Social Media and the Medical Profession


I have followed with interest an excellent reflective post by Anne-Marie Cunningham, who wrote about some “overheard” Tweets from doctors, who were using language that some people could be offended by.

“The terms used were ‘labia ward’ and ‘birthing sheds’ to refer to the delivery suite where women give birth, and “cabbage patch” to refer to the intensive care ward where many patients are unconscious.”

I have to thank Anne Marie for raising this issue. All the contributions to the debate have been very interesting to follow, as both the original Tweets and the debate that follows shed light on how much progress has been made in the education of medical professionals in the use of social media.

It has been interesting to note the different tones of the contributions on the blog, on Twitter, and on the Medical Registrar’s Page on Facebook.

I don’t think this is an issue confined to medical staff, I think all healthcare workers are still finding their feet in social media and appropriate behaviours (Lane & Twaddell, 2010). As with the ‘crowded bus’ analogy, I always think “would I be happy to say this in the lift at work?”, when posting in social media. As one commenter on the Facebook discussion stated:

“Discussions like this that take place in forums frequented by the public paint the medical profession in a decidedly un-professional light.”

Many posters agreed that

“I guess we like to think of Facebook and twitter as having a pint with our friends, whereas actually what we post on here is more like shouting something at the top of our voices on a crowded public bus. I don’t think this is about ‘thought police’ but about courtesy in public and the reputation of our profession.”

It’s a topic discussed with increasing frequency in the literature, as our patients and service users become more tech savvy, so must we (Brown, 2011 and Nacinovich, 2011).

As e-patient Dave so succinctly put it, in his response to Anne-Marie’s post,

“I say, one is responsible for one’s public statements. Cussing to one’s buddies on a tram is not the same as cussing in a corner booth at the pub. If you want to use venting vocabulary in a circle, use email with CC’s, or a Google+ Circle.

One may claim – ONCE – ignorance, as in, “Oh, others could see that??” It must, I say, then be accompanied by an earnest “Oh crap!!” Beyond that, it’s as rude as cussing in a streetcorner crowd.”

And equally sound advice from a poster on Facebook,

“Some of you need to really take a long look at the dehumanising nature of your jobs and try to rise above it… Social media makes the world a smaller place. Sometimes you should refrain from writing down your thoughts in public places like to FB and Twitter.”

If you want to post more… ahem… *colourful* content, my advice would be to set up closed groups in Facebook and only invite other doctors, or have profiles under nom de plumes and network on high privacy settings with people who you know IRL only. Otherwise, if we are to pursue congruent online and offline identity (and I think we must, for sanity’s sake) then be aware that everything you say online is actually covered under the same code of ethics and professional demeanour that covers the rest of your career. What you post privately today may well become available tomorrow, as privacy settings can be altered with frequency, for example on Facebook. Inappropriate online comment could be subject to complaints from members of the public, other professionals, patients, carers etc., and could lead to disciplinary action. I would counsel against posting comments such as the following, if you value your future career

“wow, really… if you’re offended, fuck off and don’t follow them on Twitter, and cabbage patch to refer to ITU is probably one of the kinder phrases I’ve heard…”

There is emerging literature available to guide the use of social media in medical education (Farnan et al., 2009; Landman, Shelton, Kauffmann, & Dattilo, 2010)

Blogging, and Anne Marie’s blog is a fine example, has been stated to be an appropriate developmental tool for clinicians (Bodell et al., 2009) and it would be a shame if clinicians failed to take advantage of such tools for fear of being accused of misconduct.

N.B. I have chosen not to identify posters who have written content which portrays them in a less than professional light.

  • Edit [17/09/11] Today’s Telegraph commented on this post, and has attracted interesting comments
  • Edit [18/09/11] Further discussion in the MSM today regarding this event, which is being dubbed #hcsmgate on Twitter.
  • Yesterday’s Telegraph discusses the terms used as “banter”, and additionally yesterday’s post linked to above is available, as is a dictionary of medical terms used by some doctors. h/t @health20paris for Tweeting the link.
  • Today’s Mail on Sunday discusses whether terms such as those used by the doctor @amcunningham blogged about have any place in modern, patient-centred care. h/t @Pillmanuk for Tweeting the link.
  • It is interesting to see such polarisation in the comments between people who say black humour is a way of managing stress and we should all “lighten up”, and people who think that patients deserve respect in all settings, and that includes being protected from abusive, derogatory and bullying talk. I have to say, I agree with the latter view. Comments in public should at all times uphold the values of the profession.
  • Edit [18/09/11] I responded to this blog post regarding the topic http://runningahospital.blogspot.com/2011/09/storm-brews-across-pond.html?m=1
  • Edit [19/09/11] further comment from the blogosphere:
  1. @PaulLevy’s post in Not Running a Hospital
  2. @Thinkbirth‘s post
  3. @sarahstewart‘s post
  4. @laikapoetnik  in Laika’s MedLibLog

all are recommended posts.

