Guidelines for Maintaining a Professional Compass in the Era of Social Networking
Matthew P. Landman, MDJ. Shelton, MD; RM Kauffmann, MD, MPH; JB Dattilo, MD
April 21, 2010APDS Meeting, San Antonio, TX
“Our profession, at its core, is fundamentally flawed relative to how today’s world communicates and functions. The infrastructure of health care needs a total repair from ground up. It needs to be Facebook-ed [and] wiki-ed”
• Dr. Jay Parkinson MD (age 32) associate with Hello Health, a primary care medical practice in New York
Social Networking 101• Web 2.0 applications
• Social networking sites
– Ex: Facebook, MySpace, Twitter
• “A social network service focuses on building and reflecting of social networks or social relations between people…who share interests and/or activities” Wikipedia
• Personal web profile
• Opportunity for Status updating, picture sharing, blogging
– Online and/or mobile updating
– Mobile phone – instant access
Pew Internet and American Life Project, 2009www.pewinternet.org
46%
Use of Social Networking Sites Among US Adults
8%
Top 25 Social Networking SitesRanked by Monthly Visits, Jan 2009
UV = unique visitors
http://blog.compete.com/2009/02/09/facebook-myspace-twitter-social-network/
Vanderbilt UniversityTop Visited Sites 2009
Rank
Site # Hits
1 Facebook 439,510,400
2 Google 327,526,689
4 Yahoo! 69,665,489
6 MSN 55,910,311
7 Microsoft 51,663,087
8 YouTube 51,407,941
9 Apple 44,547,233
10 Go.com 38,077,420
16 Weather.com
18,299,872
17 NIH 17,690,563
22 Vanderblit.edu
5,788,180Slide Courtesy of Dr. Donald Brady; Source: The Vanderbilt Hustler, Jan. 21, 2010
Comments Posted on Facebook in Response. . .
• “Love a good BRAIN in the early morning!!”
• “Do you feel like Hannibal Lector sometimes?”
• “Should that be served with a white or a red wine????”
• “MMM…I’m hungry now.”
Publicly Accessible Facebook Postings by Vanderbilt Residents/Faculty
• “just wired a neo-nazi’s mouth shut. And it was great.”
• “______ has the OR all in a tizzy because I am operating on a dwarf. COOL!”
• “if you are going to steal copper wire to support your drug habit, make sure the owner of said wire is not currently using it.”
• “by the CT this patient should be dead, but, in fact, she is awake enough to call the police on me”
The Vanderbilt Experience
• Performed a Facebook search– Faculty in Section of Surgical Sciences– General Surgery Residents– Attempted to replicate what a patient/future employer
might do and find if they performed a similar search• 127 faculty, 21% had a page• 88 residents, 64% had a page• Notably, only 50% of faculty & resident pages were
private• 31% of public profiles had work-related status updates• 14% mentioned patient information (without names)
Professionalism and Social Networking
• Attributes of a profession– Monopoly over use of specialized knowledge– Relative autonomy in practice and the privilege of self-
regulation– Altruistic service to individuals and society– Responsibility for maintaining and expanding
professional knowledge and skills• ACS Code of Professional Conduct– Responsibility to patients and society
Gruen et al. Professionalism in surgery. JACS, 2003ACS Task Force on Professionalism. Code of professional conduct. JACS, 2004
Conclusions
Guidelines are necessary when utilizing user-generated web 2.0 applications such as Facebook
Suggestions for Departmental Guidelines
1. Understand institutional policies 2. If an institutional policy does not exist,
consider creating a departmental policy
3. Educate (repeatedly) residents and faculty 4. Consider the role (or possible role) social
networking plays in HR issues
Suggestions for Departmental Guidelines
1. Understand institutional policies2. If an institutional policy does not exist,
consider creating a departmental policy 3. Educate (repeatedly) residents and faculty4. Consider the role (or possible role) social
networking plays in HR issues5. Appoint a departmental representative
responsible for content and maintenance
Personal Guidelines
1. Monitor your online reputation*2. Understand privacy settings of sites you use3. Remember your audience (intended and
unintended)4. Beware of the permanence of online content5. Maintain professional boundaries
*Gorrindo and Groves, JAMA 2008
"[The] precepts of professionalism extend beyond the operating room, the clinic, and the hospital, to your
family, your peers, and other professional associates, your casual contacts, your community, and wherever
you venture. You are specially acknowledged, privileged, and remunerated, but this must be
constantly earned. This is the embodiment of the surgical profession, now and persisting on through this new millennium. Each generation has an obligation to
our past, to the present, and to the future”LaMar McGinnis, Jr., MD, FACS
Presidential Address to the ACS, 2009