New AMA guidelines for Doctors who use Social Media

Damn, I knew it ! I really shouldn’t have tweeted about how I had to manually evacuate Grandma Mabel the other day.Oh, wait, I didn’t ! But apparently the Australian Medical Association felt it was necessary to publish guidelines for medical practitioners and students on how to use social media like Facebook and Twitter.There are of course already standards for ethical practice and privacy protection in place through the AMA here in Australia(as they are in New Zealand), but somehow it was deemed that we needed to be told what to post on Facebook and what not to post.

Although doctors and medical students are increasingly participating in online social media, evidence is emerging from studies, legal cases, and media reports that the use of these media can pose risks for medical professionals. Inappropriate online behaviour can potentially damage personal integrity, doctorpatient and doctor-colleague relationships, and future employment opportunities.

Well, I’m shocked I tell you.Posting stuff on Facebook can bite you in the bum later ! Who would have thought ! I see this guideline more as a legal precautionary measure by the AMA, so they can say ” We told you so”, should a doctor be so stupid as to post privileged information or information that can lead to identification of individual patients.

They give examples, too, to illustrate the dangers :

Example 1:
You are working in a rural hospital and make a comment on a social networking site about an adverse outcome for one of your patients. You are careful not to name the patient or the hospital. However, you mentioned the name of the hospital you are working at in a post last week. A cousin of the patient searches the internet for the hospital’s name in order to find its contact phone number. In the search results, the patient’s cousin is presented with your posting mentioning the hospital. The cousin then sees the subsequent posting regarding the adverse outcome involving the patient.

Again, true of course.But seriously, duh ! And as an aside, patient’s cousins are unlikely to be my Facebook friends, so they will not see my post, neither in Google nor on FB itself.I guess it’s possible.

Another example:

Dear Emergency Registrar,
Thanks a million for misdiagnosing my patient’s perforated bowel as constipation and treating aggressively with laxatives. I’m sure she appreciated the subsequent cardiac arrest and multiorgan failure. Don’t worry, she just needs a new set of kidneys and a liver and she’ll be right. And with that kind of performance, I’m sure you can help her acquire them.
Kind regards,Lowly intern
(based on an actual posting on a social networking site)

That one makes me giggle a tiny bit(and reminds me of the “A&E Registrar” I’m FB friends with, haha).I have to agree in this case, defaming someone’s professional conduct online is an ass move.

Example 3:
You get a friend request on a social networking site from someone whose name sounds very familiar, but they have a photo of a dog as their profile picture. You accept the request. After looking through their profile page, you realise that it is actually one of your previous patients. The patient sends you a message to let you know that they cannot make their next clinic appointment, but would like to know their histology results from a test ordered while the patient was in hospital. The patient also throws in a cheeky comment about some photos they saw of you wearing swimmers at the beach.

Well, don’t accept friend requests from dogs.That one’s easy.Does the AMA think we are generally retarded ?

And medical students, remove those drunk photos of yourselves posing in underpants that you have forgotten all about but are still on MySpace :

In other examples, a Twitter comment by an Australian medical student allegedlyintended as a joke between friends resulted in an international media storm for referring to US President Barack Obama as a ‘monkey’.27 A student from Ryerson University in Canada was almost expelled for running a Facebook study group where students exchanged thoughts on test questions,28 while a YouTube video of a medical parody caused a great amount of public upset and embarrassment for the students involved and their American university.29 Students are entitled to enjoy an active social life. But remember that online behaviour passed off as ‘youthful exuberance’ at this early stage in your career will still be available later on, and perhaps be seen in a less favourable light. You also need to consider whether your online activities violate university regulations (check with your university whether it has a policy relating to online behaviour), because this could form the basis of disciplinary action.

So better delete all those photos of you practicing “youthful exuberance”, Med students !

The AMA must definetely think that we are all retarded, when I look at this bit of “Troubleshooting advice:

Troubleshooting: Have you ever … ?
• Googled yourself? Search for your full name in Google, particularly ‘Australian Sites Only’ and ‘New Zealand Sites Only’. Do you feel comfortable with the
results that are shown?
• Posted information about a patient or person from your workplace on Facebook? Have a look through your old online posts and blogs;
• Added patients as friends on Facebook or MySpace?
• Added people from your workplace as friends?
• Made a public comment online that could be considered offensive?
• Become a member or fan of any group that might be considered racist, sexist, or otherwise derogatory? Browse through all the groups that you have joined
and consider whether these are an accurate reflection of the person you are, and the values that you hold.
• Put up photos or videos of yourself online that you would not want your patients, employers or people from your workplace to see?
• Checked your privacy settings on Facebook or MySpace?
• Felt that a friend has posted information online that may result in negative consequences for them? Did you let them know?

I find this whole thing rather embarrassing and patronizing, but I guess it’s necessary to have it out there, one as security for the AMA, and two as advice for those medicos who are not savvy around social media and might actually not be aware of Facebook’s privacy settings, or how eagerly prospective employers scout social media for information these days.That said, people have a right to a social life, and doctors are people, so if they choose to use social media to post a picture of them drunk at a party, or write a post criticizing the government, that should not lead to professional repercussions.Social media have made all our lifes more transparent to some extent, but there is still a right to privacy, and to having a life outside the workplace.

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