References

Bodell, S., Hook, A., Penman, M. and Wade, W. (2009). Creating a learning community in today’s world: how blogging can facilitate continuing professional development and international learning. British Journal of Occupational Therapy. 72(6) June pp. 279-281. Retrieved September 16, 2011, from http://docserver.ingentaconnect.com/deliver/connect/cot/03080226/v72n6/s7.pdf?expires=1316166667&id=64421118&titleid=6174&accname=College+of+Occupational+Therapists+Referrer+URL&checksum=1511D65AE17D156D5E8AF7A6E7F47B11

Brown, T. (2011). Are you a digital native or a digital immigrant? Being client centred in the digital era. British Journal of Occupational Therapy 74(7) July, p.313. Retrieved September 16, 2011, from http://docserver.ingentaconnect.com/deliver/connect/cot/03080226/v74n7/s1.pdf?expires=1316165615&id=64420866&titleid=6174&accname=College+of+Occupational+Therapists+Referrer+URL&checksum=54AC84699E58AB65668EDD2090BBC134

Farnan, J. M., Paro, J. A. M., Higa, J. T., Reddy, S. T., Humphrey, H. J., & Arora, V. M. (2009). Commentary: The relationship status of digital media and professionalism: it’s complicated. AAMC Academic Medicine Journal of the Association of American Medical Colleges, 84(11), 1479-1481. Retrieved from http://journals.lww.com/academicmedicine/Fulltext/2009/11000/Commentary__The_Relationship_Status_of_Digital.11.aspx

Landman, M. P., Shelton, J., Kauffmann, R. M., & Dattilo, J. B. (2010). Guidelines for maintaining a professional compass in the era of social networking. Journal Of Surgical Education, 67(6), 381-386. Elsevier Inc. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/21156295

Lane, S. H., & Twaddell, J. W. (2010). Should social media be used to communicate with patients? MCN The American journal of maternal child nursing, 35(1), 6-7. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/20032752

Nacinovich, M. (2011). Rx to communicate: The E-patient will see you now. Journal of Communication In Healthcare, 4(2), 65-65. doi:10.1179/175380611X13097840494027

About

I am an Occupational Therapist, who writes about health, particularly mental health. I am interested in social media and Web 2.0, and where these technological advances can support wellness and health.

Posted in Blogging, Evidence based practice, Facebook, Reflection, Social Media, Social Media, Stigma, Twitter, Uncategorized
19 comments on “Social Media and the Medical Profession
  1. [...] Social Media and the Medical Profession I have followed with interest an excellent reflective post by Anne-Marie Cunningham, who wrote about some "overheard" Tweets from doctors, who were using language that some people could be offended… Source: claireot.wordpress.com [...]

  2. A thoughtful, well informed and professional commentary about this important topic Claire. This conversation is a very important one to have as many health care professionals do not fully appreciate the depth and breadth of the social media reach. As we have seen from this ‘learning opportunity’ the bullying culture is still alive and well in health care, even though with educators like Anne Marie, that culture is being challenged and changed as we speak (and write). Your readers may also appreciate Paul Levy’s commentary of the storm brewing across the waters on his Not running a hospital blog. Paul was the CEO of a large Boston hospital and successfully turned that hospital around in regards to improving patient safety and from both a financial and culture perspective.
    He made the decision to blog his work as CEO a move which, from what I understand, endeared him to the population of Boston.
    http://runningahospital.blogspot.com/2011/09/storm-brews-across-pond.html?utm_source=twitterfeed&utm_medium=twitter&utm_campaign=Feed:+blogspot/mJlm+(Not+running+a+hospital)
    Thanks again for adding so richly to the conversation.

    • Claire says:

      Thank you Carolyn.

      Yes, I believe it is about time we had these debates out in the open, so that future clinicians can learn that their use of social media should be held to the same professional standards as the rest of their behaviour!

      Thanks for commenting.

    • Claire says:

      OOOh, I didn’t realise you’d blogged about this, too, I will add it to my list. Thank you!

  3. I really enjoyed your post which, along with Anne-Marie’s was very reflective and balanced. I think there are a number of issues that have arisen from this story, not least cyber-bullying…which is a whole other topic.

    Here is my response…and not half as reasoned as yours: http://sarah-stewart.blogspot.com/2011/09/what-is-acceptable-language-from-health.html

    • Claire says:

      Thanks Sarah!

      Yes, I agree, I didn’t cover cyber-bullying, and it is a topic I hope to cover at some point. Nor did I discuss misogyny, although some of the comments made during the debate have been very personal and sexist, particularly on the Medical Registrar’s Facebook page in relation to Anne-Marie. I think these issues deserve further debate- you can be sure we’ll be coming back to them soon!

      p.s. I loved your post!

