Social Media and Anonymity

Articles discussing the ethics of social media use by physicians are quite popular.  Asking whether or not it’s appropriate for doctors and patients to contact one another through Facebook, twitter, blogs, or other media seems to be the question of the hour.  For physicians who choose to blog or tweet (instead of, or in addition to, Facebook) the question becomes whether it should be done anonymously.

I confess to not understanding what all the fuss is about.  People who represent themselves as professionals ought to act professionally – both in person and online.

Facebook

Why is there any dilemma as to whether or not a doctor should accept a friend request on Facebook?  People who don’t have a doctor/patient relationship with one another can friend one another with no ethical repercussions. If two people who are friends outside of the doctor/patient relationship want to socialize online too, then that shouldn’t be a problem.  On the other hand, if it wouldn’t be appropriate to go out to dinner, a ballgame, or otherwise socialize, then FB friend requests should be declined with the same tact as in-office awkwardness that occasionally arises.

Anonymity

An even bigger topic is that of anonymity.  I find it amusing to read the multitude of accusations that it is wrong for doctors to blog anonymously.  It should be no surprise that I don’t think it’s wrong for people to blog without publishing their names (read here).  The issue for doctors (in this patient’s insignificant opinion), is one of professionalism.

If the reason for remaining anonymous is to make it possible to say things that would be construed as unprofessional coming from a doctor, then it’s unprofessional to make those posts – even anonymously.  Some medblogs are platforms for complaining about what a burden it is to deal with patients, and how horrible medical professionals have it.  The problem with these blogs isn’t the anonymity, it’s the unprofessionalism that’s trumpeted publicly for all the world to see.  If it’s not something that you’d sign your name to – big and bold as John Hancock - then it’s not up to professional standards becoming of a physician.

There are two medblogs I like that are done anonymously.  Those doctors come across as professionals who care about their patients.  If their names were to be exposed, they wouldn’t have to be ashamed of what they’ve written.

Unfortunately, those are in the minority.  No matter how many times patients hear doctors say that they won’t judge people (their job is to help, not judge), it is obvious from many anonymous medblogs that doctors and nurses judge patients quite severely.  What do doctors really think about patients?  Read some anonymous medblogs.  Whether or not that’s the majority opinion is hard to tell, but it is what doctors are shouting from the rooftops on the internet.

A blog is a public presentation.  People form an impression of the medical profession based on the exposures they have, including what is presented on the web.  If what patients learn about how doctors think and behave is based on the critical attitudes trumpeted from many anonymous medblogs, it’s no wonder that the younger segment of our society no longer respects doctors the way people did in the past.

When I’m writing a post, I don’t think, “This is anonymous, so I can say anything I wish and never be concerned about repercussions.”  I think, “There’s no real anonymity on the internet.  Someone who really wanted to know my identity could probably figure it out, so I should be careful what I say.”  Would you be willing to own your posts?  Sign your name to them?  Or would you squirm uncomfortably and have to make excuses about their content?  There is no problem with blogging anonymously - as long as the writing is done so that the author’s name could be attached.

Using social media anonymously is not a problem.  Unprofessionalism is.  People who represent themselves as professionals ought to act professionally – both in person and online, regardless of whether their name is published.

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Just a few places to read about this topic: