Facebook, Twitter, RSS, etc. may have changed the way I communicate, but in some arenas, the mere acknowledgement of social media still moves at a glacial pace. Naturally, I was surprised to see that the local hospitals’ notice boards had been outfitted with colourful new posters. Privacy tips, they were entitled.

The first one I came across went something like this:

Privacy Tip #14

Post wisely…

Cut detail when posting on Facebook, Twitter, or blogs.

Patients can be recognized without their names.

The social media triad grabbed my attention. After all, the other tips were well established truisms on shredding patient information at the end of day and not gossiping about cases in the cafeteria. This was addressing social media explicitly, which to me is an acknowledgement that the institutions are aware of the new technologies and feel some kind of need to rein in early adopters. An important step forward, I think, despite the not-exactly-rah-rah tone, because a time without rules is an exciting time, but it’s also a dangerous time.

I don’t need to tell you why privacy is one of the major minefields in medicine 2.0.

It’s clear that lines need to be drawn, though no one knows quite where. Many health care bloggers post with excellent objectives: to share their love of medicine, to discuss new technology, to give a public voice to physicians in the health care reform debate – in general, to give participatory power to the reader in the form of shared information. But who are the readers and what will they do with the information? Really, the only control the blogger has over the spread is to censor himself in the first place.

With the explosion of medical blogs in the last few years, this issue has already been brought to some prominence among the community. In 2007, KevinMD (@KevinMD) wrote about a few high-profile cases with links to articles in two major newspapers.

Here’s what I think. Some blogs focus on physicians “venting” about their patients, which is clearly inappropriate, no matter what measures are taken to obscure identity. Even personal blogs that attack other people are disrespectful and should be kept to friends-only or private journals. If friendships and romantic relationships can suffer grievously from social media (e.g., breaking up over Facebook), imagine how the doctor-patient relationship would fare.

Other blogs feel the necessity to mention patient encounters in a respectful way en route to expounding a larger theme – because, let’s face it, telling a story is more engaging. I think that if the anecdote can be shared with a focus on the “what I learned”-esque bottom line instead of on the details of the particular case, then the post is permissible. If the story is about an irate parent, then say just that — “irate parent” – briefly and go on to a well researched remainder on talking to parents. Pseudonymns are useful for purposes of brevity only, but in any case, probably shouldn’t even be necessary if the story is only a concise lead-in.

I’m glad that our local hospitals are raising awareness about the challenges of social media instead of stifling it.

I don’t actually know in real life any physicians who blog, but there must be a few in downtown TO that do. If I find any, I will definitely point them out.

I will be writing a follow-up post soon on health care bloggers (especially physicians) who must make the challenging decision of whether to blog with full transparency and credibility with their real identity or to blog under a pseudonym. For another great post on this, see Dr. V’s (@DrV) Doctors in Social Media Shouldn’t Be Anonymous.

Related posts:

• For the Most Part, There’s No Such Thing As Teens Who Tweet
• Toronto University Health Network’s Social Media Posters: Photo
• We’re All Still Jenny from the Block: An Exhortation to Local Hospitals
• Personhood and Parent-Blogging
• Medical Pinterests?