It used to be clear where we were. When we were in a patient room we carried ourselves one way.  In church or temple, we behaved a different way.  With old friends and family, the limitations and boundaries were different.

How we should be has traditionally been defined by where we were and who we were with.

Public networks change a physician’s context

Public communities change that. Doctors and patients swim in the same pool.  Employers and residency directors have access to the same search results.  Context is increasingly ill-defined so it’s easy to find yourself unintentionally breaking the rules.

This isn’t a new problem, necessarily. Long before new media there were those among us who had a hard time understanding what was appropriate for a given place.  We’ve all encountered medical students who have a hard time understanding how their clinical encounters might be different from encounters with friends.  In real life this comes down to a type of social intelligence shaped by modeling and training and tempered by maturity.  Independent of the best preparation and mentorship, there are still those who have a hard time.

I have a hard time, at times.

Now take a social platform with fuzzy boundaries, add in the detachment afforded by a remote avatar engaging at the speed of now and you’ve got a recipe for problems.  A young doctor’s racy communique fashioned for a love interest finds its way in front of a patient.  A male OBGYN resident strikes a pose next to a naked statue on the Vegas strip and it becomes an unintended part of his application for fertility fellowship.

Context collapse and context intelligence

New York University’s danah boyd has called this context collapse and it’s something to keep in mind when chattering in public. We’re now swimming in the same pool with our patients, colleagues, and future employer.

Think of it this way: post to your Facebook page like your mother-in-law’s watching. If you’re not married, imagine what it will be like to have a mother-in-law and then picture her checking out your digital spaces. If you can’t picture that, think about your residency director or future boss.
While you can’t please all of the people all of the time, contemplating how your words will play in front of different audiences will take you far when it comes to staying out of the hot seat.
So sing like everybody’s watching. Because they are.

Perhaps there’s a type of context intelligence that may be important for physicians.  This intelligence would drive…

• What medical communication and sharing is best suited for which media space and community.
• What communication space is best for a given member of our network.
• What do we share socially and what do you keep to ourselves?
• What ideas are best suited for publication in an ephemeral space like a social network or blog, and what belongs inside the enduring pages of a prestigious journal?

Context intelligence as a new kind of literacy for this generation of doctors

Think of context intel as a type of social/emotional intelligence for the connected age.  Some of it is a product of our social background, other elements need intentional discussion and training.  The concept of context intelligence it forced by a public environment that merges community and communication.  It isn’t always clear where we are.

Put context intelligence down as a new kind of literacy for this generation.

h/t to one of our Rice University Medical Media Arts Lab students, Amol Utrankar, for helping me work through this concept of context intelligence.