Even on Twitter, physician professionalism a must

Physicians need to be more careful when using Twitter, according to a review of 5,156 tweets sent by 260 self-identified U.S. physicians. Each had 500 or more followers.

The research, presented in a letter in the Feb. 9 Journal of the American Medical Association, revealed that 3 percent of these 140-character messages contained some form of unprofessional content, which included profanity, potential patient privacy violations, sexually explicit material and, in a few cases, discriminatory statements.

In addition, the team, led by Dr. Katherine Chretien, an associate professor at George Washington University School of Medicine and Health Sciences, identified 12 percent of the doctors' tweets as self-promotional, with another 1 percent pushing specific health products, some of which the doctors sold on their own websites. Ten such tweets about medical therapies contradicted existing medical knowledge or guidelines, potentially putting patients at risk, the researchers wrote.

Forty-nine percent of the tweets were related to health or medicine, mentioning specific studies or advocating something health-related, according to researchers. About 20 percent of tweets were conversations with other Twitter users.

While acknowledging that the vast majority of physician tweets were professionally helpful, Chretien and colleagues warned that even anonymous tweeters must avoid even vaguely commenting about specific patients. "The cloak of anonymity is not wholly protective and as long as a patient or family member could read a tweet and identify themselves (due to details provided, diagnosis, time/date stamp of tweet), then that is a potential HIPAA violation, even if physician is anonymous," Chretien wrote in an email to NPR.

To help boost credibility to Twitter users and make posters more accountable, Chretien suggests the industry begin verifying Twitter accounts for doctors, as some already are for celebrities and other public figures. She also noted that it would be helpful for governing bodies, such as the American Medical Association, to drill down past existing broad social media guidelines to specifically address physician use of Twitter.

To learn more:
- read the story in U.S. News & World Report
- see this piece in MyHealthNewsDaily
- read the post on NPR's Shots health blog
- check out an extract from the Journal of the American Medical Association

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