1. Professional use of social
media
Presentation to uOttawa Undergraduate Medical Education
Program
SEPT. 6, 2017
UOTTAWA
PAT RICH @PAT_HEALTH #UOSM17

2. Lecture objectives
 Discuss the potentials of social networking tools such as
Facebook, Twitter, LinkedIn and Google+ in medical
education.
 Discuss the safe and professional behaviours regarding social
networking usage.

3. There are more things in
heaven and Earth, Horatio,
/ Than are dreamt of in your
philosophy
Hamlet: Shakespeare

4. Who I am
Pat Rich –
 Medical writer, editor and social
media commentator
 Experienced health care
communicator with a keen interest
and involvement in the use of social
media tools in medicine and health
care and believers in the value of
these tools
 WHO I AM NOT
 Physician
 Academic

5. Five years and a seismic shift
Huge benefits to using social media in your
medical career should you choose to do so
Definite downsides and significant risks

6. “
”
You are learning medicine in an era when social media,
the Internet, digital care and mobile apps are becoming
increasingly interconnected

7. “
”
If the doctor-patient relationship was a
meticulously crafted house of cards, held
together by historically entrenched relations of
power and professionalism, then the Internet is
the toddler that toppled the house and bent the
cards.
Erene Stergeopolus, Aug. 30, 2017

8. The new digital era
“Today’s medical professionals must be masters of different skills
that are related to using digital devices or online solutions” and
mastering those skills “is now a crucial skill set that all medical
professionals require.”
Dr. Bertalan Mesko
“The democratization of media has made every physician an
independent publisher …physicians now have to learn to
manage and maintain their identity in the public space,”
Dr. Bryan Vartabedian,

9. Being a digital doctor
 Shape an idea in under 400
words
 Share an idea in a few hundred
characters
 Put an idea on a short video clip
 Understand the limitations of
patient-specific dialogue on
public networks
 Manage input and consumption
of information
Dr. Bryan Vartabedian

10.  Maybe you won't becoming a
tweeting, blogging doctor. But,
what content will you publish in
order to establish a healthy digital
presence for yourself or your
practice? …Will you be prepared to
help steer the conversation back
towards science when celebrities
hijack the conversation with
something otherwise?
 @thedocsmitty

11. The power of social media

12. Prevalence of social media in medicine
- Ontario
“In my now nearly 40 years as an Ontario physician I
have never witnessed such passionate engagement
with OMA affairs or the political process. (It) was
directly fuelled by the use of social media and the
enhanced connectivity between different regions and
specialties.”
Dr. Alan Drummond
(@alandrummond2)

13. The prevalence of social media in
medicine: Canada
2015 – Halifax
 Tweets – 10,748
 Participants – 1946
2016 - Vancouver
 Tweets – 15,306
 Participants – 2177
2017 – Quebec City
 Tweets – 13,861
 Participants – 2295

15. Social media in medicine: Global

16. The power of social media

17. Be a health care social media superstar
– fight Goop

18. What are/is social media
Extension of every day interaction
Conversations & exchange
Communities of shared interest
Tools for innovation

19. Why care?
“Whether physicians are active on social media
or not, an understanding of social media and its
potential implications on their professional lives
is essential.”
Dr. Hartley Stern, CEO, Canadian Medical
Protective Association

20. “… millennials whose use of social media is integrated into every
other aspect of their life, are not happy with the educational status
quo.”
BMJ Senior Editor Tessa Richards

21. Canadian studies from 2016 have documented gap
between learners and educators in understanding of
and use of social networking sites in medical education

22. Social media and academia
 Social media is a new space for academic
medicine that has enormous possibilities for
research, education, clinical care, and
dissemination of health care science.
 Institutions are starting to recognize social
media scholarship as significant and
meritorious and to include it when an
academic is being considered for promotion
and tenure.
More Than Likes and Tweets: Creating Social Media
Portfolios for Academic Promotion and Tenure: JGME, Aug.
2017

23. Fun with Twitter (educational too!)

24. An expert Canadian physician voice – Dr. Ali Jalali

25. Why consider using social media
 To stay informed
 As a learning tool in medical education
 Communicate (engage) with peers and patients
 Disseminate information
 Advocate for/against something
 To help get a job
 To deliver clinical care
 Because if you decide not to use social media, your decision
should be based on sound knowledge about what you are
choosing not to use

