AMA Policy – Professionalism in the Use of Social Media

AMA – AMA Policy – Professionalism in the Use of Social Media – This was posted recently and it is a good piece of work that will promote physician (and patient) discussion about the professional role and use of social media. Tip to Jane Sarasohn-Kahn ( @healthythinker ) for writing it up in her I-try-to-read-every-post blog, HealthPopuli.

I applaud the American Medical Association (of which I am not currently a member, but I am a member of Medical Society of District of Columbia) for recognizing that physicians are engaging in this communication and that it has benefits. The history of AMA with regard to electronic communication with patients is definitely changing for the better (several posts about the past are here).

Opening paragraph:  It seems to refer to a “one way” dialogue with patients – “provide opportunity to widely disseminate public health messages and other health communication.” Question is, can physicians actually use the medium to reduce the separation between the profession and patients to promote quality, safety, affordability, to learn to be better doctors? My answer is yes.

(a) Don’t Post patient-identifiable information online – We have to protect patients’ personal information. I think it’s important to differentiate “without their consent.”

Sometimes, they want us to share it, and we will do that with their consent. “This is important because it allows the patient story to come into our work. For example, on this blog, the stories of Regina Holliday ( @ReginaHolliday ) and ePatientDave (@epatientdave ) and Donna Cryer ( @donnacryer ), are told with their consent. Because Regina is actually a member/patient in the health care system I work in, Kaiser Permanente, she has signed a HIPAA release document allowing us to tell her story.

In actuality, I have met patients who have gone through the HIPAA release process, and it is less “allow” and more a request to “promote,” so that other patients after them will have great health care. Perhaps an organization could post its HIPAA release process for others to use. Some useful guidance on what constitutes posting patient-identifiable information can be found here, at the Ohio State Medical Association Social Media Toolkit.

(b) Using privacy settings to safeguard personal information – Sensible, and supports the idea that some physicians may include personal information about themselves online.

(c) Interacting with patients on the Internet, maintain appropriate boundaries of the physician-patient relationship – This confuses me in the way it’s written, because I am coming from a place of interacting with patients, but not necessarily “my” patients. So perhaps for this audience, it’s understood that “patient” means “your patient?” Otherwise, a physician interacting with patients who are not theirs are not in a patient-physician relationship, correct? What do our patients think about this one?

(d) Separate personal and professional content online – I do this, and I also don’t do this, so my advice is to decide which blend makes sense, because it is a blend, we are people.

(e) Physicians have a responsibility to monitor other physicians and report them to the authorities if needed – I’ve never seen this before in a social media policy (feel free to point out other policies that have this clause, if you’ve seen it, in the comments).

This seems more of an “enforcement/policing” model than a “coaching/educational” model of learning to be better. Is this how physicians are instructed to engage in quality improvement with their colleagues in real life? And what’s the role of the patient, are we accountable to them and do they have the opportunity to help us be professional online? And what’s their (the patients’) definition of us being professional?

(f) Social Media can undermine public trust in the medical profession – This is really the only one that I am not on board with. It is a reminiscent of a less than optimistic approach that I’ve posted about here before. Take a look at this piece of data from the Digital Influence Index (pointed out to me by Social Media guru @vincegolla) :

75 percent of consumers view companies with microblog accounts as more deserving of their trust than those without.

Is it possible that social media can improve trust in the medical profession, to enhance its reputation among the people it serves, to have consequences for medical careers that are transformational and supportive of lifelong learning?

See what you think, feel free to post your thoughts in the comments, and please welcome your physician in their professional use of social media to improve your health and health care.




Good wrap-up, Ted. I share your confusion surrounding the charge to police one another. This is tricky although I have to say that if we don't look after one another, someone else will.

While these sparse guidelines are a start, I think the nascent social doc needs more specific, practical guidance. This, of course, mandates some consensus regarding physician social behavior.

Some more ideas on the AMA's suggestion that we police one another:

Hi Bryan,

Thanks for the comment and analysis, I didn't consider the "if not physicians, then who?" question. It's a good one,


Ted Eytan, MD