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DIT DIARY Professional perils of social media Recognise a patient or colleague online? Swipe left… Last year a resident pulled out his phone over lunch and showed me a Facebook friend request from his direct senior that linked to a profile full of photos of her in skimpy nurse and policewoman costumes. He asked me if I thought this was an invitation to make a move (I thought not). Most junior doctors are pretty well versed in the hazards of social media posting but much of the etiquette in this area is new territory. Cases of doctors losing their jobs due to social media infractions are infrequent, however there have been notable examples such as a medical student who was expelled for a tweet calling Barack Obama a ‘monkey’ and a doctor in Broken Hill barred from practice for both sleeping with a patient and for discussing the relationship and his medical details over Facebook chat with the patient’s ex-partner. The AMA provides excellent guidance on how to avoid pitfalls such as breaches of confidentiality, inadvertently defaming colleagues and bringing the profession into disrepute. They warn against using mediums like Facebook (that include personal information) to communicate with patients. However, the complexities of practicing medicine in the Internet age are only intensifying. I’ve yet to find advice on how to handle stumbling onto the profile of a senior colleague on a hook-up app as happened to an intern I know, or what to do when you realise the patient you’re seeing is someone you’ve previously chatted to on a dating service under a screen name. That did happen to a registrar at a hospital I worked at, he chose to disclose their previous contact as the patient had not yet realised they had communicated online and offered to refer the patient to another team. The patient preferred to continue on with the current team so as to avoid explaining the reason for swapping to a new group of doctors, certainly a fraught situation to navigate. It’s awkward for a patient to see you on a dating site or app and discover information you would usually never disclose, such as your sexual orientation or idea of a perfect date. It’s also awkward for more junior colleagues to see senior medical staff in this kind of context and vice versa, nevertheless it’s happening. Doctors have just as much right to use dating and social apps in their personal time as any other private citizen. However, we are entering an era where it will be difficult for doctors to maintain adequate control over their public reputations without being inadvertently restricted in their online social interactions. It may not sound like a big deal but with dating apps like Tinder becoming increasingly popular as efficient and safe methods of meeting potential partners (in comparison to old-fashioned methods like meeting someone in a bar) doctors-in-training who are already time poor may have less opportunity than others to find potential mates. Although there’s not much guidance available as yet on how to take your consultant seriously after you've seen their poorly lit bathroom-selfie, the appropriate course of action if one does happen across sensitive information seems to be to maintain a respectful distance. Blurring of professional into social relationships has always been an issue in the hospital even if now the danger is accidentally happening across an online profile rather than running into a colleague in a pub with a drink in hand. Interaction on dating apps with colleagues is probably best avoided and social-media interaction with patients should always be avoided, but ultimately doctors do retain a right to a personal life. It will be the work of the next generation of professional clinicians to strike a balance between enjoying the expansion of social opportunity the Internet can offer and maintaining the standing of the profession in the public eye. To have the best of both worlds, reflecting on how we are perceived online and how we maintain work life balance, will be key. dr. @elizamilliken Dr Eliza Milliken Junior Doctor 6 I THE NSW DOCTOR I MARCH/APRIL 2016
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