Social media tools are– or at least should be – fundamentally rewriting the rule book when it comes to boundary issues for physicians. As one pediatrician who is active on Twitter recently told me “There is only one me.”
While maintaining a distinct divide between professional and personal life has always been a central tenet of the rules and regulations that govern the medical profession (not dating your patients while in a doctor/patient relationship being the prime example), for those physicians using social media it is abundantly clear the issue is no longer clear-cut.
Nowhere has this situation been better stated than in the recent viewpoint “Social Media and Physicians’ Online Identity Crisis” published in JAMA, Aug. 14 (v.310, no: 6, 581-582).
Authors Matthew DeCamp, Thomas Koenig and Margaret Chisolm (@whole_patients) confront the whole professional/personal divide directly and bluntly state attempting to have such a divide when using social media is “operationally impossible, lacking in-agreement among active physician social media users, inconsistent with the concept of professional identity, and potentially harmful to physician and patients.”
As they note later, the very blurring of the divide between professional and personal life is part of the draw of social media communication for many doctors because it allows for the leveling of hierarchies and more transparency.
However, the reality is that most medical regulatory authorities continue to adamantly stick to their guns and state that should physicians choose to use social media then they must strictly enforce the boundary between professional and personal identifies. Not surprisingly such an approach makes many physicians reluctant to communicate using social media for fear of running afoul of the guidelines.
The authors of the commentary from Johns Hopkins have a simple yet realistic approach to this dilemma.
They argue that rather than eliminating boundaries and “suggesting anything goes,” physicians should just ask themselves whether what they are posting on social media is appropriate for a physician in a public space – with the issue of the content being professional or personal being irrelevant.
This is an approach many physicians actively using social media have already adopted and wider promulgation of this mindset would doubtless increase the comfort level for those physicians who want to widen their horizons through the social media looking glass.