      • An excellent, recent book on cyber-bullying and cyber-cesspools is The Offensive Internet: Speech, Privacy, and Reputation, a collection of essays edited by Martha Nussbaum and Saul Levmore. Some of the essays are enough to scare one away from the Internet all together. Nussbaum writes a chapter on misogyny.

      • Claire says:

        Do you recommend it? I may get it out of the library- just for a little “light” reading! I didn’t really touch on the misogyny in the responses to @amcunningham, but t was definitely part of the equation.

        Thanks for your interest.

      • Do I recommend it? The authors in the collection are excellent (I’m a Martha Nussbaum fan). I don’t enjoy learning about how mean and unkind human beings can be, but for anyone interested in the subject of cyber-bullying and cyber-cesspools, it’s an authoritative source of information. The Nussbaum essay on misogyny on the Internet was a bit too psychoanalytic for my taste. The authors are mainly academics or lawyers, but it’s quite readable.

  4. [...] Social Media and the Medical Profession (claireot.wordpress.com) [...]

  5. [...] Social Media and the Medical Profession I have followed with interest an excellent reflective post by Anne-Marie Cunningham, who wrote about some "overheard" Tweets from doctors, who were using language that some people could be offended… Source: claireot.wordpress.com [...]

  6. [...] Social Media and the Medical Profession « Claireot's Blog I don't think this is an issue confined to medical staff, I think all healthcare workers are still finding their feet in social media and appropriate behaviours (Lane & Twaddell, 2010). As with the 'crowded bus' analogy, I always think … Source: claireot.wordpress.com [...]

  7. [...] Social Media and the Medical Profession I have followed with interest an excellent reflective post by Anne-Marie Cunningham, who wrote about some "overheard" Tweets from doctors, who were using language that some people could be offended… Source: claireot.wordpress.com [...]

  8. [...] Social Media and the Medical Profession I have followed with interest an excellent reflective post by Anne-Marie Cunningham, who wrote about some "overheard" Tweets from doctors, who were using language that some people could be offended… Source: claireot.wordpress.com [...]

  9. [...] Social Media and the Medical Profession I have followed with interest an excellent reflective post by Anne-Marie Cunningham, who wrote about some "overheard" Tweets from doctors, who were using language that some people could be offended… Source: claireot.wordpress.com [...]

  10. [...] Social Media and the Medical Profession I have followed with interest an excellent reflective post by Anne-Marie Cunningham, who wrote about some “overheard” Tweets from doctors, who were using language that some people could be offended by. [...]

  11. [...] with other medics about professional behaviour online that was termed #hcsmukgate and which I blogged about some time [...]

  12. Linda says:

    Great area of discussion. I think it is important to watch our language wherever we are, not just on social media. “Black humor” just isn’t funny because it is at someone else’s expense. It is the same as laughing at a racist joke. The other point to consider is that language not only reflects our thoughts, it also helps to shape them.

    As health care providers, we should be setting an example of treating our patients with respect, and remembering that they are people, with families who love them. If you can’t remember that, maybe it is time for a break from your job. I worked in an environment where disrespectful language was used, and family members would have been horrified if they knew how their loved ones were being referred to. I worked together with my manager to help change the language, and I think it helped change the working environment as well.

  13. Eleni Berthelots says:

    A propos, en matière d’immortel, ll se dit que le fameux libraire Gérard Collard, qu’on voit à la librairie Griffe Noire, envisage de postuler pour être élu à l’Académie .. Je pense que cela donnerait un nouvelle élan à la noble institution, foi de Saint Maurien. Qu’en penser ?

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Claireot

I'm an OT called Claire. I write about health, particularly mental health, and also about Social Media and Web 2.0 technology. I am particularly interested where these two fields overlap.
I believe that we all hold the potential for Recovery- let's grow together.

TWIM Blog Awards 2012
This Week In Mentalists Blog  Awards 2012

I'm chuffed to bits to have been shortlisted!

Kred top 50 Health Bloggers
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  • @MarkNeary1 goodness: so sorry to read about the storm: you've been hit by lightning! Hope you & Steven are ok, despite all the hassles. 2 hours ago
  • RT @Reynolds: Referral for possible non accidental injury, for parents saying son marked by satan, and for newspaper calling boy of four ‘S… 2 hours ago
  • @MsVicButcher I'm off to listen to something soothing and go to bed. I guess we just have to keep going? And hope we find a way x 9 hours ago
  • @Badassperger you know what? I genuinely think it's hard to be a good ally, and I wish you all the best with it. Goodnight x 9 hours ago
  • @Badassperger women are raised to respond to men through compliance. So it's unsurprising to me that we tend to do this, yes. 9 hours ago

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