Deborah Brauser

March 09, 2017

ORLANDO — Many neurologists who use social media (SM) do so cautiously in both office and personal settings, even when there is no official policy from their centers, a small survey study suggests.

Among the 44 neurologists who responded, 75% of the female SM users reported posting on Facebook, Twitter, and/or Instagram only for personal use; 93% of them said they'd like to see restrictions regarding work use.

In contrast, 56% of the male users posted to these platforms for personal and professional use — and 36% reported that they'd like to have unlimited access to SM in the workplace.

Interestingly, 74% of the respondents did not know of any official institutional policy regarding SM use or said that there was currently nothing in place.

"We found very conservative but telling results," lead author, Ashley Jones, research assistant in the Division of Neurology at St Michael's Hospital, University of Toronto, Ontario, Canada, told Medscape Medical News.

Ashley Jones

"Social media was widely used and posting inappropriate content was quite rare," said Jones. "It's good that they're taking a cautious approach in navigating these unknown waters. However, there needs to be more work in educating employees. And legally speaking, I think everybody should have some sort of policy."

She presented the findings here at Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) 2017.

Scrutinized Conduct

Although the ever-increasing growth of social networking "has enhanced communication amongst individuals, it has also provided a forum in which the conduct of its users can be scrutinized by all, including professional peers," write the investigators.

They note that only a few studies have examined neurologists' practices and attitudes toward SM.

"So we thought it would be interesting to look at the trends and patterns of individuals within a profession that has such a high degree of professionalism that is expected," said Jones.

The 32-question survey was emailed to subscribers of a weekly neurology and psychiatry research news site. More than 4000 neurologists subscribe to the service, but only 44 surveys were collected.

Of the 53.8% who reported using SM, 57.1% were women. Although they had a greater presence on SM then men, "their conduct and views on professional SM practices are more conservative than males," note the researchers.

Findings in the full group include the following:

  • 92% did not approve of posting patient information;

  • 87% didn't approve of "friending" patients;

  • 87% didn't like the idea of posting about workplace concerns; and

  • 75% said they never posted inappropriate content, while 25% admitted to doing so "once or twice."

In addition, 18.4% of the respondents said their institution did not have a policy concerning SM, while 55.3% were unsure about any rules that were in place.

Pause Before Sending

"In this rapidly evolving digital era, it is important for medical institutions to implement professional SM policies," including educating employees on proper online etiquette, note the investigators.

Jones stressed that one good rule is to "pause before sending" to any of the SM platforms.

"Facebook, Twitter, Instagram, and others touch people all across the world. And 99% of the time, you can't retrieve anything that you've contributed. It's definitely a good policy to think about your audience," she said.

She added that it can be a fine line that clinicians need to walk. They may want to blog about new research or jump into a fast-paced twitter conversation yet they need to make sure what they type is appropriate, especially when the topic turns to politics.

"You need to think about everything that you're posting, and be sure of your institution's implemented policies as well as suggested policies from physicians' boards."

Jones reported a story from one doctor who was upset that a friend had posted a picture of him that was in a not-so-flattering situation. "You have to be careful of what you do because you never know who is watching and what they're going to do."

Clarify Opinions

ACTRIMS President-Elect Jeffrey A. Cohen, MD, Cleveland Clinic Neurological Institute-Mellen Center, Ohio, told Medscape Medical News that the study results weren't surprising, including that having a relationship with patients on SM or commenting on colleagues was inappropriate.

That said, he noted that today's environment can be especially confusing because institutions often want physicians to have a social media presence — including those who would prefer to ignore the whole idea of posting online.

"Many centers, including ours, are trying to develop better ways of communicating with our patients, especially because that's how younger patients communicate," said Dr Cohen.

"And, like many institutions, ours has a lot of rules and regulations and vetting that's required. But if it takes 7 weeks for a tweet to be approved, it kind of defeats the whole purpose of social media."

Still, he noted that the Cleveland Clinic recently had a controversy when one of its physicians made some comments that went against the institution's formal position.

"Those are some of the issues that can arise," said Dr Cohen. "Neurologists need to be careful about clarifying what opinions are their own personal ones and which they're espousing on behalf of their institution. And they need to make sure they don't blur that distinction."

He added that using social media at meetings such as ACTRIMS 2017 can be very helpful, but again he urged caution.

"People want to know what the experts think: What were their impressions of the meeting and what did they see that was interesting? But just be careful with posting immediate thoughts. Maybe think about it a little more first."

The study was funded by St Michael's Hospital foundation Waugh Chair and the MS Society of Canada. Ms. Jones and Dr Cohen have disclosed no relevant financial relationships.

Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) 2017. Abstract P132. Presented February 24, 2017.

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