Anonymity often leads to physician bullying online
Friday, September 27, 2013
The Internet has given physicians the ability to expand their professional networks beyond the four walls of a hospital or physician practice to a limitless pool of colleagues from across the globe. Discussions that used to take place around water coolers and in doctor’s lounges have moved to online message boards, blogs and social media sites.
But the Internet has also given some physicians an outlet to unleash vitriolic commentary many would never consider unleashing on a colleague in person.
Two physicians and a nurse practitioner witnessed this type of interaction first hand when a blog post about nurse practitioners and scope of practice – a topic which most physicians have strong opinions about – led to an online battle of words and opinions that turned hateful and threatening. They used this incident as a launching pad for an Aug. 29 Health Affairs blog post in which they offered up guidelines physicians should follow when engaging in online commentary.
The guidelines offered up by Matthew Freeman, a nurse practitioner, and Drs. John Schumann and Anna Reisman, an internist and family physicians, respectively, offered these suggestions for keeping online discussions civil:
“The simplest guideline is to encourage people to identify themselves rather than hide behind the mask of anonymity,” Williams wrote in a Sept. 4 blog in response to the Health Affairs piece.
Many newspapers took a step beyond just encouraging people to use their real names by moving to a Facebook-based login system. Each comment is linked to a Facebook profile, therefore no one can remain anonymous. But Williams doesn’t think that is the best solution.
“I allow anonymous comments on the Health Business Blog because I understand that not everyone wants to add to Facebook's data mining trove by logging in to make a comment, and because sometimes there are reasons to remain anonymous,” Williams said. Employed physicians, for example, may not be able to express their opinions openly as an employee of a hospital or health system.
“However, I am quicker to delete anonymous comments that aren't constructive, and when I reply to anonymous comments I often point out that anonymity undermines the commenter's credibility,” Williams said.
Schumann said the recommendations were meant for a world in which anonymous comments are allowed.
But, “It does makes sense to have commenters take ownership of their comments by being permitted to post only with identification. No doubt that would go a long way toward minimizing vitriol,” he said.
Several medical societies, including the American College of Physicians and the Federation of State Medical Boards, have developed policy on online behavior among physicians. Those policies tend to focus more on physician-patient interactions and not physician-physician interactions. Policy developed by the ACP and the FSMB calls on physicians to act professionally and warns agains anonymity. Policy developed by the American Medical Association calls on physicians to monitor each other for professionalism.
The policy states, “When physicians see content posted by colleagues that appears unprofessional they have a responsibility to bring that content to the attention of the individual, so that he or she can remove it and/or take other appropriate actions. If the behavior significantly violates professional norms and the individual does not take appropriate action to resolve the situation, the physician should report the matter to appropriate authorities.”
“Doctors and the Bully(ing) Pulpit,” Health Affairs, Aug. 29. http://healthaffairs.org/blog/2013/08/29/doctors-and-the-bullying-pulpit/
“A Simple Rule for Online Comments: Use Your Real Name,” Health Business Blog, Sept. 4.
“Professionalism in the Use of Social Media,” American Medical Association.
“Online Medical Professionalism: Patient and Public Relationships: Policy Statement From the American College of Physicians and the Federation of State Medical Boards,” Annals of Internal Medicine. http://annals.org/article.aspx?articleid=1675927
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