"I think the big picture about where we're going with social media is getting through to medical students and deans of med schools, and medical boards. We're trying to sketch out the harms of this technology," Greysen said.
Medical blogger Dr. Wendy Sue Swanson, a pediatrician at the Everett Clinic at Seattle Children's Hospital, who says she has 8,000-plus Twitter followers, said the survey builds on what physicians and patients already know.
"The online environment is similar to the offline one; physicians can have a breach of professional conduct in either space. The online environment is a reflection of the real world. Over half of the boards have had serious disciplinary outcomes based on unprofessional behavior online," said Swanson, who had no involvement in the survey.
She'd like to see the research dig deeper, though. "My concerns are that this survey doesn't include the number of serious disciplinary outcomes offline as well. Having that data as a comparison would help us understand if the online environment mirrors the offline one or exaggerates it," she said.
Swanson pointed out that the actual number of violations reported to the boards is very small, given that the boards represent about 850,000 physicians.
"My hunch is the number of unprofessional behaviors is much higher. But because there is no current standard for monitoring online professionalism and policing it, it's difficult to harness the reality," she added.
Dr. Philip Rosoff, a professor of pediatrics and medicine, and director of the Clinical Ethics Program at Duke University Medical Center, who was not involved in the research, said a lot of physicians and medical students who use social media and other forms of electronic communication may not even realize their
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