The American College of Physicians and the Federation of State Medical Boards has issued its first formal views about how physicians should meld online technology with medical professionalism. But one of the rheumatologists behind the popular online portal, The Rheumatology Podcast, worries the statement is rooted in an old-school mentality at odds with burgeoning technology.
Michael Laccheo, MD, who is joining Arthritis and Rheumatic Diseases of Williamsburg, Va., in June, says the position statement published in the Annals of Internal Medicine may “have a chilling effect” on technological use.
Rules of the Digital Superhighway
The five positions set out in “Online Medical Professionalism: Patient and Public Relationships: Policy Statement from the American College of Physicians and the Federation of State Medical Boards” are:
- Position 1: Use of online media can bring significant educational benefits to patients and physicians, but may also pose ethical challenges. Maintaining trust in the profession and in patient–physician relationships requires that physicians consistently apply ethical principles for preserving the relationship, confidentiality, privacy, and respect for persons to online settings and communications.
- Position 2: The boundaries between professional and social spheres can blur online. Physicians should keep the two spheres separate and comport themselves professionally in both.
- Position 3: E-mail or other electronic communications should only be used by physicians in an established patient–physician relationship and with patient consent. Documentation about patient care communications should be included in the patient’s medical record.
- Position 4: Physicians should consider periodically “self-auditing” to assess the accuracy of information available about them on physician-ranking websites and other sources online.
- Position 5: The reach of the Internet and online communications is far and often permanent. Physicians, trainees, and medical students should be aware that online postings may have future implications for their professional lives.
“I think the article reeks of the old-school attitude that physicians must somehow stand completely apart from others due to ‘professionalism,’ which gives rise to the opinion that we are arrogant and distant,” Dr. Laccheo writes in an e-mail to The Rheumatologist. “They had a great opportunity to slowly move physician culture towards a more modern and approachable image, and failed, going in the opposite direction.”
The paper took five positions (see sidebar) that urged doctors to be mindful of ethical and patient-privacy issues, while using technological communications only with patients who have consented. It also suggests younger physicians take note of the eternal staying power of items published on the Internet.