I could not put up a link in my Facebook account, so here is the article itself from Student BMJ and Medscape:
Student BMJ
Abstract and Introduction
Abstract
Increasing numbers of doctors and medical students are turning to websites such as Facebook to make friends, chat, and organise social events. These innovations have made some aspects of life easier and are a powerful tool for communication, but they also blur the line between our personal and professional personas. With the veneer of friendship that's offered on these sites, it's all too easy to reveal more information than is appropriate. If this information falls into the wrong hands, problems can arise about your integrity, employment, and fitness to practise medicine.
Introduction
In a recent study in the Journal of General Internal Medicine, the Facebook profiles of a group of medical students in Florida were scrutinised with the aim of establishing how dangerous Facebook could be in the intersection of personal and professional identities. The study found some profiles publicly displaying photographs of trainee medics drinking to excess, engaging in sexual behaviour, and, in one instance, posing with a dead racoon. Three of the 10 students in the sample had also joined groups on Facebook that could be interpreted as sexist or racist.[1]
Whether the private activities of a medical professional have an impact on their ability to practise is debatable, but it cannot be denied that putting private material in such a public arena has the potential to undermine trust in the profession.
Who Uses it?
Online social networking in the medical community is a worldwide phenomenon and one that is no longer the sole domain of medical students ( box 1 ). With 90 million active users around the world,[2] it's a fairly safe bet that your colleagues and boss are on there, not to mention many of your patients. You don't need a degree in computer science to go online and see who is using this technology.
Many students now rely on this technology for organising social activities and keeping up with their friends. "Without it you wouldn't know what was going on," said a student at St George's Medical School, London. Students are using these networking tools to show their support for causes, exchange answers to exam questions, and disseminate course notes, in addition to sharing the mandatory photos of alcohol fuelled antics. In a remarkably diligent act of altruism, a group of medical students ("podmedics") have even taken to recording and sharing their notes as audio files for others to download and enjoy on the road.
Junior doctors are making time for the technology too, with most UK schools boasting groups with a few hundred members. In a quick survey, 36 regional groups of trainee general practitioners were found, and these are often open to all to observe, interact with, and market to. "Protect general practice" groups had 5000 members from diverse clinical and non-clinical backgrounds, including some of the few specialist registrars making use of the technology. In addition, a small but active group of tech savvy senior professionals use Facebook to upload videos of endoscopy cases and discuss them with small groups of colleagues.
Medicopolitics thrives in this environment. More than 10 000 individuals took action through Facebook to show opposition to recent changes in the provision of hospital accommodation for young doctors in the United Kingdom, while others weighed in to the debate about medical education. More diverse groups such as "The NHS is sucking my soul dry" and "I am a doctor and I hope my patients don't see me on Facebook" are also popular, though much to the disappointment of its 5700 members the latter was recently closed down. Perhaps a patient found it.
What Are the Dangers?
The General Medical Council guidance from Good Medical Practice hasn't changed—"You must make sure that your conduct at all times justifies your patients' trust in you and the public's trust in the profession"[3] —but it's undeniable that the advent of online social networking has increased the chances of being caught acting disreputably.
One of the problems arising is how we choose to define a friend online. If one's personal profile—detailing hobbies, groups, interests, photos, and videos—were available only to true friends, there would be little cause for concern. But the online environment breeds a false sense of security, where online friendships are often formed with little thought for the possible consequences. Michael Anderson, one of the growing ranks of junior doctors in the United Kingdom keeping a blog, was recently added by a patient, and though he was touched by the sentiment, he decided that his privacy would be compromised if he accepted.[4]
Notably, the profiles of two thirds of the medical students in the Florida study were available to Facebook users not listed as friends. This may have been a conscious decision in some cases, but more likely it reflects a widespread ignorance of the enhanced privacy settings that are available. This is hardly surprising, given that website providers, in their efforts to reassure nervous users, have produced a multitude of confusing options. There are no prizes for guessing that the default situation is to share information with users and advertisers alike.
Aside from the risk of identity theft (two in five Facebook profiles reveal information that can be used to set up bank accounts and so on[5]), it is the professional implications that are of greatest concern to the medical community. Recently the Highland Deanery suspended a trainee in general surgery for "scatological" comments made about a senior medical colleague in an online discussion, which was seen by a concerned friend who felt duty bound to take action.[6]
A senior tutor at the University of Cambridge admitted to viewing applicants' Facebook profiles out of curiosity during the admission process.[7] Although he maintained that this had no bearing on his decisions, one wonders what he may have thought had Amy Polumbo applied to Emmanuel College that year. Ms Polumbo, Miss New Jersey 2007, was thrust into the public eye last year when her title dangled perilously in the balance after lewd images from her Facebook profile surfaced in the national press.[8]
"The cost to a person's future can be high if something undesirable is found by the increasing number of education institutions and employers using the internet as a tool to vet potential students or employees," says David Smith,[9] for the Information Commissioner's Office, in relation to recent UK governmental guidance on online social networking.[10]
To some extent the medical regulators are playing catch-up with the advances in social networking, but guidance is available and it's well worth observing in your online activities.
How Can I Protect Myself?
The American Medical Association advises doctors to "recognise that your personal conduct may affect your reputation and that of your profession,"[11] and a spokesperson for the General Medical Council made it clear that regulators appreciate the need for balance. "Medical students and doctors are entitled to a private life, and to use their time away from studying and work as they wish [they] should consider whether the images of what was fun at the time could cause embarrassment if they were accessed by patients, or the public, later. In extreme cases such images could lead to a complaint being made."
The fact is that doctors and would be doctors are held to higher standards of personal conduct than other groups in society. Saintly behaviour is neither demanded nor expected, but with the job there comes an expectation of a reasonable level of common sense and decency. It is possible to protect one's personal and professional reputation while enjoying positive interactions with patients and colleagues outside the professional arena.
With the potential for such difficulties you might wonder about the rightful place in our lives for this technology. It is no doubt here to stay, but it doesn't have to be a minefield of ethics or mistrust. With a little care and attention ( box 2 ), online social networking has the potential to make life a good deal easier for medics: to connect us with our friends and colleagues, facilitate learning and communication, arrange events, and share our knowledge with the wider world. You could even join the General Medical Council's Facebook group and continue the discussion there,[12] but bear in mind that when you're online, you're anything but off duty.
Box 1. What is Online Social Networking?[13]
These websites offer a virtual space where people can share information and communicate with other people. This is usually in the form of a personal "profile," elements of which other people, "friends," can see.
- A social network service focuses on building online communities of people who share interests and activities.
- Popular websites include Facebook, MySpace, Bebo, Orkut, Hi5, and Friendster.
- Revenue is typically gained via advertisements.
Box 2. How to Have a Hassle-free Facebook Experience
Short of severing your electronic umbilical cord and suspending yourself in a box over the Thames, is there any way of using services without jeopardising your privacy or integrity?
- Make your profile private, so only your friends can view it.
- As in life, choose your friends carefully.
- Use common sense and discretion when choosing your profile photo. A happy snap of you at a party—lovely; a photo of you doing shots blindfolded at the same party—perhaps not.
- "De-tagging" is a fair way to deal with a photo which portrays you in a poor light, but persuading your friends not to publish it in the first place is even better.
- If you must act in a questionable way, be smart and don't get caught.
References
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Neil Graham, E-Mail: neil@zeebit.com
Philippa Moore, freelance journalist, London
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I hope this prompts people to act more sensibly in the future.
P/S I by the way do NOT own any piece of the article above and the ownership and rights of the article above is clearly stated above anyway.
