Thread by @medicalaxioms

Reid’s Rules of Medical Social Media:
1. Know and obey your hospital’s and residency’s rules for social media. Know the 12+ types of patient identifiers.
2. Don’t make your employer hate you. They will fire you for your next mistake even if it’s minor.

These trump all others.

No description or photograph of a patient should be identifiable to:
A. Anyone in the general public
B. Any medical staff who took care of the patient or
C. The patient themselves or their family.

This includes a “bloody room” where a patient was cared for, their clothing or personal affects, and stuff.

To present a case, it is often not sufficient to deidentify it. Better to misidentify the clinical details. Change the gender, age, lab values, etc.

The cases I present here are fictional. Amalgams of true patients but not any particular patient is specific.

Medicine has always been taught through storytelling and the specific details are always lost and edited.

Hopefully the storyteller knows the point they are trying to make and can present a truthy account.

If you wish to show an xray, identify the finding you with to illustrate then search the web for one similar to yours.

Yes they are out there.

Never include specific dates of service. Never include a photograph of skin without written consent.

When you see a colleague make a mistake, use the following algorithm:

If you hate them, say nothing. Let them suffer their fate. Cruise ships need doctors too.

If you like them (or humanity) enough not to see them suffer a career-ending setback, send them a direct message. Something like:

I think you may get in trouble for this post...

Or

WARNING: I believe you may have compromised a patient’s identifiers in your recent tweet. 😳😳😳

If you make an error and your hospital or residency program calls you into the office

A) Don’t try to defend your act. People really hate that.
B) Be as deeply and sincerely apologetic as you possible can. Be reachable and ready to learn...

Offer to learn and then to teach others. Commit to the well-being of the patient and your organization.

If you wish to dig in your heels and show the organization how right you are, also prepare your resume. I can guarantee they don’t have time for that.

Be contrite not recalcitrant. Social media is new and you may save your career with an ignorance defense.

After all even the president makes mistakes...

Understand that hospitals spend a lot of money on PR. Your hard word crafting anti-PR for them is never appreciated.

You may be tempted to use the old classic “everybody posts pictures of bloody rooms after trauma resuscitations.”

This also goes over bad. What people got away with 5 years ago or 6 months ago is not relevant to what is acceptable today.

I know. Unfair, right?

I got here 9 years ago and have learned a bunch in that time. The main thing I have learned is that the boundaries are getting tighter and more people are watching.

Stuff you post on your “personal page” can come to the attention of your employer. People will connect the two even if you try to hide it. Employers can use these words as grounds for dismissal.

There is risk involved. Those of us who choose to teach in this new realm are in constant danger of making some mistake that yesterday would be ignored and tomorrow will be the topic of some tribunal.

Personally, I find the dispersination of valuable factoids to be a worthy endeavor. I routinely block people who threaten me or the success of this project.

I tolerate risk, I don’t invite a public stoning.

I meet people who say, “I don’t know why you go on there. It’s crazy. The mob already has their pitchforks and torches.”

I say, “Yeah man. It’s just I get bored so easily.”

When I finally turn this thing off, quit and walk away, I will feel satisfied that I spent a freaking ridiculous percentage of my life tapping out aphorisms, imaginary cases and other factlike phrases for the betterment of current and future doctors I will probably never meet.

I mean, you can’t just play Xbox all day. Everybody needs a hobby.

To the person who finally takes me down, I’d like to say, “Take no satisfaction. It was hardly you at all. Just the cumulative pressure of people who love to destroy things.”

I am not one of them. I like to create things: Understanding. Connections.

Give the experience from the error without the pain of making the error.

So yeah know Reid’s Rules of Medical Social Media so you can send me a message when I accidentally break one of them.