bias.12


Both in IR culture and on social The 2014 Radiologists and


Social Media (RANSOM) survey indicated that


41%


of U.S.-based participants use social media for


professional purposes, and this number has been increasing.


terms of cases and pathology where someone’s traumatic, life-threatening experience can become “the biggest aneurysm I ever saw” or “grossest foot I ever reperfused.” In a sense, social media has provided a public window into our offices and conference rooms where discourse meant for other healthcare workers can be viewed in an unforgiving light. Even if the original patient never sees the post, these phrasings can be dehumanizing and further erode public trust in clinicians and healthcare. Dr. M’s hypothetical post is rather benign, but others are not.


In addition to patient privacy and dignity, the open exchange of medical information online has distinct benefits and risks relative to fora like peer- reviewed journals or conferences. On one hand, social media has enabled a faster means of sharing experience and insights or crowdsourcing solutions for challenging clinical situations. On the other, this speed comes at the price of fewer safeguards against misinformation in a space where information can gain prominence based on its popularity rather than accuracy.10


There is also less


room for context and explanation that may be necessary to truly replicate someone’s results.11


After all, there’s no


preceding peer-review process for what we tweet, and it doesn’t take much time to write 280 characters or less. Another potential adverse effect is optimism


18 IRQ | SPRING 2021


media, there’s a tendency to highlight the gallant successes and heroic saves rather than failures. We take pride in developing innovative solutions for problems and pushing boundaries, but these successes can come at the price of other less successful attempts and complications that are not often part of the narratives we share. This can create a false sense of ease or success, perhaps prompting others to attempt something they may not have otherwise.


Considering these challenges, it may be helpful to collectively develop a “Best Practices” guide for how best to reap the many educational and promotional benefits for our specialty while not undermining our professional values. For example, one of the authors of this article considers the following points before each professional post: “Could someone close to the patient readily identify this case?” and “If I saw this post about a loved one, how would I feel?” It’s also helpful to consider the potential effects on clinical decision-making and, where possible, provide some context and balance.


An additional potentially helpful approach for those who regularly post cases online would be to routinely discuss the possibility of using patients’ deidentified stories and/or imaging with them as part of the consent process. This would give them the option to opt out and enable clinicians to routinely note that cases were used with permission without having to discuss this retrospectively. Ultimately, it is up to individual clinicians to decide how to present themselves on social media, but we owe it to our patients, selves and colleagues to pause and check before we post.


References


1. Ranschaert ER, Van Ooijen PM, McGinty GB, Parizel PM. Radiologists' usage of social media: Results of the RANSOM Survey. J Digit Imaging. 2016;29(4):443–9.


2. Ventola CL. Social media and health care professionals: Benefits, risks, and best practices. P T. 2014;39(7):491–520.


3. Wadhwa V, Brandis A, Madassery K, Horner PE, Dhand S, Bream P, et al. #TwittIR: understanding and establishing a Twitter ecosystem for interventional radiologists and their practices. J Am Coll Radiol. 2018;15(1 Pt B):218–23.


4. Jonsen AR, Siegler M, Winslade WJ. Clinical ethics: A practical approach to ethical decisions in clinical medicine. 7th ed. New York: McGraw- Hill Medical; 2010. vi, 228.


5. Ahmed W, Jagsi R, Gutheil TG, Katz MS. Public disclosure on social media of identifiable patient information by health professionals: Content analysis of Twitter data. J Med Internet Res. 2020;22(9):e19746.


6. Palacios-Gonzalez C. The ethics of clinical photography and social media. Med Health Care Philos. 2015;18(1):63–70.


7. Cifu AS, Vandross AL, Prasad V. Case reports in the age of Twitter. Am J Med. 2019;132(10):e725-e6.


8. Abdelhamid M, Gaia J, Sanders GL. Putting the focus back on the patient: How privacy concerns affect personal health information sharing intentions. J Med Internet Res. 2017;19(9):e169.


9. Watson K. Gallows humor in medicine. Hastings Cent Rep. 2011;41(5):37–45.


10. Lee JY, Sundar SS. To tweet or to retweet? That is the question for health professionals on twitter. Health Commun. 2013;28(5):509–24.


11. Pershad Y, Hangge PT, Albadawi H, Oklu R. Social medicine: Twitter in healthcare. J Clin Med. 2018;7(6).


12. Mafeld S, Oreopoulos G, Musing ELS, Chan T, Jaberi A, Rajan D. Sources of error in interventional radiology: How, why, and when [Formula: see text]. Can Assoc Radiol J. 2020;71(4):518–27.


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