Testing the Waters
To what extent should doctors separate their personal and professional online identities?
With the advent of smartphones, the use of social media has exploded with such popular sites as Twitter, Facebook, Pinterest, Google+, Instagram, and Tumblr. As one media domain fades in popularity, several new platforms grow, each promising instantaneous connectivity with far-flung networks of people.
However, the growth of these public social media options poses a tricky problem for doctors, who must balance professionalism with their personal lives on a daily basis, particularly online.
The AMA offered guidelines in 2010 suggesting that “to maintain appropriate professional boundaries, physicians should consider separating personal and professional content online.” However, in a recent opinion piece in the Journal of the American Medical Association, Matthew DeCamp, MD, PhD, an assistant professor at the Johns Hopkins Berman Institute of Bioethics and Division of General Internal Medicine, and two co-authors call for the medical community to rethink this relationship with social media.
“Separating personal and professional identities [online] seems intuitive” as a way to protect your privacy, comments DeCamp. But, he says, “it’s practically impossible to maintain this separation because anyone can web sleuth to ‘connect the dots.’”
Arguing that in actuality “physicians don’t separate identities in most other contexts,” DeCamp points out that “medical students are taught to manage, not separate,” their personal and professional identities in all public interactions with potential and existing patients. The AMA guidelines thus ask physicians to use social media contrary to how they were trained to treat public interactions outside of the office or hospital. Younger physicians — many of whom grew up with Facebook — also may have a different sense of privacy and as a result could be more comfortable with blurred identities.
The downsides of erecting walls between personal and professional identities online, according to DeCamp, include the burden of time and resources on physicians as they maintain entirely separate social media accounts and the fact that they “might miss the opportunity to develop more meaningful relationships with patients, or patients might lose trust in their physicians if they sense they have something to hide,” DeCamp says.
It is “essentially impossible” to maintain a truly anonymous online identity, says Greg T. Mogel, MD, the regional department chief of radiology at the Colorado Kaiser Permanente Medical Group, whose Twitter handle is @gregmogel. “The decision then is whether to participate in social media at all; to participate in a very structured (and some might say artificial and disembodied way); or to participate in a way that balances being a ‘real person’ and a professional,” Mogel says.
According to Mogel, “nonparticipation is not a choice in the long run” because, much like email 20 years ago, social media is here to stay and will fundamentally impact business and personal connectivity as it grows and evolves. And while participating in a solely professional way is a “perfectly reasonable” extension of marketing and advertising, savvy individuals will sense that you are not truly engaged and are instead focused on advertising.
According to Mogel, the key to creating a successful social media presence as a doctor is to balance personal interactions with patients as you would in any public, daily encounter. “I don’t think social media fundamentally changes how one does this,” Mogel says. “In the end, the power of social media is for people to interact with you as a whole person. This requires the sharing of honest interests and feelings. That need not be highly controversial.”
However, just because a physician is interested in social media does not mean that one account has to perform every function, according to Greg Matthews, a managing director of media and engagement at WCG, a strategic communications firm, who recently trained a group of radiologists in social media use at the California Radiological Society’s annual meeting.
“It’s perfectly fine to have one account in which the physician discusses medical topics only and another in which other topics are discussed,” Matthews says. “There is no need to call attention to one account from the other, but there probably shouldn’t be any overt attempt to deny its existence either.”
The question is really one of voice, rather than of separating personal and professional identities, Matthews says. All social media accounts — those in which you identify yourself as a doctor and those in which you identify yourself by a specific interest — “should reflect who you are as a person and should be written in your own personal voice. It’s just that neither one should share content that would reflect negatively on you or the organizations with which you affiliate,” Matthews says.
Garry Choy, a radiologist in the division of emergency radiology and teleradiology at Massachusetts General Hospital in Boston, who tweets from @garrychoy, advocates for a separation between professional and personal identities online, although he agrees that this is something physicians already practice on a daily basis.
“Maintaining professionalism online is similar to maintaining professionalism in real life,” Choy says. “A physician already practices the separation of personal and professional life in the hospital or in other professional settings such as conferences, meetings, or other venues; social media venues are no different.”
Choy argues that physicians can allow themselves more freedom of expression to a limited network of people by using social media platforms’ online privacy and security settings.
However, even if physicians decide to make use of such settings, Choy points out that “any content posted on Twitter or any public social media site should pass the ‘front-page test’ — is the content acceptable to be printed on the front page of a newspaper?”
By Catherine A. Cardno, PhD