1 Department of Pathology, Mohammed Bin Rashid University College of Medicine, Dubai, UAE
Social media has increasingly been used as a platform by medical providers. The positive contribution is also balanced by risks and governed by codes of professionalism by the medical community. The values of medical professionalism include universal tenets and also those unique to the Arab world and the United Arab Emirates. We propose that institutional guidelines and self-governance in the medical community are important.
Keywords: Self-governance, Social media, Medical professionalism, Patient confidentiality, Scientific knowledge, Medical community.
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* Address correspondence to this author at the Department of Pathology, Mohammed Bin Rashid University College of Medicine, Dubai, UAE, Tel: 971- 3838767, E-mail: email@example.com
The definition of Social Media, according to Wikipedia is “interactive computer-mediated technologies that facilitate the creation or sharing of information, ideas, career interests and other forms of expression via virtual communities and networks” . The British Medical Association defines it as “any online communication channel, which allows the user to find and interact with a community, . The use of social media is increasingly prevalent in the practice of medicine with inherent benefits but also associated risk.
Several national medical societies have documents outlining specific recommendations on physician usage of social media [2-4]. In December 2019, an inaugural Summit on this topic was convened in Dubai and cosponsored by Mohammed bin Rashid University, Mayo Clinic, and the American Hospital Dubai.
As a member of the Emirates Medical Association, I have sought to summarize some of the issues related to professionalism in the use of social media. We propose further dialogue to lead to a framework based on professional values elucidated in prior publications unique to the United Arab Emirates, and suggest how these may influence medical professional engagement in social media.
2. VALUES IMPORTANT TO PHYSICIAN BEHAVIOUR IN SOCIAL MEDIA
Physicians are historically governed by principles of professionalism. Many of these expected behaviours are encoded in the Hippocratic Oath. The Association of American Medical Colleges’ (AAMC’s) core “entrustable professional activities” (EPAs) for entering residency, describes that physicians should maintain their integrity, compassion, and respect for others; be responsive to patient needs that supersedes self-interest; respect patient privacy and autonomy; be accountable to patients, society, and the profession; exhibit sensitivity to diverse populations; and be committed to ethical principles regarding care, confidentiality, informed consent, and business practices . These principles are to be upheld irrespective of “when” and “where”. As such, they transcend time, space, and any new practice models.
A similar set of ten principles for professional behaviour listed by the American Board of Internal Medicines describes the following: (1) professional competence, (2) honesty with patients, (3) patient confidentiality, (4) maintaining appropriate relations with patients, (5) improving quality of care, (6) improving access to care, (7) a just distribution of finite resources, (8) scientific knowledge, (9) maintaining trust by managing conflicts of interest, and (10) professional responsibilities [6, 7].
Recently, a consensus statement from the United Arab Emirates regarding physician professionalism described three unique Arab and Islamic values for medical professionals that include a primacy of social justice; and integral role for personal faith in guiding one’s professional practices; and the extension of professional attributes into a practitioner’s personal life [8, 9].
Furthermore, faith and relationship with God propel physicians in the pursuit of excellence, lifelong learning, integrity, and accountability, encapsulated in the Arabic ideals of Ehsan, Etqan, Taqwa, and Ehtesab .
3. OPPORTUNITIES AND RECOMMENDATIONS FOR SOCIAL MEDIA ENGAGEMENT IN THE UAE
These values need to inform the Arab physician as one approaches social media. There are broad, if not universally accepted practices of keeping the patient’s interests primary and preserving privacy and confidentiality. The medium provided by social media presents powerful positive opportunities, and perhaps even a moral imperative, to engage constructively in educating the public on health-related issues for the good of society.
Examples of the positive influence of social media include postings and campaigns that raise awareness and provide advocacy for the disease. Some recent examples in the medical realm include Katie Couric former ABC/Disney news host whose own experience with colon cancer raised awareness for screening programs. Her posts (#Myfirsttime) generated over a million views and encouraged people to access screening programs.
