Hinda Mandell felt creepy after being followed by her OB on Twitter.  Her post on Cognoscenti, Brave New World: Your Doctor, Your Private Parts, Twitter And You, is provocative on a number of levels.

Think perverts, not OBs.  It’s funny that the author’s friends and husband are concerned with her OB.  There’s little regard, however, for that serial pervert in a dimly lit room enjoying her recently shared images.

(That troubling little scenario puts things in perspective)

‘Following’ is irrelevant.  Your conversations are likely visible to every member of the planet whether or not you are followed.  Your comments are publications.  So if you’re uncomfortable with your ideas and images being seen, don’t publish them.  Or think about what you’re publishing.

Engagement is relevant.  What’s done with regard to engagement between a doctor and patient is what’s important.  Any social encounter has the potential to cross the line.  This isn’t specific to social media, however.  If you don’t like what a doctor does in the office, at the bedside, at a PTA meeting, on the phone, in church, or on Facebook, vote with your feet….or your mouse.  Relationships go both ways.  By assuming we have no control we make ourselves victims of our own visibility.

Damned if you engage, damned if you don’t.  One e-patient wants engagement, the other thinks it’s creepy.  No wonder doctors are confused when it comes to their public voice.  Let’s just face the fact that every social relationship is different and those participating need and want different things.  Policies at checkout windows will never fix that.

If you want a delineation of what I’ll do on every social platform, be prepared to wait.  I’m not sure if I follow any patients at this point but I suspect I will never have a Twitter policy on who, when and why I follow.  If, for example, a parent happens to run a blog, company, or organization that deals with technology and medicine, it might be something that I’m interested in.  I have plenty of patients who run non-profits for their children and associated diseases.  I might want to support these patients.  I won’t rope myself into a written policy because someone’s husband chooses to puff his chest out.

Committees are unlikely to legislate social engagement.  Just as there are no AMA guidelines on how I should deal with a mother who approaches me at a cross-country meet, there will likely never be actionable and practical guidelines that direct doctors to the seemingly limitless situations we face in the public space.

I could come up with another 20 points.  Where have I gone wrong?

h/t to Greg Matthews for pulling this story into my feed. 

Just found an excellent post on this story over at the Mayo Clinic by @LeeAase http://network.socialmedia.mayoclinic.org/discussion/should-doctors-or-hospitals-follow-their-patients-on-twitter