May 23, 2012, 4:05 PM — When Matt Goldstein entered medical school at Stanford, his instructors warned him about keeping Facebook or Twitter pages, saying that social media activity could lead to violations of HIPAA patient privacy rules.
As he prepares to begin his residency, Goldstein has once again received the now familiar warning. "I actually just got an email from my residency program, and they cautioned us strongly about social media and about using it judiciously."
Medical students and physicians face the choice of either not using social media or using pseudonyms that only friends know in order to avoid violating privacy rules and to steer clear of inappropriate contact with patients.
"For me, something like Facebook, which started off as a really powerful social tool to interact with friends and colleagues, in some way became a concerning liability," Goldstein said.
Goldstein said his classmates either use online pseudonyms on Facebook, Twitter or LinkedIn accounts, or they have shut down their accounts for fear of unwittingly violating privacy rules. Many have switched to private professional networking sites, which allow them to discuss medical cases in professional forums, seek out colleagues for remote consultations and read up on the latest treatments and outcomes.
In a 2009 survey of deans at 130 U.S. medical schools published in the Journal of the American Medical Association, 60% of the respondents reported incidents of students posting unprofessional online content. Violations of patient confidentiality were reported by 13% of those surveyed.
Unintentional privacy breaches
It may appear obvious that medical students and physicians shouldn't post personal patient information on social networks, but it's not always that simple.
For example, two years ago, Dr. Alexandra Thran, a 48-year-old emergency room physician, was fired from Westerly Hospital in Rhode Island and reprimanded for unprofessional conduct by the state medical board for posting information about a patient online.
According to a board filing, Thran didn't post the patient's name, but there was enough information that other people could identify the individual.