Three letters in this week's Lancet discuss social networking and health, including on how both doctors and patients are adjusting to this new method of communication.
In the first letter, Helen Atherton and Professor Azeem Majeed (Imperial College London, UK) say: "As well as seeking to produce new evidence [on social networking], we should be using current evidence on how social networking might be used to improve communication with patients."
They discuss some of the complexities that social networking is now opening up. For example, would doctors ask patients for more information on themselves if they could find that by simply looking at that patient's Facebook profile? Would doctors feel threatened by patients interacting online and discussing their treatments with each other? And would doctors feel comfortable socialising with patients online outside of care issues? The authors conclude: "Concerns about the effect of new technology on the doctor-patient relationship were probably being expressed when telephones were first introduced more than 100 years ago. Rather than viewing new technology as a threat, we should use the opportunities it offers to improve the efficiency and effectiveness of health systems and to improve people's knowledge of their health and illnesses."
In the second letter, a group representing the Australian Medical Association, the New Zealand Medical Association, and the Australian and New Zealand Medical Students' Association discuss new guidelines (see link below)* they have drawn up to assist with social networking dilemmas. They say: "Rather than prescriptive advice, we present scenarios and discuss the potential ethical and practical implications to educate readers. Unlike our American counterparts, we have not explicitly advocated the formal reporting of unprofessional online behaviour; instead we encourage medical practitioners to notify colleagues discreetly themselves."
Calling for more research into how social networking can impact health care, they conclude: "Although change is inevitable, maintenance of professional and ethical standards is essential to protect health professionals and patients. We will update our guidelines as more evidence emerges, and look forward to what transpires from other groups working in this area."
The third letter (by Dr Yu-Chuan Li, Taipei Medical University, Taiwan, and colleagues) illustrates the power that social networking websites such as Facebook can have in breaking down barriers in complex problems. In Taiwan, emergency room staff have become increasingly frustrated with the lack of government action on tackling emergency room overcrowding. They set up a Facebook group, and one person then posted the link to the comments on the Taiwanese Minister of Health's Facebook page. The minister subsequently joined the group and engaged in discussion with all parties through Facebook and beyond. The minister assured the group he or his staff read every comment.
Within a month, some 1800 members had joined. After monitoring the discussions, the Minister and his team made a surprise visit to 10 emergency departments in 10 different cities, and in a press release the next day assured, among other things, that there would be more resources dedicated to tackle emergency room crowding and quality of care. The authors conclude: "This case has implications for the future of health care, since it shows how social networking can break down the rigid social and professional hierarchical structures that can hinder reform."
Helen Atherton, Imperial College London, UK. T) +44 (0) 207 594 0778 E) firstname.lastname@example.org
Dr Sarah J Mansfield, Australian Medical Association, Kingston, Australian Capital Territory, Australia. T) +61 421975414 E) email@example.com
Dr Yu-Chuan Li, Taipei Medical University, Taiwan. E) firstname.lastname@example.org
For link to guidelines mentioned above, see: www.ama.com.au/socialmedia