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The Do’s and Don’ts of Social Media

A Guide For Gastroenterologists

Bilal, Mohammad, MD1; Taleban, Sasha, MD2; Riegler, Jonathan, MD3; Surawicz, Christina, MD4; Feld, Andrew, MD, JD4,5

American Journal of Gastroenterology: March 2019 - Volume 114 - Issue 3 - p 375–376
doi: 10.1038/s41395-018-0369-0
THE RED SECTION
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SDC

1Division of Gastroenterology & Hepatology, University of Texas Medical Branch, Galveston, TX, USA;

2Division of Gastroenterology & Hepatology, Department of Medicine, University of Arizona College of Medicine, Tucson, AZ, USA;

3Central Coast Gastroenterology, Templeton, CA, USA;

4Division of Gastroenterology, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA;

5Division of Gastroenterology, Kaiser Permanente, Seattle, WA, USA

Correspondence: Andrew Feld, MD, JD. E-mail: afeld@uw.edu.

Received July 23, 2018

Accepted August 15, 2018

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INTRODUCTION

We all know about social media, and may have a love-hate relationship, but it is here to stay. Merriam-Webster’s dictionary defines social media as “forms of electronic communication (such as websites for social networking and microblogging) through which users create online communities to share information, ideas, personal messages, and other content.” Practically, the most common uses are for networking (Twitter, Facebook, LinkedIn, and Google plus) or informational (blogs, YouTube, Vimeo, and Vine). Obviously, your guiding principles for professional conduct should be the same for your online and offline behavior, stressing the importance of maintaining trust and confidentiality. Moreover, it is important to keep your professional and social spheres separate, which may be very difficult.

Many professional societies such as the American College of Physicians (ACP) and the American Academy of Family Physicians (AAFP) have published guidelines with detailed and relevant information (1,2). If you are an employed practitioner, your employer probably has specific guidelines as well. It is also important to be aware of how your staff use online resources as they may reflect on you and your practice.

This article will review the benefits and risks of social media, as well as relevance to fellows in training and staff.

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ADVANTAGES OF SOCIAL MEDIA IN GASTROENTEROLOGY

With widespread use of social media in medicine, appropriate application by gastroenterologists can have advantages. To leverage the most out of social media, providers should consider the audience, develop clear objectives, and identify instruments to measure those objectives. These endeavors may vary according to the practice type/setting, career stage, and experience with social media platforms.

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Marketing

Marketing is key for health care organizations and practices seeking to increase visibility. More than half of patients search for a provider online before seeing them in the office (3). Patients with chronic illnesses like inflammatory bowel disease prefer using this platform (3,4). Social media engagement can play a significant role in building a successful practice.

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Professional Networking

Providers can connect with peers and patients through social media platforms to seek and disseminate new research, review clinical cases, and discuss practice management.

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Professional Development

Medical education has been enhanced through video sharing, moderated chats, and via online networks. The ACG and AGA contribute to the online professional community through Twitter and Facebook pages. In academic medicine, social media engagement also has been included in dossiers for promotion and tenure (5).

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Patient Care

Health care organizations are slowly starting to use social media for direct patient care. Patients want to receive information from their gastroenterologist through social media (6). Social media applications have been used to improve colonoscopy preparations.

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Patient Education

Social media improves patient access to medical information and other educational resources. Often, physicians are the ones responsible for providing health care information through these platforms. This helps in distribution of evidence-based discussion to counter inaccurate information. Patients can also use social media to connect to patients affected by similar conditions.

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Public Health Programs

Social media can be an important tool for public education and advocacy of health care related information. In fact, social media can guide behaviors of individuals to address obesity, smoking cessation, diet, and sexual risk behaviors (7). Using various social media tools, the ACG has been instrumental in promoting the 80% by 2018 colorectal cancer screening campaign (8).

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RISKS OF SOCIAL MEDIA

Despite the above mentioned benefits of social media, there are several associated risks (9). The healthcare provider using social media must pay special attention to privacy, professionalism and interactions with other members of the healthcare team.

