A Q&A with Dr. Kevin Pho on doctors, patients and Social Media

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Q: What is the best way for doctors to gather information about which social media platforms their patients use regularly and consider influential? Should doctors inquire about social media use as part of intake questions with new patients? Should such questions be included as part of any follow-up visits?


A: The best source for data on social media use is the Pew Internet & American Life Project. It regularly performs surveys that provide current demographic data on social media use. For instance, this past August it looked at Twitter, finding that 18% of Internet users are on Twitter, and that Internet users ages 18–29 are most likely to use Twitter. In 2012, it found that 67% of online Americans use Facebook.


Some doctors should always inquire about social media use in their patients. Pediatricians, for instance. Guidelines from the American Academy of Pediatrics now recommend that questions regarding social media use should be routinely asked to child and adolescent patients. Phenomena such as cyberbullying, “Facebook depression,” sexting and exposure to inappropriate content are all issues about which pediatricians are uniquely positioned to educate patients and their families.


To my knowledge, there are no guidelines for internal medicine physicians like me to include social media as part of intake questions. I do so if time allows, or if patients ask me directly. Rather than focus on social media specifically, a broader approach to how to search for reliable health information and interpret what patients read online is more helpful, and should be regularly included as more patients consult Google first before visiting their doctors.


Q:. Given that HIPAA prevents doctors from revealing identifiable personal details of their patients’ cases, what types of information can doctors communicate through social media that advance knowledge, provide guidance and broaden perspective—without any breaches in confidentiality?


A: Social media are ideal to connect with patients collectively, but not individually. So, when educating patients on a social network, speak to them as a group. With health news stories breaking on a daily basis, there is ample opportunity for providers to get online and share their perspective.


Consider cancer screening. Over the years, there have been continual changes in breast cancer and prostate cancer screening guidelines. And this confuses patients. I often have men in the exam room asking, “Should I be checking my PSA, or not?”


I don’t blame them. The mixed messages that are often reported make cancer screening anything but black and white.


I use as a forum for cancer screening experts and other primary care doctors to share their expertise. They often talk about issues that aren’t often reported, such as the implications of a false positive cancer screening test. This is information that patients need in order to make an informed cancer screening decision.


Speaking to patients as a collective on social media should steer providers away from any privacy risks.


If an unknown patient reaches out and asks a personal health question to a doctor on social media, the physician should not answer. Instead, take that conversation offline with a standard response that asks the patient to call the office and make an appointment, or if an emergency, to call 911 or go to the emergency department.

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