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Thursday, November 29, 2012

Doctors and Social Media...

Ok, I am busy- work, cycling, friends, family, errands, and of course, prepping for the arrival of my twin children- the first two for me and my wife.

So, I don't always get to react to news concurrently with when it occurs.

I did save an article from the October 23, 2012 Journal Sentinel, which was a reprint of a NY Times article by Jan Hoffman entitled "Take 2 of these and tweet me in the morning."  Fascinating article about doctors who tweet adolescent patients, respond to patients blogs, and the doctors also tweet and blog themselves, which these adolescent patients "follow."  These doctors believe it is a great way to capture adolescents- those who infrequently visit the doctor in order to prevent illness.  Adolescents are usually reactionary when it comes to medicine- that is, they only seek out a doctor when something is wrong.

The article states that doctors who use social media, and texting, are better able to help adolescents and keep adolescents involved with their own healthcare. Considering that people, including teenagers, live and die by their phones, I thought this was a very creative way to encourage teens to be healthy and to visit doctors regularly to be proactive in their healthcare.  Questions about drugs, alcohol, sexuality can be answered discretely through a text or link to a website, without a parent wondering why their child had to see the doctor today.

However, being a lawyer, it did raise some questions.  If you are tweeting and blogging advice, or commenting on a teens blog with advice, are you breaking doctor-patient privilege.  Such advice would no longer be "private" and I think there is a good argument that privilege has been lost.

For texting to patients, while the article says doctors ask parents permission, whose to say the parents don't actually end up reading the texts anyway?  In fact, constant texts from a doctor is probably bound to lead to a heightened curiosity among the parents as to what is going on between the doctor and teen- is something really wrong with my kid?  Is there something more I should be worried about?  Will the parent discover something that the teenager wanted to keep private with a doctor- anxiety, STD, pregnancy?

Third, what does this say about the parental role in general?  If a teenager is turning more to a doctor for advice, whether the questions are all medical or not, is the doctor usurping the traditional role of a parent - that is a parent should be a role model, guide, leader and someone a child can turn to for advice on all the questions that come with being in this gigantic universe. Moreover, if doctors are providing more and more advice, are they putting themselves in a situation where they are more likely to be sued for medical malpractice is something goes wrong?

Which brings me to the last point.  If a doctor is posting advice via Twitter, Facebook, or on a blog, the doctor has to have an understanding that even though the advice may be directed to a specific patient or the general public, individual patients may wrongly rely upon such advice and act to that patient's detriment.  Each human being is different, and where one drug or some other prescription may benefit one specific person based on a doctor's diagnosis, that does not mean such action may benefit another individual.  However, a patient following a doctor on Twitter or a blog may see the doctor's suggestion, take that advice, and end up having serious problems.

So, while doctors using social media is definitely an interesting way of reaching out to an elusive group, who at times can miss upwards of 10-15 years of consistent, necessary, proactive healthcare, the converse needs to be entertained- that is, are doctors, in participating in this medium, unnecessarily exposing themselves to the potential for legal action should something happen to a person.

Though, I guess the same question could be raised about lawyers who blog.  Though I make it clear I am not giving legal advice, I do discuss laws from time to time.  Is that discussion actually advice?  Am I presenting myself to the possibility that I could be sued for malpractice?  The short answer- most likely not based upon ABA guidelines and Professional Ethics guidelines.  But this is the law, and there are always exceptions.