At some point, every public physician is concerned about what their employer might think of what they’re doing. If you’re an academic, how will you be viewed by the traditionalists? What will your partners think of your opinions? These are all reasonable questions faced by public physicians and their employers.
Here are a couple of considerations that might help when deciding how to shape your public presence.
Remember that you’re an early adopter
Even if you’re getting into the game now, you’re still a relatively early adopter, and being an early adopter isn’t always easy. Despite being fifteen years into the Information Age, there’s still the belief that doctors follow one another in lockstep. We do things only with permission and communicate with the outside world almost exclusively through journals. Just understand this up front and manage your expectations of how you may be perceived.
If your institution has a social media policy, it may define boundaries for your public activities. Most policies are predictable in their commonsense prohibition of patient-specific dialogue and discussion of hospital business. You don’t need permission to have a voice, but what you do with that voice may have some limitations.
Remember that, despite your ability to maintain a blog on ethics, for example, many institutions would prefer you simply keep quiet and let them handle the content creation. And as many institutions don’t know how to handle physician-bloggers, the rote response may be to discourage you from thinking at all. It’s simply easier for them.
Be sure The Man doesn’t own your blog
While you’re perusing your employer’s social media policy, you might check your contract to see if they own your content. Some institutions stipulate that material written within the subject area of medicine becomes the intellectual property of the institution. If this appears to be the case, consult an intellectual property attorney for advice on options. While it’s not likely that your hospital employer will want to own your blog, it’s better to define ownership up front.
Show them what you’re doing
I think that the best personal policy with regard to your public presence is to inform your partners, hospital, or employer. While I don’t talk about health so much, I do want Texas Children’s Hospital and Baylor College of Medicine to be comfortable with what I’m doing. I frequently remind leadership to read what I write and share with me if there’s anything that makes them ill at ease. It shows I respect their opinions and my position within the organization. In b years, I’ve never been asked to remove anything.
Also, demonstrate effect if you can. If you’ve had success with a particular post or video, show it off. If you have Google analytics that show rising traffic, let them see. Hospital administrators love numbers and data, especially when the graph goes in an upward direction.
When it comes to winning the good graces of your superiors, oftentimes the best defense is a good offense.
Offer to be an agent of change
When people see the effects of your public presence, you may find yourself in a position where you can add real value to your organization. From working with your internal marketing team to training your colleagues, your experience may open up new opportunities for your own advancement.
And if you’ve got the blogging thing down, why not spread the love? Help your hospital or institution blog, with a commitment to contribute a post every couple of months. You will create goodwill, for sure.
Audience and eyeballs represent power in the digital age. As your presence grows, you will become a more important asset for your institution.
The right to publish should be balanced with responsibility to community
While the democratization of media has given us all the capacity to publish, that right needs to be balanced with our responsibility to our professional community and employer. Most problems that you hear about with doctors and social media typically involve some disturbance of this balance.
Doctors live by different rules than the rest of the world. We are entrusted with the most intimate knowledge—our patient’s stories. How we carry ourselves and what we do with that information in relation to our community, patients, and peers impact our ability to be effective.
This was the case long before status updates and real-time conversation, but our visibility and the reduction of publishing to a button means that we have to be even more careful about what we share and in what context.
I’ll repeat what’s been said before: despite your intentions, perception always trumps reality.
A disclaimer will only get you so far
If you maintain a blog or any kind of property that disseminates information, your organization will likely want you to display a disclaimer. Something along the lines, “These posts don’t reflect the opinion of said hospital.” Your chairman or office of communication or public affairs should be able to provide that language for you.
Get the disclaimer and post it, but then understand that your responsibility as a brand ambassador for your practice or hospital is not covered by that little bit of legalese. The moment people connect your public presence with your institution is the moment that the disclaimer becomes effectively invisible. The biggest problems faced by your public presence will not be stopped by a bit of cut-and-paste language.
It’s interesting that we rarely see similar disclaimers used in other forms of communication in medicine. When I speak at national meetings, I don’t begin with a slide reminding the audience that my comments are not the position of Baylor College of Medicine. At cocktail parties, we don’t use pre-small-talk qualifiers that identify us as non-spokespersons of our employers.
The point here is that, disclaimer or not, when you hit publish (or when you take to the podium to make a presentation) you become an unofficial spokesperson for your institution. You have an obligation to your clinic or employer that goes beyond what risk management wants to prevent.
The institutional responsibility to the public physician
We talk a lot about the responsibility of doctors to respect a certain standard when it comes to their voice. I’ve suggested that we’re accountable on some level to our communities, those we work with, and our patients. Extreme views and rogue behavior have a way of reflecting badly on our groups and hospitals.
The question then becomes: what responsibility do institutions, colleagues, and patients have to physicians with a voice? Is there any level of acceptance that must occur once we realize that doctors may not necessarily represent the media-driven stereotype that we’re used to? I believe there is.
While physicians must see their role in a larger organization, the larger organization must recognize the changing face of the physician. This involves:
- respecting a physician’s individual right to express, build, create, curate, converse, and advocate;
- embracing the unique brilliance of every physician’s voice with the understanding that it can be matched with a community in which that voice resonates and thrives; and
- recognizing the value of dialogue and the new means by which information is delivered.
In the end, this comes down to an institutional acceptance of how the world is changing. Doctors are nothing like the AMA suggested, and there’s no longer one way to see a physician.
That’s what everyone else needs to understand.
Policy or not, technology can’t fix stupid
While respecting the individual physician is key, it’s important to understand that technology and policies can’t fix stupid.
Internet scholar and NYU professor Clay Shirky wrote, “Social tools don’t create new motivations so much as amplify existing ones.” Basically, if you’re not inclined to care about your job, a social network is unlikely to suddenly motivate you.
Here’s another way to look at it: if you’re inclined to a bad attitude, dangerous sarcasm, anger, bitterness, and loose language, be careful what you sign up for. A jackass in real life often translates to a digital jackass. In fact, a public platform is likely to amplify elements of your natural being. Essentially, whatever you are, you’re likely to be a bigger one online.
This can be a good thing and a bad thing. If your ability to keep your voice together is in question, it may be better to keep your account closed or just watch.
This page is part of a bigger project: The Public Physician, a field guide for life online. To read more check out the Public Physician landing page. Happy reading!