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Physicians Need to Use More Discretion on Twitter, Study Suggests
- Categorized in: Department of Veterans Affairs (VA), March 2011, News, Research
WASHINGTON, DC—Today’s physicians need greater accountability and more guidelines concerning their use of Twitter®, according to a study by the Washington DC VA Medical Center. The study was published in the February 9 issue of the Journal of American Medicine. The Physicians on Twitter study set out to describe how self-identified physicians use Twitter with a specific focus on professionalism.
Katherine Chretien, MD, along with fellow investigators Justin Azar, from The George Washington University School of Medicine and Health Sciences, and Terry Kind, MD, MPH, of Children’s National Medical Center, extracted descriptive characteristics from the public profile pages of self-identified physicians who had 500 or more Twitter followers. There were 260 physicians included in the analysis.
Investigators used the physicians’ most recent 20 tweets, collected between May 1 and May 31 for a total of 5,156 messages. Investigators defined a coding guide to categorize the tweets and found 49% (2,453) were health or medical related, 21% (1082) were personal communications, 14% (703) were retweets (another user’s tweets are rebroadcast), and 12% (634) were self-promotional.
Investigators discovered 144 tweets (3%) that they categorized as unprofessional and 0.7% represented potential patient privacy violations, 0.6% contained profanity, and 0.3% included sexually explicit material, while 0.1% included discriminatory statements. They found 12 tweets promoting specific health products the physicians were selling (representing potential conflicts of interest) and 10 were statements about medical treatments not supported by existing medical knowledge, potentially leading to patient harm.
The study suggests that physicians need more education and accountability to ensure their use of social media sites such as Twitter does not impact ethical and professional standards of the practice of medicine.
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The point of the authors is well taken and worth heeding. A large body of studies suggest that people tend to be less inhibited online than in more "official" communications. However, I have concerns. Firstly, if the "physicians" were self-identified, how do we know whether all of the responders were really active, practicing physicians? Secondly, categorizing the posts may be subject to individual interpretation, especially those said to be "potential" violations. More of concern, if so minded, one could creatively portray even the most innocuous and 'acceptable' posts in a negative light, so even suppression of the rather small percentage of 'objectionable' posts might do little to improve perceptions or prevent liability. Finally - and I would strongly suggest that the authors consider this at length - is it really worth it to set up "accountability" mechanisms that many would find onerous, in order to eliminate the last 'objectionable' tweet or other SM communication? IMHO, if the risk of an inadvertent comment in a social medium were that strictly overseen, the risk would exceed the benefit of using the medium at all, thus stifling communication rather than filtering it.