Dr. Pho adds, “You have no control over what other
people say about you, but you have total control
of the content you create about yourself and your
practice.”
There are other dark sides to social media, or
‘sosh-meed’ in the vernacular or #SoMe—which
is the hashtag for social media, not a collection
of self-centeredness. “Our trainees are coming
to us addicted to technology,” according to Dr.
Papadakos. At an ACC.15 session, Dr. Papadakos
was charged with arguing against social media.
He sums the problem up as “distracted doctoring”
related to incorporating social media tools were
promoting learner engagement (71% of studies),
feedback (57%), and collaboration and professional
development (both 36%).2 The most commonly
cited challenges were technical issues (43%), variable learner participation (43%), and privacy/security concerns (29%).
On the flip side, if doctors are going to further
their reach with online teaching tools, they really
better know what they are doing! When researchers in Turkey assessed chest tube insertion techniques illustrated on YouTube videos with cur-
“Social media, electronics, all this
stuff is great, but we need to learn
how to integrate this technology into
our day-to-day practice.”
- Peter Papadakos, MD
and his gut feeling is that lives are in danger. He
noted that the American Society of Anesthesiology is going to start asking about technology use
at the beginning of residency to identify residents
“who may have a problem, because in anesthesia
someone who’s not vigilant in the operating room
is going to be very dangerous.”
He also told the cautionary tale of a physician
who was sued and the attorney got hold of his
cellphone records to prove he was distracted. “For
$125, your carrier will share a record of every text
you sent, every Tweet you did,” he said.
“Social media, electronics, all this stuff is great,
but we need to learn how to integrate this technology into our day-to-day practice,” said Dr. Papadakos.
One particular concern he holds: younger staff and
trainees may feel uncomfortable or even lack appropriate communication skills for patient care having
spent their entire lives glued to their electronics.
It has been suggested that since younger physicians and trainees are so comfortable with digital
technologies, perhaps even addicted to them,
maybe it’s best to consider moving their training
online. One study found that a “sandwich e-learning
approach” to supplement point-of-care ultrasound
courses led to equal rates of knowledge retention
compared to classroom lectures and post-course
learning. Moreover, students appreciated new media for learning experiences and were happier with
their learning activity.1
Social media is already being used for e-learning, particularly when incorporated in medical
education and clinical practice. In one systematic
review of social media in medical education found
that the most commonly reported opportunities
32
CardioSource WorldNews
rent practice guidelines, they were unimpressed
with many.2 The median total score (on a scale of
0 to 10) for videos originating from authorized
foundations was 9 compared to a score of just 4
for those from “health care professionals” (physicians, emergency medical technicians, nurses,
etc.). Accuracy did not correlate with the number
of views per video.
The researchers suggested that while medical
training can be improved by watching video clips,
mistakes and misunderstandings can be made if the
videos are missing important information or are
simply incorrect. A peer review process is needed,
they concluded.
#Oversharing
Twitter, Instagram, Facebook, and LinkedIn may
be great for patient education and engagement,
networking, etc., but they can also get physicians in
trouble, if misused. One challenge posed by social
media is separating one’s personal and professional
lives. This separation can be quickly blurred when
doctors enter the social networking realm.
Recently, a certain celebrity who seems incapable of staying off social media (who will remain
unnamed to prevent additional publicity) was
“diagnosed” by a TV psychologist with “oversharing.” It makes one wonder if oversharing will be
appearing sometime soon in the Diagnostic and
Statistical Manual of Mental Disorders (DSM).
Already there is talk of including nomophobia—
the fear of having no mobile phone handy—in the
next version of DSM.
Certainly, many who participate regularly on
social media sites find it hard to resist the urge to
share, but a policy statement from the Canadian
Medical Association notes that physicians should
retain the same boundaries and professionalism
that would apply to face-to-face communication
when interacting electronically. The statement
warns about patient confidentiality issues but
clearly suggests several benefits from social media
involvement, including more frequent communication with patients, quick access to medical
expertise, and the dissemination of evidence-based
medical information on social media sites that can
improve the quality of the information made available to the public.
Beyond issues of privacy and professionalism, physicians might also get in trouble with the
Health Insurance Portability and Accountability
Act (HIPAA), not to mention state privacy laws
and state medical laws. The issue is not TMI
(#TooMuchInformation) but PHI—protected health
information, defined under HIPAA as health information that relates to:
• the individual’s past, present, or future physical
or mental health or condition;
• the provision of health care to the individual; or
• the past, present, or future payment for the
provision of health care to the individual, and
that identifies the individual or for which there
is a reasonable basis to believe can be used
to identify the individual. PHI includes many
common identifiers (e.g., name, address, birth
date, Social Security Number) when they can
be associated with the health information listed
above.
“HIPAA does allow us to exchange privileged health
care information with another doctor for treatment
purposes, but you have to keep it quiet, it can’t be
broadcast mainline,” explained Dr. Campbell at last
year’s ACC meeting.
note: doximity.com is a private network for physicians and medical students. It is convenient and
HIPAA-compliant.
#EvenTheFDATweets
Don’t think the Food and Drug Administration (@
US_FDA) doesn’t approve of social media use. In
fact, their policy “encourages employees to use
social media to share information that may benefit
the public health.” Even for industry, the FDA has
acknowledged the usefulness of social media as a
means of rapidly communicating information about
medical products to consumers.
To assist the process, the FDA has issued specific recommendations for how to present risk-benefit
information using social media sites with character
limitations, such as Twitter and paid search results
on Google and Yahoo.
April 2016