26. The challenges
 Impact on patients
 Liability
 Privacy
 Ethics
 Boundaries
 Time theft
 Reputation
 Compensation

27. Who is making the rules?
• College of Physicians and Surgeons of Ontario Guidelines
• Canadian Federation of Medical Students (CFMS) Guide to
Medical Professionalism: Recommendations For Social
Media
• Canadian Medical Association – Issues and Rules of
Engagement
• Canadian Medical Protective Association

28. The rules (summarized)
Protect patient privacy and
confidentiality
Be professional

29. “Don’t Lie, Don’t Pry
Don’t Cheat, Can’t
Delete
Don’t Steal. Don’t
Reveal”
Dr. Farris Timimi, medical director,
Mayo Clinic Center for Social Media,
April 5, 2012

30. “Don’t be banal, self-promote excessively, share
confidential material (especially about patients),
be a troll, break the law, commit a libel, or
overdo it.”
Dr. Richard Smith, BMJ, March 1, 2012

32. Twitter pro’s and cons
PROS
 Choose the community you chose to
follow
 Connect with peers and
internationally respected peer leaders
 Stay current with curated information
from medical journals
 Stay current with latest information
from medical conferences globally
 Engage with Twitter journal clubs
CONS
 Tunnel vision
 Risk of being trolled or spammed
 FOMO
 Risk of account being hacked if not
used

33. Dr. Joshua Tepper – CEO Health
Quality Ontario

34. Downside of social media for med students

35. Medical politics aren’t
for the faint of heart
Former Ontario deputy health minister
Michael Decter quoted by Theresa Boyle
in The Toronto Star, Feb. 27, 2017

36. Downside of social media
“Twitter has proven tedious
and even toxic to what I enjoy
most. 140 characters leaves
little room for nuance, little
room for substance, little room
for clarification, and little room
for courtesy, regret, or
forgiveness.”
@DrWarsh

37. Outcomes of Ontario situation
 Canadian Medical Association hosted session on intra-
professionalism with focus on disrespectful activity on social
media – developing new Code of Ethics and Professionalism
 Some physicians reported to the CPSO for inappropriate
behavior
 Some physicians criticized OMA and other doctors for
reporting doctors to CPSO

38. Case study 1: The political resident
Brandon is a resident who, since starting medical school, has kept a blog
about his views on medicine, medical education, and health care politics.
Recently, Brandon has blogged extensively about his extreme political views
regarding the upcoming election. His residency director reads his blog and
tells him that he must delete his posts and can no longer write new ones, as
he is not only a hospital employee and a representative of the residency
program, but also a professional who must represent himself accordingly
American College of Medical Schools Digital Literacy Toolkit

39. Case study 1: Discussion
Is it reasonable for the residency program director to tell this
resident that this non-medical blog should be removed? The
residency director tells this resident to remove his blog. What
would an appropriate response be?
 A. What a resident does on his own time is his business.
 B. He should have asked him to remove the offending posts
and be careful in the future.
 C. When you are a student and resident, you are ultimately
under the guidance of your dean and residency director.

40. Case 2: Looking up a patient on
Google
Susan is a psychiatrist who is treating a patient who is unwilling
to reveal little or any personal information.
Susan believes a better understanding of the patient and his
individual circumstances would aid her in providing more better
treatment.
To do this, Susan decides to look the patient up on Google
to see what – if anything has been written about him.

41. Case 2 - Variations
 If Susan feared for the safety of the patient
 If Susan feared for her own safety
 If Susan worked in the ER
 If Susan thought her patient may be famous
“Do it if your conscience says there’s a good clinical
reason for doing so.”

42. Case 2
 “In searching for their patients online, clinicians may be unwittingly
setting legal precedents for mental healthcare. As more and more
providers Google to guide their decisions, they may be shifting the
clinical standards to which all practitioners are held.”
 “If a patient leaves a suicidal message on Facebook, and the
clinician misses it, there’s a future—seemingly more plausible by the
day—in which that clinician could be sued for malpractice if the
patient then attempts suicide. ”
Getting Googled By Your Doctor: Erene Stergeopolus

43. Using social media in medical school
Some suggestions
 Facebook presence for classmates etc.
 LinkedIn account to:
 Build network for future career
 Follow discussion forums on medical education
 Blog about your experiences
 Instragram – Mobile-friendly image based slices of life
 Twitter account to:
 Develop your list of people, journals and other accounts to follow
 Watch (and engage) medical Twitter community (e.g. #hcldr)

44. Dr. Jalali (again)

45. Thank you!
Questions?