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Facebook, Twitter, Blogs, Oh My…. Navigating Social Media in the Medical World
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Elllen Epstein Cohen, Esq. |
As a society, we have become inundated with social media. First, email worked its way into the practice of medicine as a fast, effective and useful tool by which many patients now communicate with their physicians. On its heels came the use of Blogs, Facebook and Twitter (social media), all of which have now invaded the medical community. Even the popular television show Grey's Anatomy devoted an entire episode to the benefits and dangers of "tweeting" during surgery. Certainly there is a time and a place for the use of social media in the medical community, but the difficulty lies in trying to determine what is acceptable use, and what crosses boundaries of privacy and professional propriety.
First, we must distinguish how the media is being used: personally or professionally. Often problems arise when physicians mingle their professional life into their personal life via social media. For example, recently, a Rhode Island physician was fined and subsequently fired for writing about a patient on her Facebook page, even though she did not disclose the patient's name.1 Despite the physician's personal use of Facebook, she was making comments about her professional practice, which led to violations of patient privacy laws. Second, we must examine the content of the information placed into the social media. Using an alias in social media does not insure any protection of the posted information. In 2007, a pediatrician in Boston who was on trial in a medical malpractice case decided to blog about his experience , making comments about the plaintiffs' attorneys and their case, defense strategy as well as commenting about some of the jurors. The plaintiffs' attorney discovered the physician's blog and he was questioned whether he was in fact "Flea" (the alias he had used); he admitted he was. Not coincidentally, the case quickly settled once the blog and its unflattering commentary was linked to this physician. Despite the use of aliases, the content of the blog revealed the true identity of everyone involved, and what the physician thought he was posting anonymously was the poison dart which made it impossible for him to defend his case to verdict.2
Appropriate professional use of social media can be very beneficial for patients, physicians and the community at large. For example, Dr. JudyAnn Bigby, secretary of the Massachusetts Department of Health and Human Services, describes their office's Twitter and Blog as "essential" in a recent Boston Globe article. Dr. Bigby stated that their office's Twitter account has over 1,000 followers, and the Blog for all Health and Human Services (HHS) agencies is a platform for communications with all residents. The Mass. Dept. of Public Health uses social media to quickly and efficiently disseminate information about public health issues.
Many hospitals, medical schools and medical societies now caution medical students and physicians regarding what they choose to post on social media, as these are public electronic forums over which they have little (or no) control. It must be assumed that anyone can read what is posted, even if the information is not intended for public dissemination. Harvard Medical School revised its student handbook to caution medical students against the use of social networking sites, stating that "[i]tems that represent unprofessional behavior that are posted…on social networking sites reflect poorly on you and on the medical profession… may become public and could subject you to unintended exposure and consequences."3 Physicians at Beth Israel Deaconess Medical Center made a list of a few suggestions for the use of social media in medicine, which include: (1) "google" yourself to determine what patients can see and what information about yourself is in the public domain; (2) pro-actively manage your image by posting an accurate professional biography that patients can find through an internet search; (3) separate personal from professional online "presence" by maximizing privacy settings on social networking sites, using it only for personal reasons, and thinking carefully about what you post, i.e. do not post anything that you would not want to appear on the front page of a newspaper; (4) avoid communicating with patients through social media; and (5) recognize the benefits of social media tools as valuable ways to communicate public health messages to patients, such as notices about vaccines or changes to current recommendations.
So, the next time you are about to Tweet or Blog, or post something on the wall of your Facebook page, take the time to think first. Self-edit what you post. Never assume that you cannot be identified as the person posting online information. Use these effective tools for communicating only in ways that are necessary and appropriate for your medical practice, and do not mingle the personal and professional aspects of your life in Tweets or Blogs. Never discuss confidential patient information, even without the use of patient names. While social media and networking sites for personal and professional use can be used to advantage, they can easily be misused and physicians must tread extremely cautiously in these new and uncharted waters of social media.
1Boston Globe, Daily check-up: the Story Our Drugs Tell, 4/20/11 by Chelsea Conaboy.
2http://www.boston.com/news/local/articles/2007/05/31
/blogger_unmasked_court_case_upended/?page=full
Boston Globe, Social Media For the Medical Trainee, 4/21/11 by Ishani Ganguli.
— Ellen Epstein Cohen, Esq. and and Deirdre Kirby Lydon, Esq.
Adler Cohen Harvey Wakeman & Guekguezian, LLP
Editor's Note: MMS is holding an Ethics Forum on Social Media and Medicine on Friday, December 02, 2011 from 3:30 p.m. to 5:30 p.m. at MMS Headquarters. For more information visit the Continuing Education link.
Ms. Cohen graduated from Boston University School of Law in 1983. Since
that time she has represented clients in the state and federal courts,
as well as before various licensing agencies, in Massachusetts. Ms. Cohen's
practice is dedicated primarily to the defense and representation of healthcare
providers in all fields. A frequent lecturer on risk management topics
for physicians and other health professionals, as well as an instructor
in trial advocacy through the Harvard Trial Advocacy Workshop and the Massachusetts
Continuing Legal Education, Inc. (MCLE) program, attorney Cohen is actively
engaged in teaching medical/legal issues to a wide audience. Ms. Cohen's
firm serves as Counsel to the Legal Advisory Plan of the Massachusetts
Medical Society. Ms. Cohen has been selected as a "Super Lawyer," and
as one of the "Top 50 Female Super Lawyers," as well as one of
the "Top 100 Lawyers" in MA, all as published in Boston Magazine.
Ms. Cohen has also been selected for inclusion in "The Best Lawyers
in America", 2004 - 2011, and in Boston's Best Lawyers 2008- 2010 She has been honored as one of the "Heroes in the Field" at the Massachusetts Medical Law Report's 2011 Rx for Excellence Awards.
In addition to her practice, Ms. Cohen has served as a Volunteer, Ethics
Committee Member and Overseer at two hospitals in her community. Ms. Cohen
is very familiar with the challenges of the professional woman, having
balanced the demands of raising her family with the needs of her clients
for 27 years.
Ms. Lydon is an associate attorney at Adler, Cohen, Harvey, Wakeman & Guekguezian.
Hamilton College, B.A., 2002; Suffolk University Law School, J.D., 2007;
Student Attorney, Quincy District Court Victim-Witness Advocacy Clinic,
2006-2007; Admitted to practice in Massachusetts and before the U.S. District
Court for the District of Massachusetts; Member, Boston Bar Association
and Women’s Bar Association; Class Agent and Alumni Relations Coordinator,
Ursuline Academy 2006-present.
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