Feldman, Mitchell D.

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eScholarshipTitleFrom the Editors’ Desk: What You Don’t Know Could Hurt YouPermalinkhttps://escholarship.org/uc/item/6qv4231fJournalJournal of General Internal Medicine, 25(11)ISSN1525-1497AuthorFeldman, Mitchell D.Publication Date2010-11-01DOI10.1007/s11606-010-1505-8 Peer reviewedeScholarship.org Powered by the California Digital LibraryUniversity of CaliforniaFrom the Editors’ Desk: What You Don’t Know Could Hurt YouMitchell D. Feldman, MD, MPhilDivision of General Internal Medicine, University of California, San Francisco, San Francisco, CA, USA.J Gen Intern Med 25(11):1139DOI: 10.1007/s11606-010-1505-8© The Author(s) 2010. This article is published with open access atSpringerlink.comA n e-mail that would have usually been categorized as“junk” somehow managed to elude the university spamfilter and made its way into my in-box; the subject line read:“What Doctors Need to Know About Facebook.” The e-mail wasinviting me to participate in a webinar that promised theparticipants that, among other wonders, they would learn touse Facebook as a “valuable tool for sharing information withcolleagues.” Really? As a late and somewhat reluctant adopterof Facebook, I have been unconvinced of its value for mepersonally or professionally, and have mainly ignored themany “friend” requests that somehow began showing up inmy e-mail after I finally signed up a few months ago; somecame from patients and their families, some from people whosenames I barely recognized (none, alas, from long lost flames).I was surprised, however, when a former colleague found methrough my new Facebook presence and said she was thrilledto see the wonderful pictures of my kids. I was surprisedbecause I had not posted any pictures of my now grownchildren; surprise gave way to dismay when I realized that thephotos she had accessed were actually on my 19- and 23-year-old children’s Facebook pages, many of which were not suitablefor sharing at a family reunion, and certainly not what I wouldchoose to share with colleagues or patients.The potential, and potential perils, of Facebook and otherInternet and social media are the subject of several papers inthis month’s JGIM. In one of the first empirical studies toexamine the question of the availability and nature ofphysician information accessible on the Internet, Mostaghimiet al. searched the Internet to see what kind of professional andpersonal information was freely available to the average patientabout a randomly selected sample of 250 internal medicinephysicians in Massachusetts. They found, not surprisingly,that almost all the physicians (94%) had either personal orprofessional information that could be easily accessed with asimple Google search. Perhaps more surprising was that whilemost of the information available was of a professional nature(such as quality rating sites, publications and in three cases,disciplinary actions), almost 1/3 of the physicians hadpersonal information available on-line on more than 200 websites, including Facebook pages, political and charitabledonations, and family and personal financial information. Itis likely that most of these physicians were unaware of the extentof their personal information available on-line and would not havechosen to sharemuch of it if given the choice. AsMostaghimi et al.state: “Most physicians limit their self-expression during patientencounters: few physicians would wear a political pin, discusstheir ongoing litigations with their neighbor, or detail charitablecontributions during a patient encounter. Our study demon-strates, however, that this type of information could easily befound with a single limited Internet search.”Physicians may not only put themselves at risk when theyfail to monitor their on-line presence, but they also riskcompromising the integrity of the profession. The impact ofthe rise of social media such as Facebook on medicalprofessionalism is the subject of an incisive Perspective in thisissue by Greysen et al. They argue that the time has come forthe establishment of consensus-based standards for “onlineprofessionalism.” Too often, they argue, and as Mostaghami etal. found, physicians do not consider the potential impact oftheir on-line content and may inadvertently violate profession-al standards in cyberspace that they would never violate inreal-time social interactions. Greysen et al. make the point thatwhat we don’t know may not only hurt us, but may also hurtothers such as our patients and colleagues, and the medicalprofession as a whole.Open Access: This article is distributed under the terms of theCreative Commons Attribution Noncommercial License which per-mits any noncommercial use, distribution, and reproduction in anymedium, provided the original author(s) and source are credited.Corresponding Author: Mitchell D. Feldman, MD, MPhil, Divisionof General Internal Medicine, University of California, San Fran-cisco, 400 Parnassus Avenue, San Francisco, CA 94143-0320, USA(e-mail: mfeldman@medicine.ucsf.edu).Published online September 14, 20101139

