Impact of social networking on medical field

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Story and photos by Will Latta, NewsNetNebraska

With its photos and personal notes, Facebook can shed a lot of light on what someone is like. But many psychologists remain leery of it as a tool for helping them figure out what makes patients tick.

“If a patient thought I was looking into their personal life through Facebook, for instance, I imagine it certainly wouldn’t do any good and probably would cause substantial harm,” said Dr. Ryan Ernst of Nebraska Mental Health Services.

Social media and the Web have changed the way a lot of professions do business. But medical professionals of many kinds are cautious about using the new media. It’s easier than ever to gather info about people on the Web, but their experience raises an important question: how do we know when we are crossing the line and going from acceptable research to invading privacy?

Illustration by Will Latta.

Indeed, social media and medicine could be a toxic mix. Are blogs really a modern-day window into the soul? Do they reflect the truth about their writers or only what the writers want seen? Then there’s the ticklish issue of consent. Since the material may be open to any viewer, is patient consent even necessary?

The issue has stirred enough interest that as recently as 2010 the American Medical Association (AMA) has published a policy titled: Professionalism in the use of Social Media. The policy calls for doctors to be mindful of their actions online. It says they must “be cognizant of standards of patient privacy and confidentiality.” It directs physicians to “maintain appropriate professional boundaries,” and urges them to draw a bright red line between “personal and professional content online.”

The therapeutic setting seems to be one that could be especially prone to problems stemming from this topic. With therapy, the relationship between doctor and patient is so strongly dependent on trust, that any breach of this could be catastrophic.

“Patients put a lot of trust in you (doctors) and when you breach that… all hell could break loose,” said one psychological patient in Lincoln.

Unless a patient gives consent, doctors who visit their Facebook sites are seeing more than the patient might want to share. In therapy, patients have the ability to share only what they want the doctor to know.

Yet, the temptation for a doctor to use social media to learn that untold information is enormous. Entries on Facebook may amount to journals of people’s lives. They include personal history, hobbies and habits.

Ernst says he has no interest in using Facebook or similar sites to search patient history. He learns enough about a patient in face-to-face sessions and refuses to go beyond them for fear of overstepping his boundaries.

Indeed, the therapist frets that patients might want to use Facebook to reach out to him. He would prefer that they not do so. He wants to keep his Facebook site private and not part of his worklife.

“Anytime we use some of this new media technology or any technology like that, we may opening ourselves up to risks that we’re not even aware of,” said Ernst.

Dr. Ryan Ernst, therapist at Nebraska Mental Health Centers.

Ernst shared a story about a colleague’s patient who tracked down her address through a photo of her home that appeared online. The patient later unnerved the colleague by showing her a photo of the home that he kept on his cell phone. When photos taken with cell phones appear online, they are encoded with GPS coordinates that knowledgeable people can easily find. Nothing harmful came of the affair, but the potential for problems worries some doctors.

Other potential issues Ernst discussed revolve around his own actions online. For instance, as a licensed therapist, he could open himself up to legal hassles if he offers advice online.

But sometimes social media can literally be a lifesaver. A New York psychiatrist treating an overdose victim learned about the sedatives a suicidal patient took when he was tipped off to the patient’s blog. As described by the Washington Post, however, the doctor was uneasy about invading the patient’s privacy. The doctor had to decide whether or not it was ethical to access the blog in an attempt to save his patient.

In the end, he checked the blog and the patient was saved.

As social media continue to grow and carry more and more personal information, they could prove to be helpful tools for medical professionals. But, for now, plenty of doctors remain wary.

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