In May 2010, Michael Laccheo, MD, a rheumatology fellow at the University of Iowa in Iowa City, diagnosed one of his favorite patients with a rare disease, one that’s been referenced fewer than 50 times in the medical literature. After the visit, he second-guessed himself a bit: Did he effectively explain the complex diagnosis and related treatment?
He didn’t share his reflections, though, at a dinner party or while riding an elevator with a physician colleague, but rather to a potentially much wider audience. “Sometimes, the hardest thing about my job is explaining very complicated concepts that most doctors don’t even understand to those without a medical background,” he wrote in his blog, www.laccheo.com/blog. “If I’m rambling on, speaking over your head, or you need a double espresso to keep yourself awake, just stop me and let me know.”
Although the patient could have recognized herself between the pixels, Dr. Laccheo wasn’t particularly worried about sharing the story on his public blog. The patient had already contacted a popular daytime talk show to share her story. However, Dr. Laccheo, who like other rheumatologists is trying to navigate his own path on the social media highway, says that he wouldn’t have been similarly revealing on his Facebook page.
In fact, he tightly restricts that page to friends and family. Even a passing Facebook comment, such as griping about a difficult day, could be misinterpreted, he says. “If a patient who has seen me in the office today sees that [comment], he might think, ‘Oh, is he talking about me? Was he not focused? Was he having a bad day when he saw me?’ ”
As social media avenues proliferate, so do the related opportunities and pitfalls, according to several rheumatologists and other health professionals interviewed here. On the plus side, communication forums like blogging, Facebook, and Twitter can provide an online calling card for physicians, with myriad avenues to promote expertise and to build relationships with current and potential patients. Strengthening rapport with patients could be particularly helpful in a specialty like rheumatology, given the chronic nature of many of the illnesses involved, they say.
But social media tools also can disrupt an already overbooked day and, if care is not practiced, they can erode doctor–patient boundaries. To provide some guidance, the American Medical Association issued a social media policy on how to guard against jeopardizing either patient or physician privacy.1
