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Dual Citizenship for Social Media


Words of Caution:


An article in the Annals of Internal Medicine, for April 19 Ideas and Opinions section, physicians Arash Mostaghimi, MD, MPA and Bradley H. Crotty, MD call attention to the challenges created by the expanded use of Internet tools by physicians to reach patients at work, while simultaneously using the same tools to keep in touch with friends and family in their personal lives.

Any and all physicians who use social media for private and professional work need to realize the ‘blur’ that these internet creates in segregating personal from public information. Search engines usually ignore this and cannot compartmentalize private vs. public issues.

“This online presence presents a host of challenges for physicians including the demand to “proactively review and maintain their digital lives,” and also the need to create boundaries that both protect the doctor-patient relationship and help prevent awkward moments such as fielding a friend request from a patient.

“Unlike previous advances in communication, such as the telephone and e-mail, the inherent openness of social media and self publication, combined with improved online searching capabilities, can complicate the separation of professional and private digital personae,” they write.

Physicians should assume that all posted materials are public and therefore take care to protect themselves and patient privacy. A 2010 study by the Mostaghimi and Crotty published in the Journal of General Internal Medicine showed that over 30 percent of physicians have some type of personal information on the Internet. The authors also cite research showing that 17 percent of physician blogs contain information that could reveal the identity of the patient or the doctor. They suggest that, “social networks may be considered the new millennium’s elevator: a public forum where you have little to no control over who hears what you say, even if the material is not intended for the public.”

“We’re not suggesting that physicians should be prohibited from using social media sites. Doctors just need to be savvy regarding the content and tone of what they post online. People share information openly using social media, but posts intended for one audience may be embarrassing or inappropriate if seen by another,” said Mostaghimi.

The authors go on to discourage the use of sites like Facebook and Twitter for direct communication with patients since the information is controlled by the social media companies. These types of sites, they say, should be

They advise physicians to regularly perform “electronic self-audits” of their online identity and create “dual citizenship” with a distinct professional profile intended to come up early on a search engine query.reserved for general announcements like flu vaccination.

The article was supported by an Institutional National Research Service Award and the Division of General Medicine and Primary Care. There are no reported conflicts.

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