Sometimes I have downtime in clinic and I peek in on Twitter.

Is this a problem?

It’s an interesting question because I think there are considerations for physicians and other health professionals.

Let me say first of that the needs of my kids (in my home and in my clinic) are always met before my communication needs.  Professional calls (barring emergencies), personal calls, email and social exchange of all types happen only when patient care obligations have been reasonably met.

With that said, there are a couple of things to think about:

Social media is just another form of professional communication. We should see it no differently than the telephone or email which, as we all know, are frequently misused.  To the uninformed, it’s assumed that social dialog is frivolous dialog.  But my social feeds are at the core of of my communication.  Ultimately these platforms will eclipse email as our core mode of communication.

Communication and patient care are not mutually exclusive. I hear it all the time:  I would rather have my doctor spend more time with me than writing a blog or using Twitter.  Of course, who wouldn’t?  But one does not happen at the exclusion of another.  Every heavily engaged social physician I know writes on his or her own time.  Clinic isn’t shortened in order to create time to communicate.  The two will always need to coexist.

Perception trumps reality… To an extent, what patients perceive may be as important as what what’s occured.  If a patient believes that your social dialog occurrs at the expense of their care, that’s a problem.  That goes for the occasional tweet during 30 minutes of downtime as well as your weekend on call.  While we have to educate patients about what we’re doing, we need to be sensitive to their perceptions.

…Unless reality trumps perception. Anyone who shares conversations understands that transparency comes at a cost.  When bits of your professional dialog are public, you will be judged.  But there will be those who misunderstand or take commentary out of context.  This is a well-known risk of Twitter’s 140 character limitation.  But it’s important for doctors and lurking patients alike to understand that the potential for misunderstanding doesn’t mean we stop talking.

As we move from the idea of ‘social media as goof-off medium’ to ‘social media as tool of communication,’ there will be growing pains.  The adoption of real time physician communication will draw attention to the issue of boundaries.  A lot of this will come down to the expectations we have of our providers and our understanding of how and when social dialog should take place.

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