Is Online Physician Behavior Really That Risky?


A research letter published yesterday in JAMA reports patterns of online physician behavior.  A recall survey of 68 state board executives was taken on disciplinary matters related to online misconduct.  Of the 48 respondents, 44 reported having taken at least one disciplinary action in eight categories covered by the survey.  Transgressions include inappropriate online communications, use of internet for inappropriate practice, online misrepresentation of credentials, and others.  There is no detail referencing specific social media applications.

After reading the study, it would appear that we’re doing pretty well with respect to online professionalism.  Relative to the 65,000 lifetime board actions in the database of the Federation of State Boards, 99.9% appear to be the result of offline behaviors.

One conclusion might be that doctors belong online.  Here we’re safe.  In fact, if I were a hospital or medical school administrator reading this letter, I might consider an immediate move of clinical and administrative operations online as a means of mitigating risk.

Sarcasm aside, professional misconduct is a serious matter, especially for the patients we are charged to serve.  We need complete, accurate data on physician conduct so that we can understand how to properly train our next generation of doctors.  Practicing physicians need to understand how to practically manage their digital presence.

But this letter published by Greyson et al potentially adds to a medical culture already afraid of what it doesn’t understand.  It comfortably supports the confirmation bias of some physician leaders who hope that the digital age will pass as quickly as it came.  And the suggestion that the worst in physician conduct is yet to come propagates a view of technology from the vantage point of risk rather than opportunity.

If you read the study carefully you’ll see that it supports a belief shared by Dr. Wendy Sue Swanson some time back, “We are way worse in the elevator than we are online.”

  • Physician Violations of Online Professionalism and Disciplinary Actions: A National Survey of State Medical Boards.  Greysen SR, Chretien KC, Kind T, Young A, Gross CP  JAMA, March 21, 2012—Vol 307, No. 11, pp 1141-1142.