Docs Reveal Private Patient Info on Blogs and Tweet During Surgery

by Heidi Stevenson

24 September 2009

What was that about doctors treating your personal information as confidential? Don't count on it. Imagine that you're in surgery and look up to find your doctor Tweeting away, getting the word out about the fascinating surgery he's about to do? How would that make you feel?

The Journal of the American Medical Association (JAMA) has reported doctor blogs revealing private patient information, with clinical detail, and has found that more than half of medical school students freely use Twitter to discuss the most personal information about patients.

Surgical Tweeting

The lead surgeon in the Henry Ford surgery, Dr. Craig Rogers, says of Twitter, "We're trying to use this as a way to get the word out." Wow! Surgeons are using a tool limiting messages to 140 characters as a means of educating people or each other, or perhaps to network. And they want us to believe that what they do is complex and mysterious—and we should trust them?

Seriously, what does all this mean? How can it possibly benefit patients to have doctors redirecting their attention to twiddle with a keyboard, advertising the wonders of the surgery? It's one thing for them to contact each other for information and advice—privately—but Twittering during a surgery?

Christopher Parks, cofounder of changehealthcare.com, says, "Doing this removes a real communication barrier. It helps make something scary much more comprehendable [sic]. It brings us closer together and makes us more engaged." Parks cofounded a website. He isn't a doctor. Who are "us"? Who does he think is being brought closer together? Is a patient going to feel closer to the doctor who tweets during surgery? Are messages of sound byte length going to bring doctors closer together, or significantly help in training?

Who benefits by off-the-cuff commentary? And how would you feel knowing that your body's innards are being exposed to anyone and everyone who happens to check in?

Exposing Patients' Personal Information

What about doctors and student doctors who blog and use online social networks, giving out patients' personal information? According to the BBC, many posts are quite "blue" in nature, that is, they are off-color and include sexually explicit information.

Much of JAMA's concerns seem to be focused on issues that the journal considers unprofessional, such as students posting frank commentary about their schools or their profession, using profanity, showing images of intoxication, using discriminatory language, or displaying and discussing sexually explicit material.

The study's team leader, Dr. Katherine Cretien, concluded, "Many responding schools had incidents of unprofessional student online postings, but they may not have adequate policy in place." That's all! No outrage was expressed. No concern for those whose privacy was invaded.

Even more revealing, the team's primary suggestion is that students should be taught how to set privacy and to do regular online searches for their names to see what sort of content shows up in association with them. Their concern wasn't for the effects on patients. Nor was it for a distressing lack of new doctors' concern for patient welfare or dignity. They simply think that learning to set privacy and doing searches to cover one's assets will resolve any issues.

Implications

It seems to me that the medical profession is simply so caught up in itself that the real issue—patients' welfare—has taken a backseat. Where is the disgust at such cavalier patient treatment? Where is the empathy for patients? How is it that the primary concern is merely "unprofessionalism"?

If it ever had a proper direction, the medical profession has lost its way. A patient's needs seem to be their last worry. That networking during surgery is even a consideration, let alone being promoted as a valuable tool, is frightening. It is now quite clear that the needs of the patient come last.

First, do no harm. Wonderful words that, sadly, have become nothing more than an antiquated and charming phrase in modern medicine.