Family Medicine Vital Signs

 by Kyle Bradford Jones

                Social media seems to be a scary terrain for many physicians, though it has been significantly increasing in popularity in recent years. Because of the prevailing lack of comfort among physicians, medical students and residents are not often trained in the pros and cons of social media use. Though pitfalls exist in social media participation, the opportunities are immense. An increase in training of medical students and residents is needed to take greater advantage of these opportunities.

                While social media use (Facebook, Twitter, YouTube, Instagram, Google+, LinkedIn, blogs, etc) is very common among individuals, multiple studies show that the vast majority of medical schools and residencies do not spend any time training their learners in professional use of these forums. The prevailing attitude is either a lack of recognition of its import, or to ignore it completely and hope it goes away. Nearly 1.3 billion people use Facebook, with over 600 million logging in daily. Over 250 million people use Twitter. The majority of medical students and residents use a social media platform regularly.

                This increasing use allows for improved education of patients; dispelling myths and pervasive falsehoods in medicine; advocacy and storytelling; free advertising for practices; increased networking possibilities; increased collaboration with colleagues in other locations; ability to participate in and learn from presentations at conferences that you are unable to attend; increased dissemination of research findings and evidence-based medicine; and many other positives, that do not include direct patient care.

                There have also been many studies showing that multiple residency program directors look up applicants on social media and will consider lowering the rank order of individuals for inappropriate content. Surveys among medical students show that many of those who participate in social media do not understand or recognize how their postings could negatively impact their career, or how patients or others may perceive them. Multiple examples exist of students, residents, and attending physicians posting HIPAA sensitive material on social media, which has often led to employment termination, not to mention the potential harm to the patient.

                One such issue occurred where a trauma surgeon in Rhode Island posted “non-sensitive” information about a patient on her Facebook page, but was enough that the patient could be identified. No pictures were posted, no derogatory comments were made, no names or initials were included, but it was still inappropriate. After the controversy began, the physician deleted her Facebook account, but it was too late; she was fired for her mistake. Dr Bradley Crotty, who has studied social media use in health care, was quoted in a boston.com article, saying “I think we should all learn from this and get to work on doing education and training in our hospitals to promote the professional use of social media.”

Many schools and hospitals are following this advice of Dr Crotty and training their learners in this vital area. The Keck School of Medicine at USC implemented a required professionalism course in 2011. Surveys among the participants showed that immediately after the training, as well as 4 months later, students were more vigilant about what they posted on various social media platforms. The Penn State Hershey Medical Center provided social media training to multiple health professionals. Participants expressed a greater understanding of both the pros and cons of social media use after this course.

                In addition to professionalism training, another key is for medical schools and residencies, as well as for individual faculty, is to model best practices. A recent study that we conducted at the University of Utah showed that only 32% of Family Medicine Residency Programs have a Facebook page, and only 7% have a Twitter feed. Many medical professional organizations include tutorials and basics on getting started and how to use the different modalities. The Mayo Clinic offers a Social Media Residency and Fellowship programs for health care professionals and organizations that provides more in-depth training on multiple social media tools.

If we fail to train our learners in how to properly use social media through good examples and dedicated professionalism training, then we are not properly preparing them for the practice environment that awaits them. Look at the resources available to start or enhance the training of your learners as soon as you can.

Kyle Bradford Jones, MD is a Clinical Instructor at the University of Utah Family Medicine Residency Program. You can follow him @kbjones11