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Psychiatrists’ Use of Electronic Communication and Social Media and a Proposed Framework for Future Guidelines


Journal of Psychiatric Practice®: May 2013 - Volume 19 - Issue 3 - p 254–263
doi: 10.1097/01.pra.0000430511.90509.e2
Practitioner’S Corner

Background. Recent and ongoing advances in information technology present opportunities and challenges in the practice of medicine. Among all medical subspecialties, psychiatry is uniquely suited to help guide the medical profession’s response to the ethical, legal, and therapeutic challenges—especially with respect to boundaries—posed by the rapid proliferation of social media in medicine. Ironically, while limited guidelines exist for other branches of medicine, guidelines for the responsible use of social media and information technology in psychiatry are lacking. Objective. To collect data about patterns of use of electronic communications and social media among practicing psychiatrists and to establish a conceptual framework for developing professional guidelines. Methods. A structured survey was developed to assess the use of email, texting, and social media among the active membership of the Group for the Advancement of Psychiatry (GAP) to gain insight into current practices across a spectrum of the field and to identify areas of concern not addressed in existing guidelines. This survey was distributed by mail and at an annual meeting of the GAP and a descriptive statistical analysis was conducted with SPSS. Results. Of the 212 members, 178 responded (84% response rate). The majority of respondents (58%) reported that they rarely or never evaluated their online presence, while 35% reported that they had at some time searched for information online about patients. Only 20% posted content about themselves online and few of these restricted that information. Approximately 25% used email to communicate with patients, and very few obtained written consent to do so. Conclusion. Discipline-specific guidelines for psychiatrists’ interactions with social media and electronic communications are needed. Informed by the survey described here, a review of the literature, and consensus opinion, a framework for developing such a set of guidelines is proposed. The model integrates four key areas: treatment frame, patient privacy, medico-legal concerns, and professionalism. This conceptual model, applicable to many psychiatric settings, including clinical practice, residency training, and continuing medical education, will be helpful in developing discipline-wide guidelines for psychiatry and can be applied to a decision-making process by individual psychiatrists in day-to-day practice. (Journal of Psychiatric Practice 2013;19:254–263)

KOH: University of California, San Diego; CATTELL: Tufts Medical Center and Tufts Medical School, Boston. MA; COCHRAN: University of Massachusetts Medical School, Worcester; KRASNER: New York State Office of Mental Health and Columbia University; LANGHEIM: Dean Health Systems and the University of Wisconsin, Madison; SASSO: Yale University School of Medicine, New Haven, CT, and Child Guidance Center of Mid-Fairfield County, Norwalk, CT.

Acknowledgements: The authors acknowledge Larry Gross, MD, David Adler, MD, and Frances Bell. Other members of the GAP 2009-2010 Fellowship were Neil Aggarwal, MD, Benjamin Brody, MD, Mandy Garber, MD, Stephanie Giannandrea, MD, Hesham Hamoda, MD, Chad Lemaire, MD, Rebecca Lewis, MD, and Megan Testa, MD.

The authors declare no conflicts of interest.

Please send correspondence to: Steve Koh, University of California, San Diego, Department of Psychiatry, 9500 Gilman Drive, MC 0993, La Jolla, CA 92093.

© 2013 by Lippincott Williams & Wilkins, Inc.