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Pathologists may be less likely than other doctors to receive awkward friend requests from patients on Facebook, but many physicians still view social media's expanding landscape as a potential minefield. A recent survey in the Journal of General Internal Medicine found that a majority of responding physicians, residents, and medical students considered it unethical to visit patients' profiles or otherwise interact with them on social media for either social or professional reasons.1

The study results suggest a broad reluctance among physicians concerning whether social media could be useful for communicating with patients. Even so, a small but growing number of pathologists are arguing for a more expansive view of Facebook, Twitter, and other Web-based ways of sharing content. Advocates such as Keith Kaplan, MD, chief information officer of the Carolinas Pathology Group in Charlotte, North Carolina, say creatively harnessing these tools could yield new opportunities for putting a human face on the profession, as well as collaborating with colleagues and receiving expert advice.

Organizations such as the American Medical Association have published broad guidelines on the do's and don'ts of social media, and pioneers like Dr. Kaplan and Eric Glassy, MD, senior pathologist with the Affiliated Pathologists Medical Group in Torrance, California, agree that adhering to patient confidentiality and privacy restrictions is essential. However, Dr. Glassy points to multiple pathology-boosting applications for Twitter's microblogs, for podcasts, for YouTube videos, for crowdsourced “wikis,” and yes, even for Facebook. In his recent editorial he writes, “Social media's promise of communication and collaboration will prove to be an important tool in our quest to transform, elevate, and humanize the specialty.”2

Pathology groups have “Fan Pages” on Facebook, for example, while universities and organizations are posting links to educational information. Conferences and meetings are being captured in the form of podcasts that can be listened to later, while some medical students are hearing every lecture as a podcast uploaded to iTunes. As a field, pathology is beginning to use YouTube for instructional or informational videos. And for individual businesses such as Affiliated Pathologists Medical Group, physicians now have curriculum vitaes (CVs) in the form of embedded YouTube videos. “It makes the profession of medicine a bit more personal than just a bunch of words in a CV,” Dr. Glassy says.

A few years ago, Dr. Kaplan introduced the concept of Pathology 2.0, which he defines as “the use of technology to enhance content, collaboration, discussion, and sharing.” For many of those goals, social media is providing the go-to tools. “These virtual interactions lead to real connections and personal relationships,” he says. “I tell people that I have formed more business relationships through social media than I have at networking events and meetings over the past 10 years.”

One potential application may be particularly apt for pathology: slides that were once stored away in file rooms or offices can now be digitally scanned and shared with experts halfway around the world. General content-sharing sites such as Flickr or Twitter can be repurposed for slides, whereas forums patterned on social media concepts have sprung up within the field, including the nonprofit PathXchange and the commercial venture SecondSlide.

On Twitter, pathologists can post slide images and ask other experts for their diagnoses, which necessarily have to be succinct due to Twitter's limit of 140 characters. “You could have this community of pathologists look at something like we've never been able to do before,” Dr. Kaplan says. Some opinions would be more valuable than others, he acknowledges, but at least they would generate a useful discussion.

Although everyone agrees that images and clinical information must be kept anonymous to protect patient privacy, Dr. Kaplan argues that doing so on social media sites is no different than current practice in online journals or at meetings. Many social media tools, he says, also allow users to choose who sees what.

The Carolinas Pathology Group recently began using Twitter to keep connected with patients, clients, and business associates. Physicians “tweet” about topics such as meetings they will attend, tests they offer, and other professionals joining the group. “The benefit-to-risk ratio, I think, is very high,” Dr. Kaplan says.

Dr. Glassy views social media opportunities as being comparable to e-mail. His own group already sends out text or email messages about normal Papanicolaou (Pap) test results at a patient's request. Newer means of communication such as Twitter, he says, simply add to the toolkit. In the near future, Dr. Glassy imagines pathologists sending alerts to patients through the tool's direct message function.

Social media might also ease the role of pathologists as information curators. Pathology wikis, similar in concept to Wikipedia, could allow online communities of pathologists to connect databases of useful information into valuable compilations. “There's so much information out there, someone needs to properly vet it,” Dr. Glassy says.

Some wikis have already been set up to help residents pass their pathology board examinations or interpret immunohistochemical stains. Dr. Glassy says links to vetted wikis that host relevant information about different diseases could even be added to pathology reports to help guide patients. “Those are areas where the pathologist can really help,” he says.

Using social media is not without risk. In business and especially academic settings, Dr. Kaplan says, most communication is approved in advance. Social media sites are among the rare outlets that lack that kind of committee- or peer-review process, making them both liberating and dangerous.

Dr. Kaplan cautions that physicians should make clear in their bylines or disclaimers that whatever they post represents their opinions alone and not those of their employer. Pathologists who spend their capital ranting about topics unrelated to their professional life, such as fiscal policy, also risk diluting their content and undermining their cachet. In addition, Dr. Kaplan says, maintaining credibility means physicians cannot blog or post their opinions anonymously.

Despite the pitfalls, advocates say pathologists should not underestimate the potential benefits of becoming a skilled and savvy user of social media. “Many of these applications on first blush may seem trivial,” Dr. Glassy says, “but when repurposed they can become much more powerful.”

References

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  2. References
  • 1
    Bosslet GT, Torke AM, Hickman SE, Terry CL, Helft PR. The patient-doctor relationship and online social networks: results of a national survey [published online ahead of print June 25, 2011]. J Gen Intern Med.
  • 2
    Glassy EF. The rise of the social pathologist: the importance of social media to pathology. Arch Pathol Lab Med. 2010;134:14211423.