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Professional use of social media

for residents

Where were you when the tide came in?

April 21, 2015

Pat Rich @cmaer

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Who I am

Pat Rich – Strategic Advisor, CMA

Enterprise Marketing

Experienced health care

communicator with a keen interest and

involvement in the use of social media

tools in medicine and health care and

believers in the value of these tools

WHO I AM NOT

Physician

Academic

Wh

at

is S

oc

ial M

ed

ia?

Extension of every day interaction

Conversations & exchange

Communities of shared interest

Tools for innovation

Integrates technology

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Why care?

“Whether physicians are active on social media or not, an

understanding of social media and its potential implications on their

professional lives is essential.”

Dr. Hartley Stern, CEO, Canadian Medical Protective Association

While individual physicians are at different stages in their use of

social media, it is a journey all physicians will eventually take. Social

media is becoming so pervasive its importance as a channel to keep

current on medical findings and to confer with colleagues is

undeniable.”

CMPA Supplement

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A changing environment: Are you digitally literate

enough to be a physician?

“Today’s medical professionals must be masters of different skills that are

related to using digital devices or online solutions” and mastering those

skills “is now a crucial skill set that all medical professionals require.”

Dr. Bertalan Mesko

The democratization of media has made every physician an independent

publisher …physicians now have to learn to manage and maintain their

identity in the public space,” Dr. Bryan Vartabedian,

From an article by Stephen Pelletier, in the AAMC Reporter,

Aug, 2014

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A changing environment

Reality of the networked world: social communication will define the way

MDs engage, learn and communicate

The most important decision a physician will make is who and what to

listen to

The internet has changed the way patients see doctors, their diseases

and themselves

A great digital footprint will never cover for a doctor’s poor careDr. Bryan Vartabedian, adapted tweets from lecture to first

year Baylor College of Medicine Students

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Social media “policies” by

academic medical centers or

medical schools point out the

“don’t do this, don’t do that”, but

let’s also focus on what the

trainees CAN do. Let’s

consider how we can IMPROVE

our current health care system

and ultimately the care of

patients with innovative uses of

social media and social

networking …

Dr. Alex Djuricich, Association

Dean for CME, University of

Indiana School of Medicine

Why consider social media?

To stay informed

Communicate (engage) with peers and patients

Disseminate information

To learn

Advocate for/against something

Because if you decide not to use social media, your

decision should be based on sound knowledge

about what you are choosing not to use

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Peer Leader – Dr. Jen

Gunter

OB/GYN, writer, sexpert, defender

of evidence-based medicine,

Canadian Spice. I wield the lasso

of truth. Tweets not medical

advice. I speak for no one but me.

21,000 followers on Twitter

Regular blogger

The HPV article

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Peer leader II

Dr. Helen Madamba

Obstetrician Gynecologist -

Infectious Disease specialist.

Public Health advocate. Research

enthusiast. Executive Director of

The Share A Child Movement, Inc.

147 followers on Twitter

Just learning to blog

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Social networking and ob/gyn

GYNCSM chat is for survivors,

caregivers, advocates and– this is the unique

part—healthcare providers. In addition to a

survivor, Dee @womenofteal, and patient

advocated, Christina @btrfly12, the chat has three

medical oncologist moderators: Dr. Don Dizon

(GYN/ONC), Dr. Merry J. Markham, Dr. Rick

Boulay (GYN/ONC) and Dr. Anne Becker-Schutte,

a mental health moderator.

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The rules

College of Physicians and Surgeons of Ontario Guidelines

CMPA overview of the impact of social media on your practice

Canadian Medical Association – Issues and Rules of Engagement

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“We have current roles

and guidelines but times

are changing quickly. By

2017 patients and their

health care providers

are going to be

communicating very

differently.”

Dr. Darren Beiko, Queens

University urologist, July,

2013

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The rules - translated

“Don’t be banal, self-promote excessively, share confidential material

(especially about patients), be a troll, break the law, commit a libel, or

overdo it.”

Dr. Richard Smith, BMJ, March 1, 2012

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“Don’t Lie, Don’t Pry

Don’t Cheat, Can’t Delete

Don’t Steal. Don’t Reveal”

Dr. Farris Timimi, medical

director, Mayo Clinic Center for

Social Media, April 5, 2012

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Key elements of the rules

* Apply same principles of professionalism that apply in person

* Respect patient confidentiality

“Social media should be treated as a public forum akin to an op-ed in a

newspaper or a lecture. Anything that would be inappropriate to share in

these more traditional outlets should be considered inappropriate to share

online.”

