A Rhode Island emergency room doc has been fired for posting about a trauma patient on her facebook page. While the post did not reveal patient name or personal identifiers, it had enough clinical info that a third party was able to recognize the patient.
I say if you’re going to write online about a patient, you had better disguise them so well they don’t even recognize themselves, and never post anywhere near the time of the event’s occurrence. Some bloggers I know change age, sex and other details, and post events long after they’ve happened, so no one one could ever know for sure who they’re talking about. Some doc bloggers go so far as to disguise themselves – preferring to remain anonymous both to protect themselves and their patients.
Some medical blogsites are rich with teaching cases, including x-rays and clinical information that, if disguised, would alter the diagnostic possibilities. As online venues begin to replace the time honored medical journal or local grand rounds, how do we keep our ability to teach one another with clinical cases and still respect patient privacy? In the past, the limited circulation of medical journals kept these cases amongst the medical community, but now with the internet (and the lay public’s interest in medicine), the audience for such case histories is limitless.
It may be time to develop some sort of standard guidelines and release before writing about a patient on a social media site. Email and electronic signatures could streamline that process so that we don’t lose what makes the internet different than the medical journals – immediacy and accessibility. As an example, here is JAMA’s privacy policy and a link to their patient consent.
Identification of Patients in Descriptions, Photographs, Video, and Pedigrees. A signed statement of informed consent to publish (in print and online) patient descriptions, photographs, video, and pedigrees should be obtained from all persons (parents or legal guardians for minors) who can be identified (including by the patients themselves) in such written descriptions, photographs, or pedigrees and should be submitted with the manuscript and indicated in the Acknowledgment section of the manuscript. Such persons should be shown the manuscript before its submission. Omitting data or making data less specific to deidentify patients is acceptable, but changing any such data is not acceptable.
It’s a brave new world out there, folks, so be careful. For the record , I won’t post about a patient without her explicit permission, and even then I disguise her so that no one would recognize her. Which is why this blog is a bit light on patient tales. Food is a much safer topic if you ask me….
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Other posts I’ve written on this topic
[…] of the case report in medicine, something I’d hate to see us lose, and for which there are standard guidelines for protecting patient’s rights. Let’s no throw the baby out with the bathwater […]