Monday, June 20, 2011

To Tweet or Not To Tweet?

Last week a very active tweeter/blogger, who just graduated medical school and is about to begin a residency, suddenly disappeared from the internet. A few of us who followed him discussed the situation on line but no one knew what had happened.

After hearing that we were concerned, he emailed me that the administration of the hospital in which he was about to start his training had announced at his orientation that tweeting and blogging were prohibited, citing fears of information leaks, HIPAA concerns and nebulous “liability” issues.

I am somewhat ambivalent about this. While I certainly support freedom of speech, I also recognize the hospital administration’s position. I believe discussing patients [even disguised] on line is potentially dangerous. In a previous blog, I mentioned that even an anonymous blogger can be unmasked if he is not careful or if someone is determined to discover the blogger’s identity. There is the famous case of a Boston blogger known as “Flea,” who was “outed” on the witness stand during a malpractice trial. [Digression: Interesting interview with “Flea” after the trial.]

Another problem is the tone of some medical tweeters/bloggers. As some have commented, the output of many medical tweeters/bloggers does not pass the “elevator test” [would you say what you just tweeted in a hospital elevator?]. In fact, a lot of it doesn’t even meet the standards of normal polite conversation. On occasion, many physicians have indulged in “gallows humor,” but when it is in writing and permanent, it may come back to haunt you.

In my previous blog, I mentioned that a clever plaintiff’s attorney could ask you if you blog or tweet. Even if you use an alias on line, you are under oath to tell the truth. Would you be willing to lie and say you don’t blog or tweet? What if you then were discovered? Your credibility would be destroyed and your lawyer would be asking for a recess to discuss settling the case.

What do you think? Should residents be banned from tweeting and blogging? What about medical students?


Dr. G said...

I do not think so, however I think there should be certain standards that must be upheld when tweeting or blogging by medical professionals. Social media has become part of our society, and to ask someone not to be a part of it is, well, sad.

Skeptical Scalpel said...

"Dr." G,
I agree with you. The problem is that some people step outside the lines. That's why hospitals are paranoid.

LadySurgeon said...

i wonder about this quite a bit. i am a surgical resident who keeps a blog, mostly as a way to have some emotional release. i wonder if this would ever come back to bite me...

Skeptical Scalpel said...

Thanks for the comment. Please refer to the link above that will take you to my previous blog on the subject. In it, I discuss more fully what I think the legal ramifications are.

Unknown said...

I got thrown off a cruise ship for a tweet last month being a guest speaker for a new dietary approach that I use for my patients. I know all about twitter down sides now.

Skeptical Scalpel said...

John, sounds like an interesting story. I'd love to hear more details. If you don't want to comment here, email me SkepticalScalpel at

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