Despite being a career technophile, I’ve been a bit of a holdout when it comes to joining the social networking revolution. I recently realized, however, that being in denial of the trend makes it no less real. My moment of truth came after a recent out-of-town wedding. Upon my return to the office Monday, a young manager I hardly know says to me, “You guys looked good in your tuxedos this weekend.” She noticed my confusion, and promptly popped up a few photos of me on her phone from the wedding, through her online social networking page. An acquaintance was at the wedding, and had shared her photos online. My concept of privacy was shattered.

Social networking seems to have ever-evolving functions and roles, which come to light daily. It’s growing at an amazing pace, and there is no putting that genie back in the bottle.

When it comes to your practice, however, it pays not only to be familiar with this new technology, but also to anticipate how it might help — or worse, harm — your group.

Dangerous possibilities

Consider this scenario: Two of your tech-savvy staffers working your patient reception area commonly use Web-enabled mobile phones to engage in posting cute snippets about office hijinks on each other’s social networking sites throughout the workday. These same personal social networking Web sites are shared among other staff, and persons outside the practice, by virtue of being connected to the employees through the site. So the contents are viewable by hundreds of individuals in the community.

One day, one officemate posts to her page a comment along the lines of “My ex-boyfriend Mike is sitting in our waiting room RIGHT NOW! OMG! ” Her officemate immediately posts a response on the site using his PDA phone: “That’s him 4SURE. But don’t worry; he’s getting a colonoscopy today, so he’s finally getting what he deserves!” A second later, that same staffer holds his up his camera phone, snaps a picture of the patient in the waiting room, and posts it to the same Web site with a comment about him being “Colonoscopy Mike.”

While this might seem outrageous and unlikely, it isn’t. Every day, people post things online they wouldn’t even say among friends. A false sense of anonymity permeates social networking, and people are only now beginning to realize what’s posted in cyberspace is never private. Internet savvy individuals are relying more and more on information that shows up in the foggy layer of social networking sites to do discrete research on officemates, potential employees, potential employers, and even potential spouses.

Let’s consider another scenario. An old med school friend contacts you, and in a casual conversation, you say you are thinking about leaving your partners and starting your own practice. You have concerns about a noncompete agreement in your contract, but are confident your partners will waive it. If they don’t, you’ll fight it in court while you open your practice. A few days later, you are confronted by one of your business partners, who is visibly furious. You quickly realize that your private conversation a few days earlier has been posted on your old med school friend’s social networking page as a simple note: “My old friend Dr. Smith told me he’s backing out of his contract and starting his own practice, because his partners are driving him CRAZY! Everyone wish him luck, and hope they don’t sue him into poverty!”

Unfortunately, that friend not only is connected online to you — but also to your partner physicians, who were, up to this point, unaware of your plans. Of course, now the Internet cat is most certainly out of the Internet bag.

In both scenarios, how at risk are you or your practice? Did you have a policy against posting information about office activities on social networking sites? Is it possible to unwind the damage in either case?

Set social networking rules

While the answers are not clear, and the playing field seems to change daily as social networking evolves, making some common sense rules can go a long way. Here are some approaches you may wish to consider following in your practice to avoid problems:

• Consider sharing and discussing some of these worst case examples with your entire office. Often simple education about the implications of social networking is enough to get staff thinking about their actions. Talk to your staff about the risks for them and your practice.



• Consider creating two online social networking personas — one professional, one personal. Affiliate the two personas respectively with your work and personal e-mail addresses, and keep one social networking site as a professional and public presence, and keep your personal site for family and close friends. This allows you to share some personal information with patients and work colleagues, but allows you to reserve those embarrassing family vacation photos you post for your close friends.



• Remind staff (including peer physicians) that your current policies regarding privacy and protected health information extend to their activities on their personal social networking sites. Point out that sharing any PHI (including photos of patients or comments about patients in the office) is still in violation of your existing privacy policies, whether it be verbal or online communication.



• Remind staff that postings between fellow staff (again, physicians included) could potentially become part of human resources-related litigation later, even if the postings were done outside of work hours. One thoughtless and inappropriate posting could land you in hot water.



• Develop a policy on use of PDA cell phones for texting and updating social networking pages during work hours. Don’t bother telling staff to turn off their phones (it never works), but instead tell them that texting and posting updates during work hours is not acceptable, regardless of content, based on productivity issues alone.



• Communicate the rules clearly to all new hires, and be consistent. Don’t allow some staff but not others to get away with the occasional posting. You’re just asking for mutiny if you do.



• Consider having your networking/IT staff block commonly used social networking sites on your office network to discourage abuse.

While you can’t anticipate every scenario, at least considering the potential implications of social networking for your practice can give you the chance to mitigate the possible negative impact.

Jonathan McCallister is a client-site IT manager for a major healthcare consulting firm, and he is currently assigned to a 140-physician practice. He has worked in healthcare IT management for more than eight years and in general IT management for more than a decade. He can be reached via physicianspractice@cmpmedica.com.

This article originally appeared in the January 2010 issue of Physicians Practice.