Like most of the civilized world now, I am on facebook. At first it was fun and exciting, now it
mainly acts as a time suck while waiting around at the
hospital. My news feed consists mainly
of lovely updates of what my friends from third grade had for dinner or more
recently many pictures of car thermometers in Oklahoma. I, of course, only post extremely interesting
things, like cute quotes from my kids or pictures of the XM radio in my car. Obviously everyone wants to know what song I'm listening to.
I do my best to avoid the usual internet arguments. I skim past the anti vaccine or homebirth conversations. The is definitely no “poli-booking’ for me (discussing politics on FB). I’m not ‘friends’ with patients and try to
make sure my behavior is ethical online.
Despite these precautions, I have found some grey areas in social media.
What do you do when people are making obvious bad medical
decisions online? What is our responsibility as doctors?
A girl I went to elementary school with was recently
pregnant. She lives several states away from me and I haven’t seen her since 4th grade. Every minor detail of her pregnancy was posted
in her status updates. Many of these would definitely fall in the “TMI’
category (ie: hemorrhoids ).
Near the end of her pregnancy she began having swelling,
and she would post daily pictures of her 'c-ankles.'
One night she posted a status that made my obstetrician’s
heart skip a beat, “I have the worst headache of my life, and I’m seeing little
squiggly lines. I just checked my blood
pressure and it’s 170/95”
This update, received several ‘helpful’ comments from
friends, family and other third grade classmates, such as “take a relaxing
bath” or “try Tylenol”.
I quickly sent her a private message recommending she proceed
to the hospital. These symptoms met the criteria for severe pre-eclampsia. She replied that she
had called her doctor and her doctor wasn’t concerned.
Now this was a dilemma. Is she lying? Is her doctor an
idiot? What is my responsibility
here?
I tried to go to sleep, but
every time I closed my eyes I kept picturing her having an eclamptic
seizure.
I posted a comment or her update, encouraging her to go to
the hospital that I was worried she had a serious life threatening condition.
She did not respond.
Two days later she posted that she was going to her doctor. She was
promptly delivered.
Luckily she and her baby were fine, but since this incident
(which is entirely true) I have been left wondering, what if she had
seized? Did I do enough to just tell her
to go? Should I have tried to track down
her phone number and call her? Should I
have ignored the comment all together?
Technology had introduced many grey areas in our ethics. Since we have a social media expert in our
midst and many of you are bloggers, immersed in the internet, I thought I would toss
this out there and see what you think.