The term “social media” has attracted considerable interest.  Opinions about the concept vary widely, a result of many factors including a) the purpose by which it is aimed, b) the age, background, and audience of the person either sending or receiving the information contained, and c) the specific format being used.

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

Examples of unprofessional behavior were identified in a survey of physicians’ of Twitter (JAMA). This study found that while only 3% of tweets were unprofessional, they could have important consequences because they could potentially 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 health care 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 communication.” The policy offers the following six tips:

• Never post identifiable patient information online.
• Set high privacy settings for your social media profiles.  It’s important to routinely monitor your online presence, including “Google-ing” 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 if your account is private.
• Maintain appropriate professional boundaries with patients answering specific questions but avoiding extraneous exchanges of information. 
• Separate personal and professional content online.
• Let someone know if you feel one of their postings on a social media site is unprofessional for a health care professional.
• 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 this: physicians have a plethora of special concerns that they need to take into consideration in exploring the use of social media.  But, with a little bit of caution and a lot of common sense, social media is a worthwhile endeavor. As I wrote in my last JACC 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.”  It will offer patients access to information relevant to their own personal needs.

By picking and choosing how you engage and who you engage with, social media 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 the topic, basically 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 came up during your work week (without discussing patient specifics, of course). Or, if you’re interested in networking with other health care professionals online, you could join the ACC LinkedIn group or Facebook fan 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.  There’s a great report from Ellerin Health Media (.pdf) that shows examples of approaches that physicians have taken on social media structure to optimize its value. 

Here are some useful links if you’re interested in learning more:

• "Professionalism in the Use of Social Media" (AMA Policy)
• "For doctors, social media a tricky case" (Boston Globe)
• "Professionalism in the digital age" (Annals of Internal Medicine)
• "Online Posting of Unprofessional Content by Medical Students" (JAMA)
• "When Facebook goes to the hospital, patients may suffer" (LA Times)
• "Nurses Fired Over Cell Phone Photos Of Patient" (WISN-TV)
• "Physicians on Twitter" (JAMA)
• "The Social Physician" (.pdf) (Report by Ellerin Health Media)
• "President's Page: Clouds, Science, and Education" (JACC)

Do you use social media? What sites are you on and how are they useful to you?