The Dual Online Identities of Physicians

Like everybody else, physicians are expanding their online personal identities. At the same time, they are trying to comply with codes of conduct that help consumers trust them and their profession.

There’s no problem so long as the personal online activities of physicians don’t jeopardize their obligations as professionals, which means that there is a problem, unfortunately.

In a recent study for example, 17% of all blogs authored by health professionals were found to include personally identifiable information about patients. Scores of physicians have been reprimanded for posting similar information on Twitter and Facebook, posting lewd pictures of themselves online, tweeting about late night escapades which ended hours before they performed surgery, and other unsavory behaviors.

As I mentioned Monday, medical students and younger physicians who grew up with the Internet have to be particularly careful, since they had established personal online identities before accepting the professional responsibilities that came with their medical degree.

Medical schools, residency programs and teaching hospitals can help young professionals manage their dual lives online. Some have implemented curricula and policies that foster appropriate use of social media, but surprisingly these programs are not widespread. In a recent study of medical schools that had experienced at least one incident in which a student used social media inappropriately, only 38% had adopted formal policies to handle future incidents. An additional 11% reported they were developing such policies. We can do better than this.

Non-teaching hospitals, CME providers and professional organizations like the American Medical Association can also help providers navigate the online world. The AMA’s recent guide to Professionalism in the Use of Social Media provides helpful guidance in this regard.

What You Can Do Now
Frankly, this is not something that can wait. If you haven’t already done so, you should immediately take steps to assure your personal online identity doesn’t threaten your professional identity, your patients’ rights to privacy, and other responsibilities you have as a physician. Here are some tips for getting started.

1-Look Before You Leap. If you are just starting to expand your online personal identity (say, by registering for a Twitter account), don’t feel compelled to lay yourself out there right away. There’s nothing about Twitter or Facebook that requires you to do anything after you register (nor for that matter, is anyone compelling you to generate searchable events like comments on newspaper articles, donating to political campaigns and so on). A quiet listening period up front allows you to get a feel for things before taking part. After a few days of following the tweets and posts of others, particularly other physicians, you’ll get a sense for etiquette and social boundaries.

Remember that if you see content posted by a colleague that you think is unprofessional, you should inform him or her. After that, it’s up to them to remove it or take other appropriate actions.

2-Review and Maintain your Online Profile. This advice appears in the AMA guidelines and is the centerpiece of a recent article on the subject by Arash Mostaghimi and Bradley Crotty.

The recommendation amounts to carrying-out an electronic self-audit of your online identity and taking action to create a “dual online citizenship” to the extent possible. Often, a simple search of your name on Google or Bing is sufficient for the audit. If the audit reveals a relatively sparse professional footprint online, you can beef it up by creating a web page for your office, posting your CV online, posting information about yourself on Google Profiles, starting a professional blog, and so on. You may also need to address personal issues that show up during the audit as well. Finding these issues is a key reason for doing the audit in the first place.

3-Go Ahead! Answer General Questions from Patients Online.  It’s safe and reasonable for you to answer general questions like ‘What is heart failure?’ and ‘When is the right age to get a mammogram?’, so long as you do not include individually-identifiable information about a patient. Just remember that existing and prospective patients read this stuff, so make it good!

4-Think Twice before Using Social Networking Sites to Communicate with Patients. Companies like Facebook and Twitter control the information posted on their sites. The same goes for search engine companies, who are having a field-day with your online search behavior as we speak. These companies’  privacy and security policies have been criticized as flimsy and capricious. Once you post something, it can be nearly impossible to delete it completely.

That said, social networking sites are great platforms for your general announcements like the addition of a staff member, flu shot availability and matters of public health.

Glenn Laffel, MD, PhD, is a successful entrepreneur in health information technology. He blogs at Pizaazz.

3 replies »

  1. This is a very important issue that is often disregarded by professionals. It’s great when med students and other younger, students start to tweak and maintain their online identities before their professional careers even start because it induces a great habit that will pay off in the long run. It is also never too late to clean up or create an online identity. Managing the results that is shown about you on Google is possible with free tools like the Vizibility Search Me button/link.

  2. I am not so sure that there is a great divide between the online world and non-online world. Healthcare providers need to be careful with protected health information and particularly any information that may identify a patient whether online or not. Probably, the big difference is that online it is hard to retract and many more people become aware of it.

  3. So glad that you brought this important point up. Just a few sort years ago it wouldn’t have been necessary, but with the explosion of social media, combined with a slew of incoming young professionals who have been participants in these platforms for years, your points are about as timely as can be.

    I agree with the need to control one’s online identity, especially for physicians and other healthcare providers.

    Perhaps a #5 to your list would be to seek out role models/mentors … practicing physicians who have been active in social media for the past few years. I could provide a list, but self exploration often works best.

    With that in mind, search the #hcsm (healthcare social media) hashtag in Twitter. You’ll find a whole host of active participants who have found a way to effectively engage on not just Twitter, but on a variety of platforms.