Medical professionalism and social media: Danger or opportunity?
January 19, 2017
To start the conversation on medical professionalism and social media, I would like to share this ideal tweet from Dr. Carl W. Nohr, the Alberta Medical Association’s (AMA’s) Immediate Past President:
"There is a linkage between physicians and society and that linkage is professionalism."
We tend to use the general term of professionalism throughout medical training as a standard to guide both conduct and behavior. One would argue that it is not always used in a positive vein once in medical practice with the incidents of unprofessional behavior or misconduct rising to the surface. However, we must duly recognize the professional behavior that so many physicians display. In every sense, professionalism is the basis of what it means to be a physician.
For a moment, I urge you to pause and reflect on what professionalism means to you as a physician. I imagine that if we were to poll the answers, we would see varying interpretations. But the over-arching themes would be the same.
Now, what if you were to consider what professionalism means in the context of being a physician online. Does a difference exist between medical professionalism in-person versus online? Taking it a step further, can social media engagement and medical professionalism coexist?
Let us first look at how we are defining professionalism and social media to examine the potential dangers and opportunities of this combination. Given that this is a vast topic, we will aim to focus on some of the more salient points.
Online medical professionalism
The main concept of online medical professionalism is that we should use the same principles that guide our professional conduct and behavior in-person.1 So how do we define medical professionalism? The literature supports many frameworks of medical professionalism, but for the most part they are aimed at identifying what it is to be a “good doctor” by integrating physician, physician-physician, physician-patient and physician-system relationships.
The Canadian Medical Association (CMA) has devised a policy to guide and define medical professionalism. In part, they state: “The medical profession is characterized by a strong commitment to the well-being of patients, high standards of ethical conduct, mastery of an ever-expanding body of knowledge and skills, and a high level of clinical independence.”
They also state that: “… as members of the medical profession they (physicians) are expected to share and uphold those values that characterize the practice of medicine and the care of patients.”2
This CMA policy also outlines medical professionalism as the “social contract between physicians and society.”
In essence, our professional identity exists within us as physicians, regardless of the environment we present ourselves in. This applies to any physical or online space.
What is social media?
For purposes of this discussion, it might be worthwhile to provide a brief overview of what is meant by social media. For some physicians, the words “social media” may be terrifying or uncertain – or terrifyingly uncertain. For others, it may be part of everyday life. Overall, personal and professional use of social media by physicians is increasing.3
The following categorization according to social media purpose is useful:3
- social networking (Facebook, Twitter)
- professional networking (LinkedIn)
- media sharing (YouTube)
- content production (blogs, microblogging)
- knowledge/information aggregation (Wikipedia)
Why do physicians need to consider social media?
According to Pereira et al.,4 physician colleagues from Ontario, “If professionalism is a social contract between medicine and society, and society is increasingly using social media, is it a professional responsibility of physicians to consider the rewards and risks of social media in the care of patients, society and themselves, as well as the education of learners?”
In fact, social media offers the opportunity for the medical profession to connect with society in another meaningful way. Interestingly, the peer-reviewed literature pertaining to social media in medicine began with cautions followed quickly by recognized opportunities.1 In fact, “social media is so pervasive today the question is no longer whether physicians will participate but rather how they can best use social media to advance the health of the public.”5
What are the dangers for physicians using social media?
The dangers can be summed up quickly by outlining four types of unprofessional behavior:
- Violating a patient’s privacy – it is very difficult to maintain confidentiality even when it appears to be non-identifying.
- Engaging with a patient’s direct concerns – social media is not the place to interact with patients directly.
- Violating your own privacy – posting unprofessional content, for example, venting, foul language and intoxication, can damage your reputation.
- Misrepresentation – falsifying credentials or not identifying conflicts of interest are unprofessional offline and online.
One of the other primary dangers to consider is that when you post anything online, even if it is perceived to be among friends, it can be shared without your awareness. Always remember, social media is a public space no matter what privacy features may be in place.
What are the opportunities for physicians using social media?
The opportunities for physicians using social media far outweigh the dangers. Here are some of the opportunities:
- Education – social media can be a valuable way to share and receive information. It offers an excellent way to keep current on medical literature.
- Connection – many medical professionals are on social media already, especially Twitter, so it is an excellent way to engage with other physicians and organizations. These connections can translate to real-life connections. This ability to connect can also reduce feelings of isolation associated with specialized practice or geographical location.
- Supplemental medical training – students are provided with a voice and access to experts who use Twitter to supplement their traditional medical school experience.6
- Public health messaging – social media is an effective way to disseminate public health information such as the upcoming flu season and vaccinations.
- Conference enhancement – whether or not you are attending a conference, associated hashtags can enhance the experience and learning (e.g., #icph16 is the hashtag for the recent International Conference on Physician Health in Boston).
- Creating an online presence (probably the most important point of all) – having a reputable social media profile will allow you to create your own image of how you want to be seen online.
I hope this information leaves you with the inspiration to consider using social media as a physician or the confidence to continue if you already are.
References available upon request.