For doctors, social media a tricky case

The Boston Globe | Facebook is a great place to unload after a long day at work. But what if you work in an emergency room, where privacy is paramount? And what if the thing you want to discuss is not the evening traffic or a grumpy colleague but your patients?

Don’t do it, experts caution — a lesson that a physician at Westerly Hospital in Rhode Island just learned the hard way.

Dr. Alexandra Thran, 48, was fired from the hospital last year and reprimanded by the state medical board last week. The hospital took away her privileges to work in the emergency room for posting information online about a trauma patient.

Thran’s posting did not include the patient’s name, but she wrote enough that others in the community could identify the patient, according to a board filing. Thran, who did not return calls for comment yesterday, also was fined $500.

The case was the first involving a physician’s use of social media that the Rhode Island board has heard. No such complaints have come before regula tors in Massachusetts, said medical board spokesman Russell Aims.

That’s likely to change as the use of social media in health care grows, said Bradley H. Crotty, a physician at Beth Israel Deaconess Medical Center who has studied the role of social media in health care.

“I think we should all learn from [the Rhode Island case] and get to work on doing education and training in our hospitals to promote the professional use of social media,’’ Crotty said.

Navigating the tell-all online culture can be tricky for any professional but particularly for those who must balance strict rules on patient protection. Cases across the country have highlighted the institutional challenge.

A Wisconsin hospital and several in California have made headlines in recent years as nurses and other staff members were fired for talking about patients on Facebook or posting photographs of them online.

Crotty and his colleague at Beth Israel Deaconess, Dr. Arash Mostaghimi, write in an editorial published this week by the Annals of Internal Medicine that physicians should think of the Internet as the world’s elevator: Someone nearby is always listening in.

When deciding what is appropriate to write online, “err on the side of caution, because you can’t go the other way,’’ Crotty said. “We first have to put ourselves in the shoes of the patient we may be discussing and then reflect if what we’re saying is appropriate.’’

Crotty and Mostaghimi recommend that physicians set up separate personal and professional social media accounts. Keep the personal ones set to private and use the professional ones as an extension of the practice, they say.


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