Which of these social media posts could potentially cause you to lose your job?
- “I have a 92-year-old pt. in my SNF who was hospitalized on 5/12/13 and 7/13/13, with chest X-rays from both admissions indicating right lower lobe pneumonia. Pt. demonstrates no overt s/s of aspiration on any consistency. I’ve recommended a modified barium swallow study but it will take two weeks to get it done since we are in rural Michigan with access to only one local hospital. What can I do to treat this patient while waiting to get an MBSS?”
- A photo on Facebook of you and your colleagues interacting with patients, taken at work during a Better Hearing and Speech Month celebration.
- A blog post about your exhausting day at work and your inability to deal with your organization’s increasingly “unethical” demands.
The correct answer is “all of the above.” Health care professionals who made social media posts similar to these have faced employer disciplinary action or licensing board sanctions, or have been fired—though none of them explicitly named the patient or the organization. Documented cases show that even innocuous posts seeking professional consultation on social networking sites have been treated as violations of patient privacy.
Unfortunately, privacy is a myth in the world of social media. Despite the strictest privacy settings on any social media site, your Tweets, likes, shares, comments, posts and blogs form a visual record of your dialogue with the world, and could have serious ramifications for your professional life.
Some risks of professional engagement using social media channels include:
Patient privacy. Case consultations that were once conducted in hushed voices or behind closed doors are now available for anyone to access—all it takes is for one person in your network to share what you posted in a “closed” group. Despite your honorable intentions in seeking professional consultation, your post may provide others a peek into your patient’s medical records without the patient’s expressed consent. Removing a patient’s name alone is not sufficient “de-identification”. Although individual pieces of information may be non-identifiable, the sum of the disclosed information may lead someone on your social or professional network to identify the patient through context.
Patient-provider interaction. Consider the privacy consequences of “friending” a patient. Difficult ethical issues may arise when you are privy to information about your clients or their families that wasn’t disclosed to you during a professional consultation.
Copyright infringement. Sharing proprietary, restricted-access clinical and research resources developed by your organization or another professional is an infringement of copyright.
Implied endorsements. Linking to, “liking” or following a post or news article may suggest your endorsement of information that may conflict with your organizational or professional values and ethics.
Lack of disclosure. Failure to indicate if the posted content is based on research, professional experience or personal opinion—especially when your organizational affiliation is evident—could constitute lack of disclosure.
To post or not to post … ?
- Consider these questions before making your next social media post:
- Does it reveal any protected health or proprietary information?
- Does it depict a person or my organization in a negative light?
- Does it conflict with my organization’s values or the ASHA Code of Ethics?
- Does it violate my organization’s social media policy?
- How will it affect my clinical practice or professional reputation if someone on my network shares this information?
Returning to our opening examples, the first post clearly violates patient privacy and the second could also violate patients’ privacy and, arguably, rules for patient-provider interaction. Although the third post doesn’t violate privacy laws, it definitely depicts the blogger’s organization in a negative fashion. In light of the risks outlined above, clinicians should evaluate the consequences of posting such information.
The social media policies of health care organizations such as Duke Medicine [PDF] and the American Medical Association [PDF] provide excellent guidelines on the professional use of these platforms. ASHA’s online community guidelines are also informative. Use these resources to maximize the power of social media for public education, professional collaboration, information exchange and learning—without placing yourself at risk.