Skip to main content

Are social networks blurring the boundaries between professional and personal lives?

Facebook, Twitter, Yammer and the Internet overall is a game changer. The rulebook of how we practice medicine has changed.

The NY times posted an article in which a young trainee describes caring for a dying patient in the ICU who reached out to her thru Facebook. She describes how she struggled with this and describes his eventual death.

I find that people I meet in a clinical setting as well as in a professional setting have typically "googled" me before they step foot into my office. Maybe this is a "silicon valley neurosis"... ...maybe it is a whole new world in that we live in a fish bowl. I am curious to know whether others have had patients who "poked" you on Facebook? How are you dealing with the blurring boundaries between your prefessional and personal lives (assuming that you have time for a personal life, that is :-)

Comments

One of the most helpful articles I've read on this subject is posted on PsychCentral's blog: "Google and Facebook, Therapists and Clients," by John Grohol, PsyD,http://psychcentral.com/blog/archives/2010/03/31/google-and-facebook-therapists-and-clients/
Anonymous said…
Ive struggled with this quite a bit. Both my medical and non-medical colleagues think I am exaggerated in my worries. I have had many people look me up on google--which is why I often do a self search to make sure what I know is out there. I've decided not to be on facebook, but even with this, you still are left with an online identity that you cant always control.
Anonymous said…
I have not opened a Facebook account, partly to avoid this.
David Tribble, MD said…
Social networking is yet one more place where we physicians must develop and maintain boundaries. In the past, we have had to contend with going to the grocery store or church, as well as the incessant demands of other medical workers for prescriptions for antibiotics and the like. Facebook and Twitter are yet one more layer of similar interaction.
There is a larger problem, however, involving not only physicians, but any of us who may work for larger organizations. Anything we say, do, or get involved in may be considered to reflect on the organization for which we work. We run the risk of HIPAA violations. We run the risk of finding out the hard way that our ability to swing our [verbal] fist ends where someone else's nose begins.
The principle is no different. The potential audience is considerably larger, however.

Popular posts from this blog

Dying without Dialysis

There is a terrific article in this weeks Journal of Pain and Symptom Management by Fliss Murtagh of King's College in London about the epidemiology of symptoms for patients with advanced renal failure who die without dialysis.  This study is important because while we know that patients with advanced renal failure have a limited life expectancy and the average age of initiation of hemodialysis is increasing, we know little about the alternatives to hemodialysis.  Specifically, we know nothing about symptoms affecting quality of life among patients who elect not to start dialysis (so called "conservative management" - is this the best label?).  This article provides a terrific counterpoint to the article in last years NEJM showing that nursing home residents who initiated hemodialysis tended to die and decline in function (see GeriPal write up here). 

The study authors followed patients with the most advanced form of chronic kidney disease (the new name for renal failu…

The Dangers of Fleet Enemas

The dangers of oral sodium phosphate preparations are fairly well known in the medical community. In 2006 the FDA issued it’s first warning that patients taking oral sodium phosphate preparations are at risk for potential for acute kidney injury. Two years later, over-the-counter preparations of these drugs were voluntarily withdrawn by the manufacturers.  Those agents still available by prescription were given black box warnings mainly due to acute phosphate nephropathy that can result in renal failure, especially in older adults. Despite all this talk of oral preparations, little was mentioned about a sodium phosphate preparation that is still available over-the-counter – the Fleet enema.

Why Oral Sodium Phosphate Preparations Are Dangerous 

Before we go into the risks of Fleet enemas, lets spend just a couple sentences on why oral sodium phosphate preparations carry significant risks. First, oral sodium phosphate preparations can cause significant fluid shifts within the colon …

Survival from severe sepsis: The infection is cured but all is not well

Severe sepsis is a syndrome marked by a severe infection that results in the failure of at least one major organ system: For example, pneumonia complicated by kidney failure. It is the most common non-cardiac cause of critical illness and is associated with a high mortality rate.

But what happens to those who survive their hospitalization for severe sepsis? An important study published in JAMA from Iwashyna and colleagues provides answers and tells us all is not well. When the patient leaves the hospital, the infection may be cured, but the patient and family will need to contend with a host of major new functional and cognitive deficits.

Iwashyna examined disability and cognitive outcomes among 516 survivors of severe sepsis. These subjects were Medicare enrollees who were participants in the Health and Retirement Study. The average age of patients was 77 years.

When interviewed after discharge, most survivors were left with major new deficits in their ability to live independently. …