distractions” like social media, he says. “But if folks who are really on the front lines of care cannot engage in this space, their thoughts, insights and experience will not be flowing through the network.”
And meantime, Montori says, “the thoughts of those who aren’t that busy, or who are paid to be in that space” will dominate. “Patients are receiving what they think is a signal but in fact it’s noise,” he says.
