The Perils and Pitfalls of Social Networks (Series 1-2 of 5)

Tailored for the Facebook-user-Physician (and others)

Consider the following situations:

1. You maintain a personal Facebook account that identifies you by photograph, name, age, and practice status. You use the highest privacy setting. A patient who lives in your neighborhood and whose children go to the same school as yours makes an online request to “friend” you. You Google the patient and find her social contacts and information about her employment and political opinions. How would you respond to her request?
2. You are in private practice and maintain contact with colleagues through online social networks. You notice a recent tweet from a colleague employed by a prominent local hospital asking for advice from psychiatrists about management of an acutely suicidal patient without explicit patient permission. What, if anything, should you do?

These situations raise some key questions. Can physicians, nurses, pharmacists, and other healthcare professionals separate their personal and professional identities online? What are the duties of healthcare providers to maintain the integrity and status of their respective professions when it comes to other clinicians’ use of social media?

A Primer for Responsible Social Networking

What Are Social Networks?

Online social networks are locations on the Internet where one can create a personal profile and connect to others to create a personal network, among the most popular of which are Facebook, Twitter,Friendster, and LinkedIn. Other tools that permit interaction and spread of information include blogs, wikis, and file-sharing sites. Examples of some healthcare-seeking sites used by patients include Medhelp and DailyStrength. Physician rating sites such as123people use a meta search engine to categorize findings from publicly available records and sites (such as licensing agencies and property tax records) into information clusters that include email addresses, phone numbers, and social network profiles. The use of such networks and sites has exploded in recent years to include a substantial proportion of patients and practicing clinicians.

How Do Physicians Use Social Networks?

A recent study of physician use of Twitter examined the self-identified profiles of 260 physician users and reported that 30% posted 20 tweets within 1 day or less. An analysis found that 3% of tweets were unprofessional; 0.7% violated patient privacy, 0.6% contained profanities, 0.3% included sexually explicit material, and 0.1% included discriminatory statements. The public profiles posted by physicians in this study included their names in 78% of cases, a photograph of themselves in 78%, and a link to a Website in 92% of cases.

A national, randomly stratified survey conducted earlier in 2011 found that 93.5% of medical students, 79.4% of residents, and 41.6% of practicing physicians used online social networks. Practicing physicians were most likely among the 3 groups to have visited the profile of a patient or their family member (15.5%). However, a sizeable majority of respondents, 68.3%, indicated that interacting socially with patients was unethical. The survey also found that patient-doctor interactions within social networks were typically initiated by patients.

A 2009 survey conducted in France found that 73% of residents and fellows had Facebook profiles, with over 90% displaying real names, birth dates, and personal photographs. Among the respondents, 85% reported that they would automatically decline a request by a patient to “friend” them and 15% would decide on an individual basis. Moreover, 76% believed that the patient-doctor relationship would be altered by patients having open access to their doctor’s Facebook page.

Landman and colleagues reported that 64% of residents and 22% of faculty in surgical specialties at 1 institution had Facebook accounts, of which half were publicly accessible. A cross-sectional study conducted in New Zealand of 338 recent medical school graduates revealed that 63% had active Facebook accounts. While a majority, 63%, had activated privacy options, among those with publicly available information, 37% revealed the user’s sexual orientation, 16% noted religious views, and 43% indicated their relationship status. Almost equal numbers displayed photographs of themselves using alcohol (46%) as included photographs of themselves demonstrating healthy behaviors (45%).

One university in the United States reported 44.5% of residents and medical students using Facebook, with over three quarters including at least 1 personally identifiable piece of information and only a third availing themselves of privacy settings.A significant proportion showed potentially unprofessional behaviors (photographs of intoxication, overt sexuality, and foul language). A 2009 survey of deans at US medical schools found that 60% had experienced incidents of students posting unprofessional content and 13% had found violations of patient confidentiality occurring as a result of online postings by students within the past year.

Next posts: 

The Downside to Social Media; Professional Associations Respond; and Back to the Cases.

 

Hyper Acidity Symptoms, Tell Me More

Upon the request of majority of our subscribers…………..

 

Signs Of Hyperacidity and Heartburn

In hyperacidity and heartburn, there is the feeling of discomfort or pain in the upper abdomen a few hours after a meal. Usually, the pain is accompanied by frequent release of gas as well as some painful sensation in the chest area. This is due to the presence of excess acids in the stomach even after food has been digested.

A person may also feel a decrease in his appetite.

There is nausea and vomiting. Malaise and flatulence are also common. There is a feeling of restlessness as well as the feeling that one is too heavy in the abdomen. There is a sour belching. Usually, the belching has the aftertaste of the food eaten.

A person may suffer from either indigestion or constipation. There is a stiffness of the stomach, particularly in the upper abdomen. There is a sensation as if the stomach is boiling.

A person may lack desire to eat other kinds of food. When one drinks water, it commonly results to a sensation of wanting to vomit. A person may also feel a desire to vomit a few minutes after eating.

Diet For Dealing with Heartburn And Hyperacidity

• The best way to deal with both heartburn and hyperacidity is to modify the diet. Remove anything that is acidic from the diet because this can only add to the acidity that is already being experienced. Thus, it is not a good idea to take unripe fruits, especially those that are sour such as mangoes.
• There are, of course, many fruits that are quite good for the body and do not cause hyperacidity. Such fruits include apples, watermelon, and bananas.
• Avoid garlic, onion, pepper, cabbage and radish.
• Foods that are excessively spicy should also be avoided.
• Also, foods with lots of vinegar, mustard, and tomato sauce should likewise be avoided.

How To Treat Heartburn at home

• Drink warm ginger juice added with honey to taste.
• Do not go to bed on a very full stomach. Lying down can cause the acid to move back up the tract instead of going down. This will lead to acid reflux.
• Do not drink alcoholic beverages because these cause hyperacidity, too. Likewise, smoking should also be avoided.
• Also, do not consume carbonated beverages.

The topic and suggestions above should not take the place of a proper consultation with a medical doctor (physician) for an accurate diagnosis, management and care.