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Profiles

If you intend to use social media for professional purposes, it is generally wise to have separate professional and personal profiles (10). Physicians are held to a higher standard of conduct than the general population and professional societies and regulators also seek to maintain the public trust in our profession (1,2,10,11). Although what you do in your personal life is up to you, there is fine line that distinguishes personal and professional opinions when it comes to social media. Physicians have had difficulties when sharing something about their personal lives which then also impacted their professional careers.

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Pictures

All healthcare professionals should use utmost caution while posting pictures on social media. Physicians should refrain from posting pictures which could be interpreted as unprofessional, e.g. picture showing one inebriated. Trainees should not post anything that they would find embarrassing. Many employers will do a social media search in the recruiting process. Use caution in posting pictures at the work place. Unintentional breaches of privacy can happen, e.g. a picture of two nurses at work, but a patient’s name could be seen in the electronic health record on a computer screen behind them. As a general rule: Think twice before posting anything.

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Opinions

You can share guidelines or already proven scientific information. However, you should limit personal scientific opinions that have not been proven and avoid controversial topics. Social media is not a safe space to vent. You never know who can see your posts and how it can impact others.

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Privacy

Privacy is the biggest concern in the era of social media. There should be no PHI anywhere in social media. Even sharing events without any direct patient identifiers can lead to breach in privacy, e.g: “a patient came in today with a gastrointestinal bleed (GIB) – it was a bloodbath in the endo suite.” Although there are no patient identifiers, but this could still be traced: someone knows where you work and that is where their friend went today with a GIB. Thus, inappropriate use of social media can violate the HIPPA Act. One should also never rant about a colleague on social media.

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Legal implications

Physicians should always be aware of their state’s and institution’s social media policies (11,12). Failure to adhere to those policies can lead to repercussions which can be as severe as losing your job or license.

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SOCIAL MEDIA FOR SPECIFIC GROUPS

Social media platforms offer multiple opportunities for medical staff and trainees to communicate, network, and share research ideas or findings. In one survey of pediatric residency program directors, 38% characterized themselves as being very familiar with social networking sites and nearly a quarter used these sites daily (13).

Pitfalls using social media are often unanticipated and potentially devastating. In a survey of medical student deans, 60% of institutions reported incidents of medical students posting unprofessional online content (14). Reported incidents included the use of discriminatory language and profanity, violation of patient confidentiality, sexually suggestive material, and depiction of inappropriate behavior including intoxication. Unprofessional online behavior has also led to residency termination as well as defamation cases resulting from derogatory comments about medical colleagues. Additionally, senior educators have been the subject of reports of intimidation, harassment and cyberbullying directed at trainees (15). Many institutions now offer educational programs regarding social media. Written guidelines concerning social networking as well as remediation programs are becoming more common as well (13).

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CONFLICTS OF INTEREST

Guarantor of the article: Andrew Feld, MD, JD.

Specific author contributions: MB, ST, JR, CS, and AF wrote portions of the manuscript. MB, ST, JR, CS, and AF were involved in concept design. CS and AF edited the manuscript and provided expert opinion. All authors approved final version of the manuscript.

Financial support: None.

Potential competing interest: None.

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REFERENCES

1. American Academy of Family Physicians (AAFP) Social Media Guidelines for Family Physicians. AAFP Communications/Social Media. 2013: https://www.aafp.org/dam/AAFP/documents/about_site/SocialMediaFamPhyspdf. Accessed on 28 June 2018.
2. Farnan JM, Snyder Sulmasy L, Worster BK, et al Online medical professionalism: patient and public relationships: policy statement from the American College of Physicians and the Federation of State Medical Boards. Ann Intern Med. 2013;158:620–7.
3. Bernstein KI, Promislow S, Carr R, et al Information needs and preferences of recently diagnosed patients with inflammatory bowel disease. Inflamm Bowel Dis. 2011;17:590–8.
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11. Social Media Guidelines for Physicians December. Adopted by the MMS House of Delegates in May 2011, and updated December 2015. http://www.massmed.org/Physicians/Legal-and-Regulatory/Social-Media-Guidelines-for-Physicians/#.WzWFXNJKg2w. Accessed on 28 June 2018.
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15. Retrouvey HWA Are medical trainees and doctors prepared for the new social media frontier? 2017. http://healthydebate.ca/opinions/medicatrainees-doctors-social-media. Accessed on 3 May 2018.
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