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Professional use of social media

for residents

Nov. 28, 2013

Pat Rich @cmaer

Medical residents and social media – A perspective

When I was a child, I spoke as a child, I understood as a child, I thought as a child; but when I became a man, I put away childish things

1 Corinthians 13

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Who I am

Pat Rich – Managing Editor, CMA Member Communications

Experienced health care communicator with a keen interest and involvement in the use of social media tools in medicine and health care and believers in the value of these tools

WHO I AM NOT

Physician

Academic

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Social media “policies” by academic medical centers or medical schools point out the “don’t do this, don’t do that”, but let’s also focus on what the trainees CAN do. Let’s consider how we can IMPROVE our current health care system and ultimately the care of patients with innovative uses of social media and social networking …

Dr. Alex Djuricich, Association Dean for CME, University of Indiana School of Medicine

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I think there are too many people on the Web offering advice to you on how to use social media. Most of this advice is just regurgitated advice from people you may never have heard of before,

…You really don’t need “How To” tips on blogging or Twitter. Oh, I’m confident that you’ll be told otherwise – but those folks, well-intentioned as they may be, don’t understand that you’re smarter than that.

Rather than learn bad habits from the get-go, take advantage of your lack of experience. It’s okay to make mistakes that don’t cause harm and violate the privacy and dignity of others.

From: Physician Social Media: Has Advice About It Become a Crock? Yes @philbaumann, Jan. 1, 2013

Wh

at is

So

cial

Med

ia?

Extension of every day interaction Conversations & exchange Communities of shared interest Tools for innovation Integrates technology

Why consider social media?

To stay informed Communicate (engage) with peers and patients Disseminate information Advocate for/against something Because if you decide not to use social media, your

decision should be based on sound knowledge about what you are choosing not to use

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A changing environment

New health information technology tools Engaged patients Collaborative, team-based care

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A changing environment

A variety of forces are conspiring to redefine the physician: tech | information | health 2.0. We must understand our evolving role

Reality of the networked world: social communication will define the way MDs engage, learn and communicate

The most important decision a physician will make is who and what to listen to

The internet has changed the way patients see doctors, their diseases and themselves

Med students are at a very unique point in med history: Between a collapsing analog age and an emerging digital age

A great digital footprint will never cover for a doctor’s poor careDr. Bryan Vartabedian, adapted tweets from lecture to first year Baylor College of Medicine Students

Wh

y ca

re?

Case study: The Political Resident

Brandon is a resident who, since starting medical school, has kept a blog about his views on medicine, medical education, and health care politics. Recently, Brandon has blogged extensively about his extreme political views regarding the upcoming election. His residency director reads his blog and tells him that he must delete his posts and can no longer write new ones, as he is not only a hospital employee and a representative of the residency program, but also a professional who must represent himself accordingly

American College of Medical Schools Digital Literacy Toolkit

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Discussion

Is it reasonable for the residency program director to tell this resident that this non-medical blog should be removed? The residency director tells this resident to remove his blog. What would an appropriate response be? A. What a resident does on his own time is his business. B. He should have asked him to remove the offending posts and be

careful in the future. C. When you are a student and resident, you are ultimately under the

guidance of your dean and residency director.

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Case study: The Case of the Facebook Faceplant

The Case of the Facebook Faceplant

From: Academic Life in Emergency Medicine – MEdIC Series

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The rules

College of Physicians and Surgeons of Saskatchewan Guidelines Numerous Resident and Medical Student Guides Canadian Medical Association – Issues and Rules of Engagement

….. Und so weiter

Where your colleagues get guidance

CMA, CAIR or CFMS guidelines 23.91 % Guidelines from appropriate regulatory authorities

(e.g. College of Physicians and Surgeons or CMPA) 43.48 %

Generic guidelines found online 10.33 % I just wing it 35.69 %

Source: CME Epanel Survey – Nov. 2013 (unpublished)

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“We have current roles and guidelines but times are changing quickly. By 2017 patients and their health care providers are going to be communicating very differently.”

