Pros and Cons of Social Media For Healthcare Providers
Allison Grady, MSN, PNP-BC
Editor Elizabeth Moran, MSN, RN, CPNP-PC
Social media is an ever-present fixture in our modern culture. We see advertisements on television asking viewers to “connect with us on social media,” are encouraged to “follow” our favorite celebrities via Instagram, and even our president communicates with the American people in increments of 280 characters on Twitter. But what, exactly, is social media and furthermore, how does it fit into the context of healthcare?
The American College of Physicians and the Federation of State Medical Boards defines social media as “digital technologies that facilitate the conception and sharing of information, ideas, career interests, and other forms of expression via virtual communities and networks,” (Borgman H, Cooperberg M, Murphy D, et al. Online professionalism—2018 Update of European Association of Urology recommendations on the appropriate use of social media. European Urology. 2018;74:645). This definition is much broader than the most recognizable forms of social media, such as Facebook, Snapchat, and TikTok. When we consider the breadth and depth that social media has on our lives, we realize both the benefits and possible pitfalls that this platform presents for Nurse Practitioners, Physician Assistants, and other health professionals. In the broader context of social media as digital technology for communication, social media can both be seen as an opportunity to connect or could be a detriment to our reputation if used inappropriately. Though we all have the right to our own personal lives, recognizing that what we put out onto the internet is a representation of ourselves is a necessary component to being a professional. Without this recognition, the work that has been done by fellow APPs to advocate for more independent practice, more acknowledgment for contributions to science, and ongoing commitment to safe and high-quality care may be lost because of behaviors that do not align with the tenants of professionalism by a few. Thus, we are forced to ask ourselves when using social media: What lens are we giving our patients? What do we have to gain? How much do we stand to lose?
Understanding the Benefits
Social media can have major benefits for health care providers. Social media can be a way to:
- Connect participants at meetings and to drive interest in special events. In 2019, at the National Association of Pediatric Nurse Practitioner’s (NAPNAP) Advocacy Day, various members of NAPNAP visited with federal legislatures to lobby on issues important to the organization and the health of children. Through the hashtag #NAPNAPHillDay, participants could upload photos from their experience on Facebook and Twitter. The hashtag was created as a means of connecting participants, as well as allowing those who could not participate in person to follow along. Through the power of social media, they could see which of their legislators were meeting with members, they could re-tweet or share the photos so others could see the work that the organization was engaged in, or even share stories of their own local level advocacy efforts using the same hashtag. It was a great example of harnessing the power of social media to connect with those of similar interests and educate others on the work of a professional organization.
- Share professional information. Social media can be used to host journal clubs, a “virtual debate” between experts in a field, and/or to exchange information related to one’s own practice and geographic location. The platform can help to identify trends in infectious disease, public health patterns, and changes to clinical practice or surgical technique more efficiently than waiting for published research or case studies to reach well-trafficked journal sites.
- Advance one’s career. Through the social media connections made on professional websites, Open Forums, LinkedIn, or other similar platforms, it is easy to ask questions, network with those within your profession, and seek and provide mentorship.
For each positive that is mentioned about social media, there are also potential downsides.
- For health care professionals, one of the most egregious pitfalls of social media is the breach of confidentiality and privacy. Whether it is a moment of frustration, anger, pride, or simply sharing the “reality” of our day, we must remember that as health professionals we have an obligation to keep the details of our patient’s illness and circumstances private. Thus, when we post—no matter how well protected we believe our privacy settings to be and no matter how quickly we delete or change a detail after our initial post—we need to remember: “Posted content must be assumed to be permanent, public, and even if deleted may still exist in an archive, database, or download formats. Information may prove to be damaging to an individual’s reputation among colleagues and patients and may affect future relationships and employment,” (Pillow MT, Hopson L, Bond M, et al. Social media guidelines and best practices: Recommendations from the Council of Residency Directors Social Media Task Force. West J Emerg Med.2014;15(1): 28).
