By Matt Wood
Some people use social media strictly for personal purposes. Others use it to tout their expertise on a subject or to market a business. Many use it for a little of both. The choice is usually a matter of personal preference and ambition, but for physicians using social media to discuss medical issues and communicate with others, it’s much more complicated.
BMJ recently published an article on the difficulties physicians face trying to maintain a distinction between personal and professional lives on social media, as they navigate the legal and ethical issues involved discussing medicine and interacting with the public online. I spoke to some physicians at the University of Chicago Medicine who are avid users of social media and asked them why they decided to start using social media, and how they draw the line between the personal and the professional online.
Vineet Arora, MD, associate professor of medicine, writes a blog focused on medical education called FutureDocs and runs a lively Twitter account (@FutureDocs). She’s written about why she started blogging and how social media has helped advance her career, and said in our interview, “My main reason for getting started was to stay current and learn what others were thinking about.”
This soon turned to her contributing the discussion as well. “You learn that you can also contribute to the discussion, dispel myths and connect with people who share your interests and can help you advance your thinking,” she said.
Jeffrey Matthews, MD, surgeon in chief and chairman of the Department of Surgery, echoed this sentiment about participating in the medical discussion online. “I started using Twitter (@JBMatthews) as an experiment to celebrate and publicize some of the goings on in the Department of Surgery,” he said. “But it soon morphed into a way to also comment on interesting news stories that affect our institution, our department, the field of surgery and broader issues of science intersecting with politics.”
Social media has other professional benefits for physicians, especially those starting their careers. Andrew Nickels, MD, a resident with an interest in allergy/immunology and medical ethics, said he also started using Twitter (@EthicalAllergy) for knowledge sharing, but finds value in it as a networking tool as well. “Social media allows me to establish a network of colleagues that provide me with worthwhile content,” he said.
The biggest challenge for physicians using social media, and one that the doctors I spoke to said scares many of their colleagues away, is the risk of running afoul of HIPAA regulations by violating patient privacy or posting inappropriate content online. In March, JAMA published a research letter reporting that most medical licensing boards they surveyed had received at least one complaint about unprofessional online behavior by physicians, such as sexual misconduct, prescribing medicine without an established clinical relationship and misrepresenting credentials.
Ves Dimov, MD, an allergist/immunologist and assistant professor of pediatrics and medicine said his role as a social media user is to help other physicians use it effectively in their practice. “Everybody is aware of the risks, but we need to show them how to do it and provide examples of best practice,” he said. “Highlighting only the negatives of social media use in medicine is like teaching medical students only with “Morbidity and Mortality” conferences. We need to discuss positive outcomes too.”
With 9,000 followers, his Twitter account (@DrVes) was ranked among the top 6 most influential people in Chicago and among the top 3 in medicine worldwide. He has written about how doctors can use social media as an extension of their natural communication skills and to provide valuable information to patients. He said the payoff to using social media outweighs risks if certain simple rules are observed. “I’ve been using social media for eight years now, and it’s been a tremendously positive experience,” he said.
For all its benefits though, all of the physicians I spoke to said drawing the line between personal and professional use is challenging. David Song, MD, chief of the Section of Plastic Surgery, said he steers clear of the issue and keeps his Twitter account (@dhsong) and Facebook page strictly professional now.
Nickels said he made a clean break by creating his Twitter account specifically for professional purposes, and using the Facebook account he’s had since college for personal stuff. “I try to think about my Twitter posts as a public comment to a room of trusted colleagues and patients, not friends,” he said.
Matthews uses the same strategy, with one exception. “I do like to Tweet about sports events I’m watching, particularly the Chicago Bulls,” he said.
Arora said she also maintains a personal Facebook account, and has a simple rule of thumb for Twitter. In a post on her blog answering some of the common questions she’s asked about Twitter, she said, “My general rule is not to tweet about anything that could get me in trouble with my employer or at home.”
In 1993, the New Yorker published a famous cartoon depicting a dog using a computer saying to another dog, “On the Internet, nobody knows you’re a dog.” With social media profiles increasingly tied to real world identities, and as people use these tools to further their careers, keeping truly anonymous online is rare. Now on the internet, everybody knows you’re a doctor.
McCartney, M. (2012). How much of a social media profile can doctors have? BMJ, 344 (jan23 1) DOI: 10.1136/bmj.e440