Social Networking - Crozer-Keystone Health System - PA

Social Networking - Can It Negatively Affect Your Reputation and Your Professional Career?

November 2009

Note: Risk management CME questions and answers can be found at the end of this article.

With the onset of technology and advancements in communication tools there is a need to share information faster, the opportunity to share information with a broader population, and the potential to merge the lines between personal and professional communication.

Social networking tools have bonded people of all ages together. It is no longer a teenage dominated communication forum. However, this enhanced way of communication comes with risks. Risks include: breaches in patient confidentiality that can destroy the trust/relationship between patient and physician and disclosure of embarrassing, unprofessional behavior of a given healthcare provider.

The American Medical Association notes in a recent research that 13% of medical-related messages posted breach confidentially agreements between doctors and patients (Business Technology Leadership, 9/25/09). The potential to have conversations with loose controls to monitor Protected Health Information (PHI) is increased by using e-mail, internet, Facebook, etc.  While medical blogs may serve a legitimate educational purpose they can also serve to compromise a patient’s privacy. Even without patient identifiers used, enough information may be provided to suggest or assume the communication is about a specific patient, thereby breaching his/her privacy. Researchers at the University of Pennsylvania in a study of 271 medical blogs noted that more than 57% provided enough information to indicate the identity of the author, 17% of the blogs that discussed patient interactions included identifying information about either the doctor or the patient and three included photos of the patient (J Gen Intern Med 2008 October 23 (10): 1642-1646). Electronic communication is never a private matter and is discoverable.     

Good judgment and professionalism should dictate personal and private actions.  Healthcare providers are held to a higher level of responsibility as the public looks to them to entrust their physical care as well as ensure their privacy. Patients lose a sense of respect when finding inappropriate postings of their healthcare providers, i.e., in a compromising state such as inebriated, sexually inappropriate, or mocking another. Don’t be fooled - the public does use the internet to research and obtain information about their physician.

Patient confidentiality is a patient right. Discussions or postings about your work day, patient care, and patient interactions are private and should only be entertained with those that “need to know”. The use of electronic tools automatically transitions any conversation from a private communication to a public forum. There are countless examples on the internet whereby healthcare professionals and students have breached patient privacy without relaying patient name. Example include: pictures of x-rays showing foreign objects lodged in a patient’s rectum and medical students posed with a cadaver in inappropriate position. 

How you communicate - forum, time, place, audience - can have a dramatic effect on patient confidentiality and you personally. Criminal, ethical, civil, regulatory, and employment penalties can be attributed to a misstep or miscommunication. Once information is posted electronically, it is essentially memorialized for life. The delete button has limitations and there are lines that should not be crossed.

CME Questions - November 2009

CME Answers - November 2009

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