From the Editors’ Desk: What You Don’t Know Could Hurt You

Mitchell D. Feldman

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Journal of General Internal Medicine

From the Editors’ Desk: What You Don’t Know Could Hurt You
Mitchell D. Feldman, MD, MPhil
Division of General Internal Medicine, University of California, San Francisco, San Francisco, CA, USA.
J Gen Intern Med 25(11):1139
DOI: 10.1007/s11606-010-1505-8
© The Author(s) 2010. This article is published with open access at
Springerlink.com
A n e-mail that would have usually been categorized as“junk” somehow managed to elude the university spam
filter and made its way into my in-box; the subject line read:
“What Doctors Need to Know About Facebook.” The e-mail was
inviting me to participate in a webinar that promised the
participants that, among other wonders, they would learn to
use Facebook as a “valuable tool for sharing information with
colleagues.” Really? As a late and somewhat reluctant adopter
of Facebook, I have been unconvinced of its value for me
personally or professionally, and have mainly ignored the
many “friend” requests that somehow began showing up in
my e-mail after I finally signed up a few months ago; some
came from patients and their families, some from people whose
names I barely recognized (none, alas, from long lost flames).
I was surprised, however, when a former colleague found me
through my new Facebook presence and said she was thrilled
to see the wonderful pictures of my kids. I was surprised
because I had not posted any pictures of my now grown
children; surprise gave way to dismay when I realized that the
photos she had accessed were actually on my 19- and 23-year-
old children’s Facebook pages, many of which were not suitable
for sharing at a family reunion, and certainly not what I would
choose to share with colleagues or patients.
The potential, and potential perils, of Facebook and other
Internet and social media are the subject of several papers in
this month’s JGIM. In one of the first empirical studies to
examine the question of the availability and nature of
physician information accessible on the Internet, Mostaghimi
et al. searched the Internet to see what kind of professional and
personal information was freely available to the average patient
about a randomly selected sample of 250 internal medicine
physicians in Massachusetts. They found, not surprisingly,
that almost all the physicians (94%) had either personal or
professional information that could be easily accessed with a
simple Google search. Perhaps more surprising was that while
most of the information available was of a professional nature
(such as quality rating sites, publications and in three cases,
disciplinary actions), almost 1/3 of the physicians had
personal information available on-line on more than 200 web
sites, including Facebook pages, political and charitable
donations, and family and personal financial information. It
is likely that most of these physicians were unaware of the extent
of their personal information available on-line and would not have
chosen to sharemuch of it if given the choice. AsMostaghimi et al.
state: “Most physicians limit their self-expression during patient
encounters: few physicians would wear a political pin, discuss
their ongoing litigations with their neighbor, or detail charitable
contributions during a patient encounter. Our study demon-
strates, however, that this type of information could easily be
found with a single limited Internet search.”
Physicians may not only put themselves at risk when they
fail to monitor their on-line presence, but they also risk
compromising the integrity of the profession. The impact of
the rise of social media such as Facebook on medical
professionalism is the subject of an incisive Perspective in this
issue by Greysen et al. They argue that the time has come for
the establishment of consensus-based standards for “online
professionalism.” Too often, they argue, and as Mostaghami et
al. found, physicians do not consider the potential impact of
their on-line content and may inadvertently violate profession-
al standards in cyberspace that they would never violate in
real-time social interactions. Greysen et al. make the point that
what we don’t know may not only hurt us, but may also hurt
others such as our patients and colleagues, and the medical
profession as a whole.
Open Access: This article is distributed under the terms of the
Creative Commons Attribution Noncommercial License which per-
mits any noncommercial use, distribution, and reproduction in any
medium, provided the original author(s) and source are credited.
Corresponding Author: Mitchell D. Feldman, MD, MPhil, Division
of General Internal Medicine, University of California, San Fran-
cisco, 400 Parnassus Avenue, San Francisco, CA 94143-0320, USA
(e-mail: mfeldman@medicine.ucsf.edu).Published online September 14, 2010
1139


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From the Editors’ Desk: What You Don’t Know Could Hurt You

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