Case 1: The Rude Anesthesiologist
An anesthesiologist at a large academic medical center maintains an active Twitter presence under an anonymous name. She is well-known in the online community as someone who pushes the limits of public dialog by sharing details of patient encounters that are often disrespectful and crude. During one thread, this doctor discussed an impending ER encounter with a patient suffering with priapism. One observing physician screen-captured the conversation and created a post on his blog calling the behavior out of line and unprofessional. Case study and materials
Case 2: Image of the Profession
YouTube is a free streaming video service where people can both upload and watch video clips. End of year talent shows are popular at many medical schools, featuring both live and recorded performances by medical students. One video posted by students from a large national medical school shows students parodying a popular rap song and dancing lewdly with skeletons. Dr. Zubin Damania, a Stanford-trained internist, has been making lighthearted video parodies to popular rap songs with an underlying serious message about public health and prevention. One of his videos is called “One Injection,” a parody of a pop song by band One Direction which contains sexual references and overtones, urging viewers to get the flu shot; outcomes showed later that it resulted in a 35 percent increase in flu shot adoption. Case study and materials
Case 3: Free Speech vs. Professionalism
A mortuary student posted several messages about a cadaver she was working on in anatomy lab on Facebook. Examples include: nicknaming the cadaver ‘Bernie’, “Hmm, perhaps I will spend the evening updating my 'Death List #5,' " and that she would soon stop seeing "my best friend, Bernie," "Bye, bye Bernie. Lock of hair in my pocket.” The University of Minnesota filed a formal complaint that alleged the student engaged in "threatening, harassing or assaultive conduct." However, they were sued for infringing on the student’s free speech. The Minnesota Supreme Court ruled in favor of the University on 6/20/12, stating that censure was justified by "narrowly tailored" rules directly related to "established professional conduct standards. Case study and materials
Case 4: Friending Patients on Social Media
After doctors initially misdiagnosed her son with strep throat, a mother posted several pictures of her son’s worsening rash and facial edema on Facebook. Although she received many responses that were incorrect, a non-physician neighbor suspected the boy had Kawasaki’s disease based on previous experience with the illness in her own son. The mother took the son to the hospital for immediate work up, and it turned out to be the correct diagnosis. As a result of social media, her son avoided additional complications and recovered from Kawasaki associated liver dysfunction. Case study and materials
Case 5: The Political Resident
Brandon is a surgery resident who, since starting medical school, has kept a blog about his views on medicine, medical education, and health care politics. Recently, Brandon has blogged extensively about his extreme political views regarding the upcoming election. His residency director reads his blog and tells him that he must delete his posts and can no longer write new ones, as he is not only a hospital employee and a representative of the residency program, but also a professional who must represent himself accordingly. Case study and materials
Case 6: The Screaming Baby on Facebook
A pediatric gastroenterologist receives a Facebook friend request from a woman in his community. Unfamiliar with the woman, the pediatrician messages back by asking where they may have met or how they might know one another. The woman replies, “You don’t know me, but I have an 8-week-old baby who won’t stop crying and will only take 12 ounces of formula per day.” For background, pediatric gastroenterology is a subspecialty experiencing significant shortages in certain parts of the country. The wait to see a pediatric gastroenterologist can be several weeks. Note: 12 ounces of milk for a two-month-old baby represents dangerously low intake. Case study and materials