CFMS Guide to Medical Professionalism:

Recommendations for Social Media

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CMA guidance

Rules of Engagement

Understand technology and audience

Be transparent

Respect others

Focus on areas of expertise

Impact on patients

Liability

Privacy

Ethics

Boundaries

Time theft

Reputation

Compensation

Th

e c

ha

llen

ge

s

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What not to do

Chicago Doctor Accused of Posting Photos of Intoxicated Patient

Aug. 20, 2013 (AP)

By ALANA ABRAMSON A former Northwestern University student claims

that after she was admitted to an Illinois hospital for extreme intoxication, a

doctor there took photos of her and posted them to social media sites with

commentary about her condition.

Elena Chernyakova filed suit in the Cook County Circuit Court against Dr.

Vinaya Puppala, the Feinberg School of Medicine and the Northwestern

Memorial Hospital on Aug. 15, claiming invasion of privacy and infliction of

emotional distress. Puppala is a fellow in the Multidisciplinary Pain Medicine

Fellowship at Feinberg, which works in conjunction with Northwestern

Memorial Hospital, according to court documents.

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Twitter post by Tennessee cardiologist, Nov. 15,

2012

What not to do - II

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What not to do III - Cell phones in hospitals

“… one would be hard-pressed to find a health care team in which at least

one member is not engaged on their smartphone during rounds. While you

attend to the flashing light or fancy ring tone, others are usually wondering if

you are looking up a life-saving dose of an inotrope, answering a text

regarding dinner plans or simply being rude. Although technologies

themselves may be neutral, their use or misuse may not be.”

“Physicians also routinely answer their phonesand discuss confidential

patient information in environments that they previously would have avoided

for such discussions — cafeterias, elevators and other public places inside

the hospital or out.”

From “Be smarter with cell phones” editorial, CMAJ 2011

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Mobile device use in

hospital

• Does the hospital have a

policy

• Will it harm interaction with

patient?

• Is it a secure network for

sharing data?

• Can others overhear

confidential information?

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The Boundary FallacyKeeping a boundary between

professional and personal life on 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.”

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.

“Social Media and Physicians’ Online Identity Crisis”

published in JAMA, Aug. 14 (v.310, no: 6, 581-582).

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Social media and medical education

“Medical educators must begin modelling

professionalism online the way they currently do in

person. They will likely do so only when medical

curricula explicitly require use of social media as a

component of teaching.”

Drs. Moneeza Walji and Matthew B. Stanbrook CMAJ Online release April

7, 2015

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-“For those of us

who have the

philosophy that we

want to graduate

docs who are

better than we are,

Twitter is a great

thing.”

Dr. Chris Simpson, cardiologist

and CMA President-Elect

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I think there are too many people on the

Web offering advice to you on how to use

social media. Most of this advice is just

regurgitated advice from people you may

never have heard of before,

…You really don’t need “How To” tips

on blogging or Twitter. Oh, I’m

confident that you’ll be told otherwise

– but those folks, well-intentioned as

they may be, don’t understand that

you’re smarter than that.

Rather than learn bad habits from the

get-go, take advantage of your lack of

experience. It’s okay to make mistakes

that don’t cause harm and violate the

privacy and dignity of others.

From: Physician Social Media: Has

Advice About It Become a Crock? Yes

@philbaumann, Jan. 1, 2013

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Using social media in residency: Suggestions

Facebook presence for colleagues etc

LinkedIn account to:

Build network for future career

Follow discussion forums on medical education

Twitter account to:

Develop your list of people, journals and other accounts to follow

Watch (and engage) medical Twitter community (e.g. #hcsmca,

#hcsm)

Follow and engage your professors

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Why Twitter:

• Easy to set up

• Unthreatening

• Non-Intrusive

• Low maintenance

• Useful

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An expert Canadian physician voice

Dr. Ali Jalali, teaching chair, faculty of medicine, University of Ottawa

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CMA Leadership

• CMA Rules of Engagement

• CMA Online Course on

Social Media Use

• CMA guidance on use of

medical apps by patients

• Current president leading

advocate of social media

use by physicians

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▸Questions?

Case study: The Political Resident

Brandon is a resident who, since starting medical

school, has kept a blog about his views on medicine,

medical education, and health care politics. Recently,

Brandon has blogged extensively about his extreme

political views regarding the upcoming election. His

residency director reads his blog and tells him that he

must delete his posts and can no longer write new

ones, as he is not only a hospital employee and a

representative of the residency program, but also a

professional who must represent himself accordingly

American College of Medical Schools Digital Literacy Toolkit

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Discussion

Is it reasonable for the residency program director to tell this resident that

this non-medical blog should be removed? The residency director tells this

resident to remove his blog. What would an appropriate response be?

A. What a resident does on his own time is his business.

B. He should have asked him to remove the offending posts and be

careful in the future.

C. When you are a student and resident, you are ultimately under the

guidance of your dean and residency director.

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Case study: The Case of the Facebook Faceplant

The Case of the Facebook Faceplant

From: Academic Life in Emergency Medicine – MEdIC

Series