Psychiatry and Professionalism in the Digital Age

The popularity of social media has brought with it an innovative way for physicians to connect with others, whether that be networking with colleagues, promoting health information, or advocating for patients. However, social media has also created professionalism and ethics concerns for the modern psychiatrist, particularly psychiatry trainees. Guidelines for ethical conduct on social media are new and developing, and were the basis for a disscussion at a workshop called “Blurred Lines: Challenges Encountered by Psychiatry Trainees in Maintaining Professionalism in the Digital Age” at the APA annual convention. Drs Jennifer Laidlaw, Kathleen Sheehan, and Adrienne Tan of the University Health Network in Toronto were the presenters.

Social media is defined as “Internet-based media and interfaces designed to connect people to each other and facilitate interaction with user-generated content.”¹ The importance and impact of social media use in health care is clear: 72% of patients seek health information online and 20% use social media to connect with others with the same illness.² In addition, physicians are also using social media: 87% have a personal social media account and 67% maintain a professional account.³ Social media use has become essential in modern health care for instantaneous information sharing and collaboration between health care professionals and for providing credible information and advocacy for patients and the general public.

However, with both physicians and patients using social media, situations of questionable ethical and professional conduct often arise. Thirty-five percent of physicians report receiving a “friend” request from a patient, and 16% of physicians admit they have visited a patient’s online profile.⁴ In a study of medical student social media use, 60% of the US medical schools under examination reported unprofessional online content posted by their medical students.¹

Unprofessional behavior included breaches of confidentiality, use of profanity or discriminatory language, depictions of intoxication, and sexually suggestive material.

Current guidelines by the AMA, Federation of State Medical Boards (FSMB), and a joint paper by the FSMB and American College of Physicians are evolving and often lag behind fast-growing social media presence of medical professionals.

A few important points from these guidelines:

• All content should be considered public and permanent

• Always consider patient privacy and confidentiality in social media

• Use privacy settings to safeguard personal information and content

• Maintain appropriate boundaries when interacting with patients online

• Consider keeping separate personal and professional social media accounts

• When you find unprofessional content posted by a colleague, bring it to the attention of the colleague; if it is not adequately addressed, bring it to the attention of appropriate authorities

As the use of social media becomes necessary for the online presence of medical professionals, this topic will continue to be essential for the train-ing of current and future psychiatrists.

Guidelines for Physicians When Using Social Media

AMA: http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion9124.page

Federation of State Medical Boards:http://www.fsmb.org/pdf/pub-social-media-guidelines.pdf

American College of Physicians: http://www.acponline.org/pressroom/online_medical_professionalism.htm

This article was originally posted online on 5/15/2014 and has since been updated.

Disclosures:

Dr Peek is a psychiatry resident at Tulane University School of Medicine, Department of Psychiatry and Behavioral Sciences, New Orleans, Louisiana. Her website is www.psychgumbo.com and Twitter handle is @psychgumbo.

References:

1. Chretien KC, Greysen SR, Chretien JP, Kind T. Online posting of unprofessional content by medical students. JAMA. 2009;302:1309-1315.

2. Fox S, Jones S. PewResearch Internet Project. The Social Life of Health Information. A shifting landscape. June 11, 2009. http://www.pewinternet.org/Reports/2009/8-The-Social-Life-of-Health-Information/02-A-Shifting-Landscape/1-Americans-are-tapping-into-a-widening-network-of-both-online-and-offline-sources.aspx. Accessed May 12, 2014.

3. Modahl M, Tompsett L, Moorhead T. Doctors, patients, & social media. September 2011. http://www.quantiamd.com/q-qcp/DoctorsPatientSocialMedia.pdf. Accessed May 12, 2014.

4. Bosslet GT, Torke AM, Hickman SE, et al. The patient-doctor relationship and online social networks: results of a national survey. J Gen Intern Med. 2011;26:1168-1174.