- Blurring of boundaries. It brings many of us joy to see those we have worked closely with have a life “outside of the hospital.” The use of social media might be a way to hold on to a relationship with a family when the patient has died or when the professional relationship is otherwise severed because of an emotional connection. It is a very human response to want to stay connected with those who have touched our lives. Our interest and curiosity for those we have cared for is, for many, part of the reason that we entered into the profession. We want to see someone living a “normal” life after beating cancer. We want to know how a family who has lost a loved one is coping. While indeed these are perhaps natural, human responses, they do not always make for professional success. By “friending” patients, following their Instagrams, or otherwise engaging in social media with our patients—no matter how passively—we are blurring boundaries and, arguably, losing some of our objectivity. In 2011, approximately one-third of physicians who use social networking reported receiving a friend request from a patient or a patient’s family member,” (Chreiten KC, Kind T. Social media and clinical care: ethical, professional, and social implications. Circulation. 2013;127:1414). Social media is only increasingly possible—imagine how that number has grown in nearly 10 years.
Boundaries are what allow us to have some distance from our work, to compartmentalize this sector of our life, to reduce our burnout, and to keep a part of ourselves protected. In so many other aspects of our lives, we share intimate details about ourselves, but there is no reason to do that with our patients. While it may humanize us to our patients, there is an ethical and professional argument to be made that our job is not to be the friend of our patient, but rather to be the one who facilitates the healing and health of our patients. It is our job—not the job of our patient—to set these limits and expectations.
What Others are Saying
Social media policies are common for many organizations. Familiarize yourself with the expectations of your place of employment and the recommendation of your specialty/professional organization. Although multiple sources are available, the European Association of Urology Recommendations on the Appropriate Use of Social Media has some excellent examples and clear writing on this topic (Borgmann H, Cooperberg M, Murphy D, et al. Online professionalism—2018 update of European Association of Urology (@Uroweb) Recommendations on the appropriate use of social media. Europena Urology. 2018;74:644-650).
How to Access More Information on Professionalism and Social Media in Healthcare
ANA (American Nurses Association)
“Social media is now a daily part of all our lives. It can not only be entertaining and informative, but it also has the potential to help your career as a nurse and the nursing profession in general.”
NCSBN (National Council of State Boards of Nursing)
THE NURSE’S CHALLENGE
- Be aware.
- Be cognizant of feelings and behavior.
- Be observant of the behavior of other professionals.
- Always act in the best interest of the patient.
AAPA (American Association of PAs)
“The American Medical Association (AMA) has guidelines explicitly for healthcare providers regarding maintaining a presence on social media. We recommend following the Professional Guidelines for Social Media Use found within AMA’s Journal of Ethics.”
AMA (American Medical Association)
American Journal of Ethics: Professional Guidelines for Social Media Use: A Starting Point, Terry Kind, MD, MPH
5 guidelines for medical professionalism
INRC (International Nurse Regulator Collaborative)
6 ‘P’s of Social Media Use
Professional — Act professionally at all times.
Positive — Keep posts positive.
Patient/Person-free — Keep posts patient or person free.
Protect yourself — Protect your professionalism, your reputation and yourself.
Privacy — Keep your personal and professional life separate; respect the privacy of others.
Pause before you post — Consider implications; avoid posting in haste or anger.
AHSM (Association for Healthcare Social Media)
“As an organization, we play a key role in developing best practices for social media use in health and to advocate for the recognition of social media as an important public health tool in the fight to combat misinformation.”
- Social media has many opportunities for health professionals. It can expand our circles by connecting us with those in our professional community and our geographic community.
- If you are engaging in social media, either with professional peers or patients, and you find yourself wondering if something is appropriate, it probably is not. Pause before you post!
- Ask yourself why you want to friend a patient/family? Are you “eavesdropping on their life” or do you genuinely want to be their friend? Should that matter? How do you separate your work life from your home life? Everyone needs a break.
- Just because your colleagues DO something, doesn’t mean you SHOULD.
Allison Grady, MSN, PNP-BC, is a pediatric nurse practitioner in the oncology division at Children’s Hospital of Wisconsin/Medical College of Wisconsin in Milwaukee and a clinical instructor at the University of Wisconsin-Milwaukee School of Nursing. She is a 2011 graduate of Yale School of Nursing and has professional interest in pediatric end-of-life care, bioethics, and professionalism. Prior to clinical practice she was an editor for the American Medical Association’s Journal of Ethics (nee Virtual Mentor).