JAMA Viewpoint Calls for Revising Physician Social Media Guidance

In a viewpoint published in the Journal of the American Medical Association, three ethics and psychiatry experts from Johns Hopkins University argue that industry guidelines on online medical professionalism inappropriately call on physicians to separate their personal and professional identities.

In a viewpoint published in the Journal of the American Medical Association, three ethics and psychiatry experts from Johns Hopkins University argue that industry guidelines on online medical professionalism inappropriately call on physicians to separate their personal and professional identities.

Instead, social media guidance should focus on what is appropriate for physicians to share in the public realm, the authors write.

In the viewpoint, Matthew DeCamp, Thomas Koenig and Margaret Chisolm outline four reasons why calling on physicians to maintain distinct professional and personal online identities is not a practical requirement. They argue that such guidelines:

• Are operationally impossible, since “no current technology” can prevent the public from using the Internet to “connect [physicians’] professional and personal content;”
• Lack user consensus and have been unable to garner “physician endorsement and adoption;”
• Are inconsistent with the concept of professional identity; and
• Are potentially harmful because physicians would have to manage the “psychological or physical burden of trying to maintain [two] identities” and patients might miss out on certain benefits and might experience less trust if they “sense that their physician is intentionally hiding something.”

The authors suggest that physicians’ social media content should be decided “on whether it is appropriate for a physician in a public space.” They argue that this guidance would have several advantages:

• It does not require physicians to perform an “impossible” task or rely “on an incorrect concept of professional identity;”
• It likely would be accepted by the physician community because it builds “on the vast experience physicians already have in navigating public spaces, rather than asking them to do something new or unfamiliar;” and
• It fits into “existing general professionalism curricula at medical schools, which encourage students to be mindful of professional identity in public and private spaces, not to fully separate their identities.”

The authors conclude, “Absent this approach, the professional transgressions motivating guidelines will persist and the potential benefits of social media will remain unrealized” (DeCamp et al., JAMA viewpoint, 8/14). 

I think it is important to keep in mind that the AMA released mere “guidelines” for those who need some guidance in identifying the boundaries. However, our professional reputations are on the line and it is up to us, as individuals, to manage them.

(Physicians and social media / shutterstock)