Postings that knowingly or inadvertently compromise patient confidentiality need to be avoided at all costs. Even with patient consent, the healthcare provider must realize the permanency of content posted online, and the ease of images being shared and reposted by others. Failure to remove patient identifiers is inappropriate and negligent behaviour. However, even “de-identified” images have metadata that could allow the viewer to determine patient identity. Most societies strongly discourage the posting of specific patient operative images on social media sites. Online patient testimonials are discouraged as these are not anonymous postings, and could have implications for the patients in the future should they seek care in other settings.
Accountability to a higher authority is a unique perspective brought by Arab medical professionals [8, 10]. Thus, harmful and detrimental practices (which may include trolling, harassing, abusing) are not only impacting our society and neighbors, but also represents a failure in the pursuit of integrity. As self-regulating professionals, there is a strong collective cultural value that needs to preserves the honorable practice of medicine in cyberspace. The need for physicians to monitor ourselves individually and collectively cannot be overemphasized. As professionals, we abide by a share code of conduct that needs to extend to our identities and presence in light of new technologies. As professionals, we should seek to practice at the highest standards and should try to exceed the minimum required regulatory and statutory requirements.
Finally, most current western documents on social media in medicine prescribe clear boundaries for the professional and personal identities of physicians. Again this is one area where Arab values can positively inform future deliberations. As professional behaviour also impacts one's life, there are potential benefits as we mitigate the risks of a more holistic Arab approach to the medical use of social media in a globalized world.
We recommend that each organization should develop specific guidelines (a link to Mayo Clinic guidelines is provided ) for its staff using social media that reflect these commitments, and that physicians as professionals need to adhere and collectively govern and monitor our professional behaviour online.
ETHICS APPROVAL AND CONSENT TO PARTICIPATE
HUMAN AND ANIMAL RIGHTS
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
The author declares that there is no conflict of interest regarding the publication of this article.
We appreciate the comments and input by Lee Aase of Mayo Clinic Social Media Office. Thanks to EMA President Dr. Mouza al Sharhan for her encouragement and support in this submission.
Social media 2019.https://en.wikipedia.org/wiki/Social_media
Saberi G, Nemati SH, Fakhreiya S, Heidarzadeh A. Medical professionalism and its education to medical students. J Res Med Educ 2013; 10(2): 100-6.
Gholami-Kordkheili F, Wild V, Strech D. The impact of social media on medical professionalism: A systematic qualitative review of challenges and opportunities. J Med Internet Res 2013; 15(8): e184. [http://dx.doi.org/10.2196/jmir.2708] [PMID: 23985172]
Sawsan A-R, Halah I, Hatem A, et al. Creating a framework for medical professionalism: An initial consensus statement from an arab nation. J Grad Med Edu 2016; 8: 165-72.
Ho M-J, Al-Eraky M. Professionalism in context: Insights from the united arab emirates and beyond. J Grad Med Edu 2016; 8: 268-70.
T.A. Arawi. The muslim physician and the ethics of medicine. J Isl Med Assoc 2010; 111-6.
Social media guidelines for mayo clinic staff https://socialmedia.mayoclinic.org/mayo-clinic-employee-social-media-guidelines/
Abdullah Shehab Emirates Cardiac Society Emirates Medical Association Dubai (UAE)
Dr. Abdullah Shehab has 22 years of experience in Internal medicine, cardiology and interventional cardiology and medical education. Currently, he serves as the General Secretary of Emirates Cardiac Society and Vice President of Gulf Intervention Society. He is a Fellow of royal college of physicians UK, American college of physician, European society of cardiology, of American college of cardiology, American society of cardiac intervention and fellow of American heart association. Professor Shehab is the Chief editor of Emirates Medical Journal and also serves as editor in many other regional and international journals. Dr. Shehab has published 149 paper in Medline. His research interest includes: Heart failure, Coronary artery disease, Dyslipidaemia, Hypertension, Arrhythmias, Cardiac intervention, Cardiac imaging, Screening for cardiac disease in sport players, Cardiovascular disease in pregnancy.