Regulating How Doctors Behave

Institutions are looking for rules to govern how doctors should behave using public digital media.  When I’m asked about rules I usually suggest that we start by referencing the standard manual of physician behavior.  That, of course, gives us a nice place to start.

Blank stares.

But certainly there are agreed upon guidelines that direct a physician’s conduct with everyday situations?  There must be rules that guide the handling of patients who approach us in the grocery store?  If I remember correctly the Federation of State Medical Boards issued specific, bulleted recommendations on how a physician should interact with patients who they know in their church or synagogue.  And there must be specific guidelines on the appearance of alcohol consumption in public.  Inappropriate communication with patients using the telephone or U.S. Postal Service has been addressed with firm consensus by the AMA, I’m sure.

The specific rules of countless day-to-day situations were never before spelled out in guidelines and policies.  The subtleties of our conduct and reactions to situations were shaped by modeling, personal judgment and the standards of our respective communities.

We used to be smart.  Or at least we gave physicians more credit.  We understood that some things are better left to communities rather than regulatory bodies.

I looked for formal, published guidance on how I should behave.  This 1927 essay from the Bulletin of the New York Academy of Medicine was all I could find.

Defining Social Standards for Doctors

There’s lots of discussion about how doctors should carry themselves online.  I think it’s simpler than we make it out to be.

Consider that we all live and work in communities.  We’re are shaped by those around us.  None of us do what we do alone.  And what I do and how I behave affects the way my community feels about me.  There are benefits and consequences to what I do.  I can blast fireworks in my yard 2 am, speed in my neighborhood, or get drunk and disorderly at the local Mexican restaurant.  I can volunteer as a scout leader or lead a food drive for a local woman’s shelter.  It’s my choice.  How I operate in public influences how people see me, how I’m received, and ultimately, how people work with me.

New media doesn’t change that.  We live and connect in online communities much like in real life.  And what we do in the virtual space has risks and benefits.  It’s interesting that before the democratization of media there was little discussion about how physicians should carry themselves in public.

Ultimately, defining one social standard for doctors is tricky.  Our patient and professional communities vary.  Standards vary.  We have to understand what works individually for the spaces we occupy and the company we keep – online and off.

We can argue about what doctors should and shouldn’t do online.  One thing’s for sure: In the context of our communities, good stuff build us up and poor judgment can close doors.

It’s simpler than we make it out to be.