A tweet said the small-town hospital was deluged with suicidal patients that day, and the person who posted it appeared to show frustration with the endless hassle. The post could be seen as whiny, disrespectful and invasive of patient privacy—or supportive and compassionate, depending on how it was read.

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This tweet illustrates the two edges of the social media sword—an opportunity to promote health care and a minefield that can scar a physician for years to come. How to navigate Facebook, Instagram, Twitter and other social media to help your patients and foster your online image as a positive one was the subject of a student education session at the 2016 AMA Annual Meeting in Chicago.

“Avoid saying anything you would not say out loud at work to your boss,” said Tyeese Gaines, DO, Medical Director at Landmark Medical Center in Woonsocket, RI, and media strategist for Doctor Ty Media, LLC. At stake, she told trainees, is patient privacy, their reputation and their job—current and future.

“There are a lot of things you can’t take back, so think about these things early,” Dr. Gaines said. “Are these the things you want potential employers and colleagues to see?”

Insider commentary, criticism and rants have led to reprimands and dismissal, said Dr. Gaines, who spent 15 years in journalism and today advises physicians on media relations. She listed some pitfalls to avoid:

  • Post no information that would cause an individual patient to be recognized—especially in small communities.
  • Avoid unflattering opinions and photos.
  • Don’t assume a forum is private.
  • Remember that online posts live forever, and potential employers will search them.

All the more reason to limit posts, keep them professional, avoid friending co-workers and classmates, and clean up past posts that could be taken out of context, Dr. Gaines said.

“This is your profession, this is what you chose, and you can’t just post anything anymore,” she told students. They seemed to take her counsel to heart.

“A good rule to live by is, if there’s any doubt in your mind that it could be misconstrued, just don’t post it,” said Nicole Paprocki, a rising second-year student at Midwestern University College of Osteopathic Medicine.

The session inspired some students to look for more information and guidance.

“Our training should be a lot more reflective about things like this,” said Nousha Hefzi, a rising second-year student at Wayne State University School of Medicine. “It’s mostly about how to protect your password, things like that.”

That training could benefit both students and seasoned physicians who did not grow up with social media, she said.

At its very best, social media offers a chance to advocate for patients and provide better care, Hefzi said: “Any sort of media can be turned into an educational message, depending on how you use it.”

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