HCSMgate

We’ve all been in one of those conversations where someone makes a remark, often in humor, and someone else in the conversation explodes in response. The Twitter equivalent of that conversation occurred a few weeks ago when @Doctor_V reacted to some tweets by @Mommy_Doctor.

The issue arose following some tweets by @Mommy_Doctor, an anesthesiologist, about a patient with priapism (that thing that they warn you about in the ads for ED meds).  You can see the offending tweets in @Doctor_V’s original blog post.

@Doctor_V, who has stated in no uncertain terms that doctors should be transparent about their identities online, is actually Bryan Vartabedian, MD who describes himself as “…a pediatric gastroenterologist at Texas Children’s Hospital/Baylor College of Medicine. I write and think about the convergence of social media and medicine.”

I’m intrigued at the level of anger from both @Doctor_V and the other commenters on his blog post.  They seem to represent a singular vision of how social media should be used by physicians and that @Mommy_Doctor’s particular approach is out of bounds.

This is where my own interpretation of the situation differs from @Doctor_V’s.  Some people use Twitter to share great insights they’ve found while others share the conflicts they encounter in their daily choice of breakfast cereal.  Not every social media post out there needs to be deep and meaningful.  In the case of @Mommy_Doctor, she was sharing her particular real-world view of life as a physician while injecting a lot of humor.  I suspect this was a coping mechanism that helped her deal with the stresses of juggling the demands in her life.  There was no way to do this without also maintaining some level of anonymity.

That said, @Mommy_Doctor knew the line that she was walking.  Despite the claim in her Twitter profile (she has cancelled her account in the wake of this situation) that “Tweets are based on fictional characters and situations,” I have a hard time believing that she was not discussing a real patient.

There have been some impassioned defenses of the original posts as well as a lot of post-game analysis of the discussion that occurred.  There is not, however, any sort of consensus on the appropriateness of the original tweets or how we may need to clarify what’s appropriate and what’s not.

I’ve shared my thoughts on what makes for a good social media policy as organizations attempt to provide rules and guidance to their employees’ personal use of social networks.  It’s equally important to have a personal social media policy that answers the following questions (do one of these for each platform that you use):

  • Are you intending to use this as a personal channel, professional channel or as an official channel of your organization?
  • What’s the purpose of the blog/Facebook page/Twitter account/etc.?  Do you focus it on a particular set of issues, or are you sharing anything of interest?
  • Who is your intended audience for this information?
  • How will you present yourself on this channel?  Will you reveal your identity or use a pseudonym?  Keep in mind that it’s never OK to pretend that you’re something that you’re not if this is a professional or official organization channel (such as pretending that you’re a patient when you’re actually a physician or hospital administrator).
  • What boundaries are you setting around the issues you plan to discuss?  How will you discuss patient issues?  How will you discuss sensitive organization issues?  Will you discuss politics?
  • How will you handle negativity when it’s directed towards you personally or towards an individual, organization or cause that you support?
  • How much to do you intend to engage with others vs. engage in self-promotion?

Putting those thoughts together before you begin will likely make your social media outreach more interesting and engaging.  Checking in with them periodically will help keep you from straying into territory your uncomfortable with.  If @Mommy_Doctor had just referred to a self-created personal media policy before posting on this particular issue we wouldn’t have had to lose her voice in the social media landscape.

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