Semin intervent Radiol 2022; 39(02): 203-206
DOI: 10.1055/s-0042-1745717
Ethics Corner

#PauseBeforeYouPost: Ethical and Legal Issues Involving Medical Social Media

Eric J. Keller
1   Division of Interventional Radiology, Stanford University, Stanford, California
,
Vongai C. Mlambo
2   Stanford School of Medicine, Stanford University, Stanford, California
,
Scott A. Resnick
3   Division of Interventional Radiology, Northwestern University, Chicago, Illinois
,
Robert L. Vogelzang
3   Division of Interventional Radiology, Northwestern University, Chicago, Illinois
› Author Affiliations
Funding None.

Medical social media (SoMe) has continued to grow in popularity and complexity with an estimated 90% of clinicians using it personally and 65% professionally.[1] Likewise, over half of clinicians report using SoMe for educational purposes,[2] and 85% of the general public use SoMe to connect with and seek healthcare information.[3] These platforms have numerous benefits, facilitating networking, education, advocacy, and outreach. It is not uncommon for conferences to now have sessions highlighting SoMe as a powerful tool for practice building and advertisement. Crowdsourcing can also help both patients and clinicians navigate challenging clinical decisions by seeking advice from experts across practices and continents, which would be difficult to access or facilitate efficiently through other forums.

However, these numerous benefits come with an equally diverse set of risks including concerns regarding patient privacy and dignity, conflicts of interest, interprofessional respect, information accuracy/misuse, and equity and justice.[1] [4] [5] [6] [7] Even online activity occurring on personal accounts can have professional implications, affecting enrollment, employment, and litigation. A growing number of organizations, professional groups, and literature are calling attention to these issues, but, in the authors' opinion, these risks are generally underdiscussed and appreciated. This article uses a series of anonymized case examples to highlight some of these challenges and offers suggestions on how to avoid potential pitfalls while taking advantage of the many beneficial aspects of medical SoMe.



Publication History

Article published online:
30 June 2022

© 2022. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Ventola CL. Social media and health care professionals: benefits, risks, and best practices. P&T 2014; 39 (07) 491-520
  • 2 Bowser D. Social media behavior and attitudes of us physicians: implications for continuing education providers - a clinical care options (CCO) white paper. Clinical Care Options; 2017: 1-7
  • 3 Bennett KG, Berlin NL, MacEachern MP, Buchman SR, Preminger BA, Vercler CJ. The ethical and professional use of social media in surgery—a systematic review of the literature. Plast Reconstr Surg 2018; 142 (03) 388e-398e
  • 4 Denecke K, Bamidis P, Bond C. et al. Ethical issues of social media usage in healthcare. Yearb Med Inform 2015; 10 (01) 137-147
  • 5 Chretien KC, Kind T. Social media and clinical care: ethical, professional, and social implications. Circulation 2013; 127 (13) 1413-1421
  • 6 Gifford ED, Mouawad NJ, Bowser KE. et al. Society for Vascular Surgery best practice recommendations for use of social media. J Vasc Surg 2021; 74 (06) 1783-1791.e1
  • 7 Busl KM, Rubin MA, Tolchin BD. et al; Ethics, Law, and Humanities Committee, a Joint Committee of the American Academy of Neurology, American Neurological Association, and Child Neurology Society. Use of social media in health care-opportunities, challenges, and ethical considerations: a position statement of the American Academy of Neurology. Neurology 2021; 97 (12) 585-594
  • 8 Beauchamp TL, Childress JF. Principles of Biomedical Ethics. 8th ed. New York: Oxford University Press; 2019
  • 9 45 C.F.R. § 160. 103
  • 10 45 C.F.R. §§ 164.502(d)(2), 164.514(a) and (b).
  • 11 Cifu AS, Vandross AL, Prasad V. Case reports in the age of Twitter. Am J Med 2019; 132 (10) e725 –e726
  • 12 SIR Code of Ethics. Society of Interventional Radiology. Accessed February 25, 2022 at: https://www.sirweb.org/globalassets/aasociety-of-interventional-radiology-home-page/about-us/governance/sir-code-of-ethics_approved-november-2018.pdf
  • 13 Watson K. Gallows humor in medicine. Hastings Cent Rep 2011; 41 (05) 37-45
  • 14 Wyatt KD, Finley A, Uribe R. et al. Patients' experiences and attitudes of using a secure mobile phone app for medical photography: qualitative survey study. J Med Internet Res 2020; 22 (05) e14412
  • 15 Pershad Y, Hangge PT, Albadawi H, Oklu R. Social medicine: Twitter in healthcare. J Clin Med 2018; 7 (06) E121
  • 16 Lee JY, Sundar SS. To tweet or to retweet? That is the question for health professionals on twitter. Health Commun 2013; 28 (05) 509-524
  • 17 Attai DJ, Anderson PF, Fisch MJ. et al; Collaboration for Outcomes on Social Media in Oncology (COSMO). Risks and benefits of Twitter use by hematologists/oncologists in the era of digital medicine. Semin Hematol 2017; 54 (04) 198-204
  • 18 42 U.S.C. § 1320a-7b.
  • 19 42 U.S.C. § 1395nn.
  • 20 Lo B, Ott C. What is the enemy in CME, conflicts of interest or bias?. JAMA 2013; 310 (10) 1019-1020
  • 21 Lundh A, Lexchin J, Mintzes B, Schroll JB, Bero L. Industry sponsorship and research outcome. Cochrane Database Syst Rev 2017; 2: MR000033
  • 22 DeJong C, Aguilar T, Tseng CW, Lin GA, Boscardin WJ, Dudley RA. Pharmaceutical industry-sponsored meals and physician prescribing patterns for Medicare beneficiaries. JAMA Intern Med 2016; 176 (08) 1114-1122
  • 23 Chugh D, Bazerman MH, Banaji MR. Bounded ethicality as a psychological barrier to recognizing conflicts of interest. In: Moore DA, Cain DM, Loewenstein G, Bazerman MH. eds. Conflicts of Interest: Challenges and Solutions in Business, Law, Medicine, and Public Policy. Cambridge University Press; 2005: 74-95
  • 24 Hsieh LJ, Madadi SR, Shore KT, Keller EJ, Makary MS. Potential bias in image-guided procedure research: a retrospective analysis of disclosed conflicts of interest and open payment records. J Vasc Interv Radiol 2022; 33 (02) 141-147
  • 25 Chambers TS. No Nazis, no space aliens, no slippery slopes and other rules of thumb for clinical ethics teaching. J Med Humanit 1995; 16 (03) 189-200
  • 26 Wiersma M, Kerridge I, Lipworth W. Dangers of neglecting non-financial conflicts of interest in health and medicine. J Med Ethics 2018; 44 (05) 319-322
  • 27 Kreindler SA, Dowd DA, Dana Star N, Gottschalk T. Silos and social identity: the social identity approach as a framework for understanding and overcoming divisions in health care. Milbank Q 2012; 90 (02) 347-374