Friday, June 10, 2011

Ongoing debates about physician's online behavior

More and more physicians are sharing their personal and professional experiences online through blogs, Facebook, Twitter, etc. While some behavior is clearly illegal (HIPAA) it is not always clear what is inappropriate. This is made all the more challenging by the privileged relationship between doctors and patients and shared expectations of trust and dignity. One of the central challenges, in my mind, lies in the root of our medical education, the case report. From early on (perhaps day one) in medical school, difficult concepts are usually couched in terms of a single patient, a "case" to illustrate the salient points and facilitate learning.

That sort of thing cannot really be done easily online. If I describe a patient, even anonymously, if you know where I live, you can figure out where I work and therefore possibly which patient I might be discussing. Furthermore, my patients have access to the internet, so even if the HIPAA feds can not nail me for exposing patient information, I would be mortified if a patient found me online reposting their confidences or mocking their illnesses.

I bring up the topic because a recent Twitter conversation about a patient with an unfortunate condition and between that patient's doctor and her Twitter followers has been active in the medical blogosphere, with comments aplenty. What do you think? Was this inappropriate information to share?

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