Doctors Debate Social Media Ethics

It all began as a tweet about a patient's lengthy priapism.

SOCIAL MEDIA A physician expressed compassion and feelings of awkwardness addressing a patient enduring 36 hours of agony with a prolonged erection. Later, the Internet had mobilized 'prosecution' and 'defense' teams for the anonymous mommy_doctor (MD) tweeter.

FIRST, I must point out the "mea culpa" that has since been tweeted by MD: "In any case, I've learned my lesson and will tone it down. Some." Thank you. She later also indicated that the patient did not actually have a priapism.

SECOND, after smelling smoke in the forest, ClinicalPosters.com sent her a tweet with a link to the blog formed in her (dis)honor so MD could either evacuate or join the volunteer fire department. Wouldn't you want to be alerted if there was a besmirching free-for-all about you? Apparently the riot ensued without first approaching her.

THIRD, I see how the conversation devolved, egged on by a MD follower with a perhaps complimentary/flirtatious tweet. The "fish or cut bait" remark, in this context may, by some, be interpreted as sexual innuendo. However, the literal definition of the phrase (if there is such a thing for slang) is rather innocuous: "Decide what you want to do and stop wasting time; either act now or give someone else a chance or turn." MD did exercise a bit of restraint in allowing the reader to color in his/her own interpretation. Since she did not extend the metaphor, is it appropriate to publicly castigate her for what her statement might have implied?

Does this incident rise to the magnitude of the surgeon who was fired for photographing an unconscious patient's (highly identifiable tattooed) genitals?

Well, if MD's patient has a Twitter account (or knows someone who does), it is quite likely he could, with a bit of investigation, personally determine the identity of MD and decide whether "she wrote enough that others in the community could identify the patient."

Doctor_V has trumpeted his opinion that no patient info should be discussed publicly, whether or not details are obfuscated. The MD tweets may have revealed information that a patient in the described situation might likely deem private, privileged and embarrassing.

The incident originating by an anonymous MD about an anonymous patient has taken on a life of its own. It has been publicly tried and judged by peers within blog comments. The only prominent figure in this ordeal is the one who brought the whole situation to light, Dr. Bryan Vartabedian—someone receiving his own share of praise and consternation. So what was this really all about? Increasing blog traffic?

As Dr. Kevin Pho said: "Confronting physicians in the media … is low hanging fruit."

Note: This post was submitted to the Vartabedian blog but summarily deleted for not originating from a "palpable human being" with a proper "link to a digital property."

June 1, 2011: mommy_doctor deleted her Twitter, TwitIQ and Flickr social media accounts, and has restricted public access to her WordPress blog.

Tags: anonymity, censoring, hipaa, legality, physicians, privacy, shunned, somed