“I have to post this!”

Issue: BCMJ, vol. 60 , No. 7 , September 2018 , Pages 342 Editorials

While on social media one night, I was scrolling through photos of food adventurers, fashion bloggers, and exotic travelers, when suddenly a photo of a surgeon holding up a large mass in the OR showed up on my feed. The photo included blood, IV lines, the intubated patient, and all. I took a second look and of course could not resist clicking into the comments. The 25 kg ovarian mass had been removed from a patient who had suffered from abdominal pain for years. What was more shocking is that the photo got 14 000 likes in 1 day.

Were the likes for the surgeon who operated on the patient? Or for the patient, who had suffered for years and now been cured? Or because the photo contained graphic content that satisfied the public’s curiosity about medicine? I was confused, curious, and intrigued.

I decided to look into the policies regarding medicine and social media, and found an article published in 2017 by the Canadian Medical Protective Association (CMPA) that addressed this issue.[1] The CMPA suggests that “physicians who share information about their existing patients on social networks are obligated to protect patient confidentiality . . . by ensuring that the posted information is properly de-identified.” The article also mentioned that physicians may share identifiable personal health information if the patient’s consent is obtained and documented consent is signed. The College of Physicians and Surgeons of BC adopted similar professional guidelines last year.[2]

I know of physicians who will ask for their patients’ permission to take photos of an interesting clinical case for teaching purposes, or for use on their own blogs and social media platforms. If a patient’s consent and agreement were obtained, then it is unlikely any legal action would arise. But what happens when a stranger halfway around the world decides to distribute the photo and claim it as their own, perhaps even posting their own opinion and diagnoses of the case? If online photos were to be redistributed without the knowledge of the original author, and the patient were to make a complaint and bring forward legal action, the author who originally posted the photos may be liable despite doing their part to maintain patient confidentiality.[1]

There are myriad online comments to the interesting clinical cases, with physicians and patients sharing similar experiences or acknowledging the wonders of the human body. I wonder what a patient thinks if their diagnosis or treatment plan differed from those suggested by anonymous comments. Would their faith in their doctor waver? Or maybe they would add to the conversation to try and garner support?

As social media becomes more prominent, many physicians and patients find it to be a useful tool for sharing information and experiences. It can even act as a support group. As the online community grows, there are also many positive opportunities for professional education and networking, promotion, and public health awareness.

Next time you come across a photo of an interesting clinical case on social media, allow your curiosity to see what the photo is about; maybe even learn something from it. But don’t forget to look at it objectively and consider how social media has become intertwined not only into our personal lives, but also our professional ones.    
—YS


References

1.    CMPA. Social networks in healthcare: Opportunities and challenges for a connected future. Accessed 24 July 2018. www.cmpa-acpm.ca/en/advice-publications/browse-articles/2017/social-networks-in-healthcare-opportunities-and-challenges-for-a-connected-future.

2.    College of Physicians and Surgeons of BC. Professional guideline: Social media. Accessed 24 July 2018. https://www.cpsbc.ca/files/pdf/PSG-Social-Media.pdf.

Yvonne Sin, MD. “I have to post this!”. BCMJ, Vol. 60, No. 7, September, 2018, Page(s) 342 - Editorials.



Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

About the ICMJE and citation styles

The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

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