“To Post or Not to Post” - Are You Asking the Question?

Medical students need to abide by the same professionalism standards as doctors.¹ Both doctors and medical students have the right to a private life but it’s becoming increasingly difficult to keep distinct your personal self and your medical self. This blurring of boundaries can have adverse effects on you and your current or future patients.

The permanence, searchability, copying ease, and lack of control over audience differentiates online networks from “traditional” public meeting places. What happens in cyberspace now can “come back to haunt you” later!

Examples of things going wrong when healthcare students have communicated online

• Medical students have been expelled in the US for unprofessional conduct online.²
  - Problematic incidents include students breaching patient privacy, using inappropriate language, and being obviously intoxicated.²
• Medical training and job applications have been unsuccessful because of information found online.
• A Queensland medical student was expelled from his political party after making comments online that were considered racist.³
• Four US nursing students were temporarily dismissed from their nursing program after posing for photos with a human placenta and one photo was posted on Facebook. The college considered the behaviour “… insensitive and disrespectful toward the mother and the human tissue …”⁴

Pointers for protecting yourself

• If you wouldn’t say something in a crowded cafeteria or under your name in a hard copy magazine, don’t say it online.
• Don’t think you are unidentifiable because you use a username or pseudonym.
• Check your intent before posting – social media comments are often self-serving.
• Never make belittling comments in any way related to your institution online.
• Be mindful that it is not uncommon for employers to search for job applicants’ Facebook profiles and online presence generally.
• Strongly avoid online networking relationships with past or present patients.
• Keep a check on pages you’re responsible for. An individual or organisation may be held liable for publishing comments posted by a third party that may be misleading, defamatory or discriminatory.⁵
• Know your site privacy settings, make them as tight as possible, and check them regularly.
• Know the online communication policies of the institutions and organisations you’re involved with.

Protecting patients

When you begin interacting with patients, you begin to be at risk of the most common problem related to doctors networking online: breaching confidentiality. Even descriptions of a specific case history without providing names or other personal information can be enough to allow others to identify a patient and violate patient privacy and confidentiality laws.

• Don’t talk about patients on social media.
• If you want to discuss a patient case in an educational web forum, blog or any online environment, always get the patient’s express consent for this (and include it in the medical record) before putting any information, including photographs, about them online. Note the consent within the post.
• Think thoroughly about whether a patient is truly de-identified before making an online post, e.g. a single posting about an unidentified patient may be compromised by other postings.

Online Professionalism –
more information

Access further information on this subject on this subject through the Education section of our Member Online Service website.

Social Networking – stories of success and strife

Pause before you post!

Always check the common tendency to share online the stories, thoughts and photographs from your day. Embrace the many advantages of online communication but never compromise your respectfulness, boundaries or patients’ privacy.

References

1. Australian Medical Association, New Zealand Medical Association, New Zealand Medical Students' Association, Australian Medical Students' Association. Social Media and the Medical Profession.  A guide to online professionalism for medical practitioners and medical students. Available at: ama.com.au/social-media-and-medical-profession.

2. Chretien K, Greysen S, Chretien J, Kind T. Online Posting of Unprofessional Content by Medical Students. J Am Med Assoc 2009;302:1309–15.

3. Pollard E. Young Lib Expelled Over Obama Monkey Slur. ABC News online.  16 April 2010. Available at: abc.net.au/news/2010-04-16/young-lib-expelled-over-obama-monkey-slur/399176.

4. Haas J. Johnson County Community College Responds to Lawsuit. Kansas: Johnson County Community College;  2011. Available at: jccc.edu/press_releases/2011/gen-lawsuit.html.

5. Keogh K. Social Media, Health and the Law. New South Wales: TressCox Lawyers; 2011. Available at: tresscox.com.au/resources/resource.asp?id=909.