Thread by @medicalaxioms

Reid’s Rules of Medical Social Media
1. Know your hospital/organization’ s rules and abide by them.
2. The rules might change so recheck the policy every 6 months or so.
3. Your employer has the final say about what is okay or not. I mean if you want to keep your job. [thread]

No description or photograph of any patient, part of a patient, or their room or belongings should be identifiable to:
1. The public
2. Medical personal who cared for them
3. The patient, their family, or friends

This includes a photo of the patient’s
- face
- skin
- blood
- shoes
- clothing
- cane
- handwritten note

There are a number of pictures of “bloody rooms” on social media platforms. Even without a date or location, these are not okay.

Who am I to say? Hey I’m just trying to keep you out of trouble.

The details of a case presented on social media should not match any living person you have cared for. If you wish to present a case you have seen, change most or all of these:
- age
- gender
- location
- social details
- lab numbers

Make it clear to anyone who asks that this is a fictitious case at most loosely based on one or ideally many patients you have seen who presented in a similar way.

Medicine is taught through storytelling and there is value to putting a face on the story you are telling to make your point.

No patient should have to suffer the violation of their privacy for you to teach your intended lesson.

If you wish to show an X-ray, review the one from the case you are describing then find a similar one out there in the internet. Close will be plenty good enough.

Some say no bit of a patient’s skin should be presented on social media without written permission. This is true but like @Doctor_V I feel that no image of a patient you have cared for should ever be presented.

When you see a colleague make a mistake, send them a discreet direct message if possible. No need to draw more attention to the error before it is taken down.

If your hospital, organization, employer or administration contacts you about a post on social media I recommend the following:
1. Take a screen shot of it.
2. Take it down immediately
3. Do not try to build a defense for your actions. Be apologetic and contrite...

I have been asked to comment on enough of these issues to understand that the people who pay you have no interest in learning about medical social media.

They have no patience for you explanation about the rightness of your cause or the value of your content.

They don’t even care that their organization wasn’t meantioned, that this is your personal page, that you take this and that step to separate your social media persona from your employer.

There is no “personal” social media when you reach the public role and status of a physician. A google search page can link you to the people who write your paycheck in a few minutes.

All these rules are designed to protect the most vulnerable person in the medical system. The patient.

Ring sick and coming to the hospital scary and there is already plenty of dignity lost when you get into a hospital gown and tell your life story in a crowded ER. Hospitals wisely do not tolerate violations of patient privacy beyond what is necessary.

My own views and rules have changed over time, especially as I have been asked to comment on seemingly innocent content that nevertheless caught the attention of the public, a patient, or some hospital administration.

I’ve seen people try to make the “maintain with the flow of traffic” defense.
- I’ve seen other people do this
- there are lots of pictures like this out there
- 5 years ago people posted stuff like this

Again, the people who pay you don’t want to hear it. They want to hear
1. It’s gone
2. You recognize your mistake
3. You won’t do it again
4. You want to help to teach others “the rules”

Let me know if I missed any rules you live by.

@Doctor_V
@ErinGeiselman
@HeartOTXHeartMD
@TomVargheseJr
@MDaware
@ethanjweiss
@emily_fri
@EM_RESUS
@OtisBRickman
@DGlaucomflecken
@NaanDerthaal
@AmyGDalaMD
@DrSuperSalty
@GoodishIntent
@jonessurgery
@kidney_boy