Twitter and Facebook have become integral part of our life and there are people who want to tweet every moment of their day to day activity. There is significant increase in tweets posted by medics such as trainee doctors that are breaching confidentiality of patients as reported by Journal of American Medical Association. I think as you enter a profession, especially medical, you are excited to learn and share your new experiences. Trainee doctors are keen to share private patient stories and details that have created concern form the medical community. Let us review the current issue in somewhat detail.
How bad is the tweeting patient story?
The Journal of American Medical Association has reported that more than half of 78 US medical schools have studied and reported cases of students reporting unprofessional content online. It was observed that one in ten of these violated the patient confidentiality. The most common form of so called “web gossiping” was in form of blog, including one on Facebook, which contained enough details of the clinical procedure that could lead to potential identification of the patient.
What were main inclusions in the medical web gossip?
The blogs are named “blue blogs” mainly contain:
- discriminatory and unprofessional language
- sexually suggestive material
- photo showing drunkenness and illicit drugs
- details of clinical history and procedure of patients
- Most of the school issued informal warnings against such cases, but some were serious enough to expel the student
- Some schools have policies in place that cover online social networking and blogging
line-height: 150%; margin: 0in 0in 0pt;">
Still there is a lot of discussion of the action that can be taken. Dr Katherine Chretien of the Washington DC VA Medical Center, lead investigator suggests that medical students should be taught about the risks involved in posting material online as a part of their training from the get go. The UK’s regulator of doctors, the General Medical Council, does not have guidance to cover medic’s blogging. So there is a clear need to put together a firm policy by medical councils and medical schools around the world to protects patient confidentiality.
Dr. Chretien says that “students may not be aware of how online posting can reflect negatively on medical professionalism or jeopardize their careers”. On the same note, patient confidentiality breaches may be unintentional. Health professional may share the stories that are de-identified and respectful to encourage reflection, empathy and understanding, but there is a risk of patient privacy violation. I think there a thin line between sharing information about medical cases with the broader community and breaching patient confidentiality.
A patient put lot of trust in the hands of medical professional and revelation of confidential information is inappropriate. Social networking media is coming as a big help in distributing information in fraction of seconds; some users have taken it bit far as to violate patient privacy, which may be unintentional. None-the-less the responsibility of and faith on medical professional can not be compromised.
While medical councils and schools are in a phase of analyzing gravity of the situation and working through controls to tackle the situation, I hope social networking sites themselves are thinking through the solutions. We are asked to fill out multiple forms before a medical procedure; it would not surprise me, if someday in near future there is a clause that asks you, “if you want to give permission to share your case on social networking sites”.