The ACC Corner: Physicians Should Not Fear Social Media

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 - David R. Holmes, Jr., MD, FACC
David R. Holmes, Jr., MD, FACC
The term "social media" has attracted considerable interest. Opinions about the concept vary widely, a result of many factors including: the purpose by which it is aimed; the age, background and audience of the person either sending or receiving the information contained; and the specific format being used.

Social media has great potential in the medical profession to enhance collaboration among physicians, as well as improve communication between providers and patients.  However, there is also a potential downside: the consequences relating to unprofessional behavior.

Examples of unprofessional behavior were identified in a survey of physicians on Twitter (JAMA 2011;305(6):566-8). This study found that while only 3 percent of tweets were unprofessional, they could have important implications because they have the potential to violate patient privacy, be sexually explicit or discriminatory or contain objectionable profanity or possible conflicts of interest. Well-documented, albeit very isolated, examples of physicians and other healthcare providers losing their hospital privileges after posting patient-specific data on Facebook also highlight potential consequences of misuse of social media.

The events prompted the American Medical Association (AMA) to publish a policy this year on "Professionalism in the Use of Social Media," which outlines how physicians can engage in social media in a way that supports "personal expression … foster[s] collegiality and camaraderie within the profession," and "provide[s] opportunity to widely disseminate public health messages and other communications."

The policy offers the following six tips:
  1. Never post identifiable patient information online.
  2. Set high privacy settings for your social media profiles. It's important to routinely monitor your online presence, including "Googling" yourself, and viewing your Facebook profile from the view of someone who is a friend and someone who is not. Do not tweet anything you're not comfortable with the whole world seeing, even with a private account.
  3. Maintain appropriate professional boundaries with patients answering specific questions but avoiding extraneous exchanges of information.  
  4. Separate personal and professional content online.
  5. Let someone know if you feel one of his or her posting on a social media site is unprofessional for a healthcare professional.
  6. Recognize that what you post online can affect not only your reputation, but the reputation of your institution and the medical profession. This is particularly the case if you identify yourself as a physician or medical professional on a social media site.
The bottom line is: physicians have a plethora of special concerns that they need to take into consideration in exploring the use of social media. But, with some caution and a lot of common sense, social media is a worthwhile endeavor.

As I wrote in a recent President's Page: social media and the internet "will offer unparalleled opportunities to reach the global world of cardiovascular specialists, patients and society as a whole. It will provide opportunities for people to define and optimize their own individual approaches to learning, their own learning portfolios—the definition of personalized learning" (J Am Coll Cardiol 2011 57:2376-2378). It will offer patients access to information relevant to their personal needs.

By selectively choosing how to engage with social media, the forum can do whatever you want it to. For example, if you want to use it to learn more about a topic, you can use Twitter to follow others who tweet on that topic—using Twitter as a news aggregator. If you want another way to educate your patients on cardiovascular issues, you can start a blog that discusses topics that come up during the work week (without discussing patient specifics). Or, if you're interested in networking with other healthcare professionals online, you could join the ACC LinkedIn group or Facebook page—or any other cardiovascular-focused group, of which there are many—to do so. Social media truly is a source of endless possibilities. You are limited only by your creativity and time.

Dr. Holmes is president of ACC.