Guidelines for Maintaining a
Professional Compass in the Era of
Social Networking
Matthew P. Landman, MD
J. Shelton, MD; RM Kauffmann, MD, MPH; JB Dattilo, MD
April 21, 2010
APDS Meeting, San Antonio, TX
“Our profession, at its core, is fundamentally flawed
relative to how today’s world communicates and
functions. The infrastructure of health care needs a
total repair from ground up. It needs to be Facebooked [and] wiki-ed”
• Dr. Jay Parkinson MD (age 32) associate with Hello Health, a
primary care medical practice in New York
Social Networking 101
• Web 2.0 applications
• Social networking sites
– Ex: Facebook, MySpace, Twitter
• “A social network service focuses on building and reflecting
of social networks or social relations between people…who
share interests and/or activities”
Wikipedia
• Personal web profile
• Opportunity for Status updating, picture sharing, blogging
– Online and/or mobile updating
– Mobile phone – instant access
Slide courtesy of Dr. Don Brady
Use of Social Networking Sites Among US Adults
46%
8%
Pew Internet and American Life Project, 2009
www.pewinternet.org
Top 25 Social Networking Sites
Ranked by Monthly Visits, Jan 2009
UV = unique visitors
http://blog.compete.com/2009/02/09/facebook-myspace-twitter-social-network/
Vanderbilt University
Top Visited Sites 2009
Rank
Site
# Hits
1
Facebook
439,510,400
2
Google
327,526,689
4
Yahoo!
69,665,489
6
MSN
55,910,311
7
Microsoft
51,663,087
8
YouTube
51,407,941
9
Apple
44,547,233
10
Go.com
38,077,420
16
Weather.com
18,299,872
17
NIH
17,690,563
22
Vanderblit.edu
5,788,180
Slide Courtesy of Dr. Donald Brady; Source: The Vanderbilt Hustler, Jan. 21, 2010
Imagine seeing this headline on
your desk . . .
Slide Courtesy of Dr. Donald Brady
Comments Posted on Facebook
in Response. . .
• “Love a good BRAIN in the early morning!!”
• “Do you feel like Hannibal Lector sometimes?”
• “Should that be served with a white or a red
wine????”
• “MMM…I’m hungry now.”
Publicly Accessible Facebook Postings
by Vanderbilt Residents/Faculty
• “just wired a neo-nazi’s mouth shut. And it was
great.”
• “______ has the OR all in a tizzy because I am
operating on a dwarf. COOL!”
• “if you are going to steal copper wire to support
your drug habit, make sure the owner of said
wire is not currently using it.”
• “by the CT this patient should be dead, but, in
fact, she is awake enough to call the police on
me”
The Vanderbilt Experience
• Performed a Facebook search
– Faculty in Section of Surgical Sciences
– General Surgery Residents
– Attempted to replicate what a patient/future employer
might do and find if they performed a similar search
• 127 faculty, 21% had a page
• 88 residents, 64% had a page
• Notably, only 50% of faculty & resident pages were
private
• 31% of public profiles had work-related status updates
• 14% mentioned patient information (without names)
Professionalism and Social Networking
• Attributes of a profession
– Monopoly over use of specialized knowledge
– Relative autonomy in practice and the privilege of selfregulation
– Altruistic service to individuals and society
– Responsibility for maintaining and expanding
professional knowledge and skills
• ACS Code of Professional Conduct
– Responsibility to patients and society
Gruen et al. Professionalism in surgery. JACS, 2003
ACS Task Force on Professionalism. Code of professional conduct. JACS, 2004
Conclusions
Guidelines are necessary when utilizing usergenerated web 2.0 applications such as
Facebook
Suggestions for Departmental Guidelines
1. Understand institutional policies
2. If an institutional policy does not exist,
consider creating a departmental policy
3. Educate (repeatedly) residents and faculty
4. Consider the role (or possible role) social
networking plays in HR issues
Suggestions for Departmental Guidelines
1. Understand institutional policies
2. If an institutional policy does not exist,
consider creating a departmental policy
3. Educate (repeatedly) residents and faculty
4. Consider the role (or possible role) social
networking plays in HR issues
5. Appoint a departmental representative
responsible for content and maintenance
Personal Guidelines
1. Monitor your online reputation*
2. Understand privacy settings of sites you use
3. Remember your audience (intended and
unintended)
4. Beware of the permanence of online content
5. Maintain professional boundaries
*Gorrindo and Groves, JAMA 2008
"[The] precepts of professionalism extend beyond the
operating room, the clinic, and the hospital, to your
family, your peers, and other professional associates,
your casual contacts, your community, and wherever
you venture. You are specially acknowledged,
privileged, and remunerated, but this must be
constantly earned. This is the embodiment of the
surgical profession, now and persisting on through this
new millennium. Each generation has an obligation to
our past, to the present, and to the future”
LaMar McGinnis, Jr., MD, FACS
Presidential Address to the ACS, 2009
Thank you