On Monday night, Dr Bryan Vartabedian, a pediatric gastroenterologist in Texas, wrote a blog post about physician behavior on Twitter. In the world of health and social media, it’s caused a near nuclear explosion of thought, an outpouring of opinion, and most importantly a much-needed discussion. Discourse is perfect for progress.

I think about this all the time.

In the post, Doctor V called out an anonymous physician blogger and tweeter, (@Mommy_Doctor), on her tweets about a patient suffering from an embarrassing and painful medical condition. Nearly 100 comments later and numerous other blog posts, physicians and patients are openly battling and exchanging perspectives.

I wonder, what do you think? I rarely write about patients directly. More, I write about what I learn from patients. I never want a patient or family member to stumble upon anything I write and wonder if I’m writing about them. When I have written about patients, I have asked permission and even then, waited for a period of time before writing about them to avoid the time-stamp the internet provides.

The reason many physicians don’t author content online is their concern about privacy. Their hesitancy is admirable. In our own time, I suspect most of us will end up communicating online, but it will be at different times (decades) for each of us.

Some history: I have had one tweet that I’ve taken down after a physician called it a HIPAA breach. It wasn’t (I even consulted with my colleagues in bioethics) but I swiftly took it down. I’m not here to be devout and certainly not trying to stoke the fire. I was thankful for the feedback and remain pleased I took that particular tweet down. I talked with the family involved immediately. I learned a great deal from a peer’s observation. We are dependent on our wise and smart community to help guide what we do for our patients, particularly online.

I really wonder what you think about this. Will you read Doctor V’s post and let me know? My comment on Dr V’s post is number 98:

When I speak about physician use of social media, I take the stand against anonymity for physicians. Simply put, remaining anonymous protects the person/physician tweeting, not the patients, or the profession for that matter.

Like many have said before, we need to aim above HIPAA and we sincerely need to consider how our content and voices over social media reflect not just the respect of our profession, but trust in what we do. Compliance and patient outcomes depend on it. Consider what distrust in physicians does to vaccine hesitancy, for example. It has public health ramifications (118 measles cases since January).
You might also have to step back from the democracy of opinion here. It’s not the majority that matters (how many people chime in and state which side of this particular tweet stream they support). I’d say if one or more individuals believe your content is a breach of privacy and professionalism, you ought to step back, consider taking it down, and revisit your oath.