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To Tweet or Not to Tweet

Is social media a cause for concern or a way forward for health professionals?

By Emily Leighton, MA’13

Social media is a very powerful tool. It has the power to highlight our professional values, and the power to degrade our professionalism.” With this view, Dr. Barry Schwartz, assistant professor, Schulich Dentistry sets out a 21st century dilemma for health care practitioners and educators.

In 2017, social media is no longer a new phenomenon, but its influence on professional standards, pedagogy and the academic environment remains uncertain and contested.

As Schulich Medicine & Dentistry’s social media community continues to grow, it’s worth examining what this digital disruptor can teach us about professionalism and education.

Is social media a professional responsibility?

“If professionalism is a social contract between medicine and society, and society is increasingly using social media, is it a professional responsibility of physicians to consider the rewards and risks of social media in the care of patients, society and themselves, as well as the education of learners?”

This question is posed in a 2015 research paper published in the Postgraduate Medical Journal, “Thou shalt not tweet unprofessionally: an appreciative inquiry into the professional use of social media.”

Research shows that an increasing number of professionals of all stripes are relying on social media as an information source and communication tool. The Matters of Opinion 2017 report on Canadian media consumption habits found that social media’s status as a primary source of news and information has more than doubled in two years.

“Society is on social media, which means it’s essential to have a voice in terms of leadership, education and awareness,” said alumna Dr. Sara Taylor, MD’98, a physician practising in British Columbia after a recent move from Alberta. Dr. Taylor has written and presented on the topic of professionalism in social media for several years.

And it’s not just individuals like Dr. Taylor who are realizing the importance of social media in a professional context. Professional bodies are now formally addressing it as well. Groups such as the Canadian Medical Association and the Canadian Dental Association have adopted policies and guidelines for members. Most academic institutions, including Western University, also have social media policies in place for faculty, staff and learners, and codes of conduct now extend to behaviour in the digital world.

Challenging the values of professionalism

If such a responsibility does exist, what does this mean for the long-standing cornerstones of professionalism in medicine, dentistry and academia? Respected and established values like boundaries, privacy and confidentiality present unique challenges on social media.

“Social media is seen as disruptive to tradition and convention, particularly related to patient communication and relationships,” explained Dr. Javeed Sukhera, assistant professor in Psychiatry.

Maintaining professional boundaries on social media is complicated – patients, co-workers and students can access personal information and engage in inappropriate or uncomfortable interactions.

“It’s easy to transcend into too casual a relationship with patients,” said Dr. Schwartz. Dr. Sukhera agrees. “We’re giving the world a window into ourselves beyond our clinical duties more than tradition has permitted in the past, which can be problematic,” he said.

Privacy is ambiguous even with a growing number of personal settings and options available to users – which can lead to a false sense of security.

“When there is ambiguity about privacy, that’s when trouble can arise,” said Dr. Taylor. “We can be fooled into thinking we’re having a conversation among friends, but our messages can really be shared anywhere.”

Patient confidentiality is also a concern, even if posts or images are considered non-identifying.

Despite the challenges, the traditional values of professionalism continue to reign supreme in the digital realm. “Social media highlights the importance of professional values that we already have in place,” explained Dr. Schwartz.

Social media adopters and supporters at Schulich Medicine & Dentistry are proving that when faculty and learners are trained to recognize and adhere to these professional considerations, being connected online can be an extremely useful and positive tool.

Expanding education and training

The complex and dynamic digital world emphasizes the need to integrate social media training into teaching at all levels, including continuing education.

As the faculty lead for the ethics portfolio in Schulich Medicine’s psychiatry residency program, Dr. Sukhera is taking steps to bridge the knowledge gap by incorporating discussions around digital professionalism.

“We’re giving the world a window into ourselves beyond our clinical duties more than tradition has permitted in the past, which can be problematic.” —Dr. Javeed Sukhera

Formal discussions with residents cover a range of topics, from the nuances of specific social media platforms to ethical issues with Googling patients to navigating potential defamation or slander on physician rating websites.

“We need to have these discussions with learners in a proactive way to diminish fear and equip them with guidance and facilitation,” said Dr. Sukhera. “We talk about how to navigate these complexities while remaining anchored to professionalism and clinical best practice, as well as seeking emotional support if needed.”

Schulich Medicine & Dentistry students in the Doctor of Medicine and Doctor of Dental Surgery (DDS) programs are introduced to professionalism from the outset of their education, beginning with the professional oaths at the White Coat Ceremony.

“It gets the students thinking in this direction, about upholding the values of the School while they’re here and maintaining and building upon those down the road,” said Dr. Schwartz.

Dr. Schwartz teaches a unique curriculum in ethics and professionalism for dentistry students in each of their four years in the DDS program, exploring social media and interpersonal communication through a variety of activities and assignments.

His approach focuses on critical thinking and self-reflection. “I try to instill that being a reflective practitioner is integral to being professional,” he said. “We’re less likely to make mistakes if we reflect before hitting the send button.”

Dr. Taylor says finding role models is crucial for navigating unfamiliar territory. “Before you dive in and get active, the best thing you can do is observe first,” she advised. “Look up people in your field, your community and find examples of what good professional behaviour online looks like and mirror that.”

It’s difficult to anticipate what the next 20 years of social media will look like. But the professional values learned and practised at the School will help the next generation navigate the murky waters ahead.

“The professionalism bar is now set very high and there is a tremendous responsibility moving forward,” said Dr. Schwartz. “I give students the tools and resources, and I try to inspire them to be the best professional they can be.”

Why should you consider social media?