In November 2010, the American Medical Association adopted a policy on Professionalism in the Use of Social Media. This was a notable step for the AMA, acknowledging in the text of the policy that social media tools offered professional value to physicians:
Participating in social networking and other similar Internet opportunities can support physicians’ personal expression, enable individual physicians to have a professional presence online, foster collegiality and camaraderie within the profession, provide opportunity to widely disseminate public health messages and other health communication.
The remainder of the policy, however, was rather cautionary in tone, focusing largely on how to avoid pitfalls in social media, without providing guidance on how to use social media effectively to meet the goals laid out above. Dr Ted Eytan posted an analysis and critique of the policy on his blog that reflected some of those concerns. Perhaps it is notable that the Study Report by AMA’s Council on Ethical & Judicial Affairs on the issue (CEJA Report 8-I-10) is not posted for public review alongside other CEJA reports on the AMA website.
[Update 2011-10-27: CEJA report 8-I-10 was eventually published in the Summer 2011 issue of the Journal of Clinical Ethics, so you can read it if your library/institution has a subscription. The PMID is 21837888.]
Last month, the Massachusetts Medical Society published a set of Social Media Guidelines for Physicians that in many ways mirror the AMA policy — but with some subtle and very interesting differences. Unlike the AMA CEJA, the MMS did publish the report behind its recommendations (109, A-11). The report includes the following sections:
- an analysis of the unique nature and potential of social media for patient engagement,
- the barriers to physician participation,
- specific guidelines for minimizing risk (including the AMA’s policy),
- the argument for physician engagement, and
- a set of best practices for getting started.
All of this then leads up to the recommendations for the guidelines. As I said, that text is very similar to the AMA’s Policy, but with the following subtle differences:
- The contrasts in the language of the two preambles are notable. While AMA refers to social media as venue for “personal expression,… collegiality and camaraderie”, MMS focuses on the business case, referring to them as “an effective method to connect with colleagues, [and] advance professional expertise.” Likewise, while AMA seems to view social media as a bullhorn (“…to widely disseminate public health messages and other health communication”), MMS sees them as more, well, social: “[an effective method to] educate patients, and enhance the public profile and reputation of our profession.”
- Point (e) of the AMA policy indicates that physicians have a responsibility to monitor each other online and address unprofessional behavior by colleagues, involving the authorities if necessary. MMS prefaces this point by reminding physicians that this is nothing new: it is simply an extension of their existing professional responsibility into online spaces.
- MMS adds an important item that is absent from the AMA policy: “Physicians must disclose all financial or other material relationships they have with regard to the maker or provider of products and services they review or discuss in online communities. This includes discussions and reviews of products and services provided to the physician for free.”
- Finally, and most importantly, notice the contrast in the last item of each policy [emphasis added]:
- AMA: “Physicians must recognize that actions online and content posted may negatively affect their reputations among patients and colleagues, may have consequences for their medical careers (particularly for physicians-in-training and medical students), and can undermine public trust in the medical profession.”
- MMS: “Physicians must recognize that online content can have a significant impact on public trust in the medical profession, both positively and negatively. The content that physicians post online may also influence their reputations among patients and colleagues, and may have consequences for their medical careers, particularly for physicians in training and medical students.”
And that’s the key. Social media have the potential to be lots of things, depending on how one engages with them: they can be powerful or weak, constructive or destructive, a wasteful time-sink or a powerful investment in achieving professional goals. One thing they are not, however, is disappearing or declining. As Lee Aase of Mayo Clinic has said many times, there are two kinds of ROI for social media in health care: the “return on investment”… but also the “risk of ignoring”. When they acknowledge both the potential risks and benefits of social media, organizations such as AMA and MMS can guide physicians to use their newfound powers for the greatest good.