As we work to get our fellow physicians to emerge from the shadows, the last thing we need is a social health horror story.  This week a Rhode Island physician was formally reprimanded for breaching patient confidentiality on Facebook.  You can get catch up with the core story of Facebook and the Rhode Island Doctor on MSNBC or read KevinMD’s nice analysis.

Look for a screen grab of the MSNBC headline at a compliance lecture near you (pointer slapping against screen: “This is what happens when doctors use Facebook“).

A few thoughts of my own:

Don’t assume ill intent. While it’s never Kosher to disclose protected health information, we don’t know the nature of the dialog in this case. This may have been innocent mistake made while sharing a remarkable experience. On the other hand, it could have represented poor professional judgment.

Irony. The world clamors for doctors to be more engaged. But when (not if) we make a mistake our names are at risk of going viral.  And yes, the bar should be set higher for us.  I just wonder if news like this represents the best way to handle a profession’s social growing pains. This story represents one more reasons for doctors to hide under their exam tables.

It’s the medium, not the message.  Unfortunately disclosure of protected health information occurs more often than we’d like to admit. But when was the last time we saw MSNBC headline a patient privacy violation made on the radio?  Anything Facebook is newsworthy.  Ultimately this story’s more about the medium, less the transgression.

How do you define a jury of your peers? When it comes to the definition of unprofessional digital behavior, I’m concerned that early adopting doctors may not be given the benefit of the doubt when it comes to professional review. In fact, peer review by those who think that Twitter is something done by delinquent teens may not really represent peer review.  Expect physician transgressions on public platforms to evoke extraordinary consequences.

Could this be a teachable moment? With the blessing of her hospital’s compliance officer, a guest post on 33 charts or KevinMD, for example, would turn a negative into a positive. Think how an open dialog of this case could influence medical students and the discussion surrounding digital professionalism.  And everyone loves redemption. Westerly Hospital, you have my number.

Here’s an absolute: if you don’t talk about patients it’s impossible to commit a health privacy violation (or correct me if I’m wrong).

This is just one casualty of an evolving communication medium.  Expect more.