Dr. Darren Beiko, Queens University urologist, July, 2013

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The rules - translated

“Don’t be banal, self-promote excessively, share confidential material (especially about patients), be a troll, break the law, commit a libel, or overdo it.”

Dr. Richard Smith, BMJ, March 1, 2012

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The rules - translated

Don’t Lie, Don’t Pry Don’t Cheat, Can’t Delete Don’t Steal. Don’t Reveal

Dr. Farris Timimi, medical director, Mayo Clinic Center for Social Media, April 5, 2012

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Key elements of the rules

* Apply same principles of professionalism that apply in person

* Respect patient confidentiality

“Social media should be treated as a public forum akin to an op-ed in a newspaper or a lecture. Anything that would be inappropriate to share in these more traditional outlets should be considered inappropriate to share online.”

CFMS Guide to Medical Professionalism: Recommendations for Social Media

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CMA guidance

Rules of Engagement Understand technology and audience Be transparent Respect others Focus on areas of expertise

Impact to patients Liability Privacy Ethics Boundaries Time theft Reputation Compensation

The

cha

lleng

es

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What not to do

Chicago Doctor Accused of Posting Photos of Intoxicated Patient

Aug. 20, 2013 (AP)

By ALANA ABRAMSON A former Northwestern University student claims that after she was admitted to an Illinois hospital for extreme intoxication, a doctor there took photos of her and posted them to social media sites with commentary about her condition.

Elena Chernyakova filed suit in the Cook County Circuit Court against Dr. Vinaya Puppala, the Feinberg School of Medicine and the Northwestern Memorial Hospital on Aug. 15, claiming invasion of privacy and infliction of emotional distress. Puppala is a fellow in the Multidisciplinary Pain Medicine Fellowship at Feinberg, which works in conjunction with Northwestern Memorial Hospital, according to court documents.

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Twitter post by Tennessee cardiologist, Nov. 15, 2012

What not to do - II

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The Boundary FallacyKeeping a boundary between professional and personal life on social media is “operationally impossible, lacking in-agreement among active physician social media users, inconsistent with the concept of professional identity, and potentially harmful to physician and patients.”

Rather than eliminating boundaries and “suggesting anything goes,” physicians should just ask themselves whether what they are posting on social media is appropriate for a physician in a public space – with the issue of the content being professional or personal being irrelevant.

“Social Media and Physicians’ Online Identity Crisis” published in JAMA, Aug. 14 (v.310, no: 6, 581-582).

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Why consider using social media

To stay informed As a learning tool in medical education Communicate (engage) with peers and patients Disseminate information Advocate for/against something Because if you decide not to use social media, your decision should be

based on sound knowledge about what you are choosing not to use

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Why consider using social media (post-graduate)

For public health purposes (e.g. tracking epidemics or spread of new pathogens) To show your clinical technique on YouTube For public health purposes (e.g. tracking epidemics or spread of new

pathogens) To help get a job To deliver clinical care!!!

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-“For those of us who have the philosophy that we want to graduate docs who are better than we are, Twitter is a great thing.”

Dr. Chris Simpson, cardiologist and CMA President-Elect

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Using social media in residency: Suggestions

Facebook presence for colleagues etc LinkedIn account to:

Build network for future career Follow discussion forums on medical education

Twitter account to: Develop your list of people, journals and other accounts to follow Watch (and engage) medical Twitter community (e.g. #hcsmca,

#hcsm) Follow and engage your professors

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Social media and you

Students come to medicine with a relatively self-focused view of their networked world, and don’t yet understand how they fit into the broader networked world.  As they mature professionally, they recognize that they are part of a broader community, which brings accountability.  This progression has real importance when we expose ourselves to the great wide open.

Dr. Bryan Vartabedian, Aug. 14 (Wing of Zock via. 33charts)

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An expert Canadian physician voice

Dr. Ali Jalali, teaching chair, faculty of medicine, University of Ottawa

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▸ Questions?