Atul Gawande can shine a bright spotlight, even with just a few tweets. On Saturday he linked to an article about new social media guidelines for physicians which states:

Aside from not “friending” patients [on Facebook], the guidelines also recommend the following to physicians:

• Don’t use text messaging for medical interactions, even with established patients, except with caution and the patient’s consent.

• Only use e-mail within the context of an established relationship with a patient, and with that patient’s consent.

• Establish a professional online profile so that it appears at the top of a web-based search, above any physician rating site.

• Discourage e-mail or on-line communications with individuals who are not patients, instead referring them to make an appointment or visit an appropriate health provider.

• Manage their digital image, including refraining from posting about personal social activities that might not reflect positively or providing less-than-measured comments on Twitter, blogs, or in response to online articles.

I captured a bit of the online conversation in a Storify, tweaking the title to characterize it more broadly: Doctor-patient online communication. I didn’t want it to scroll away and be lost, since I think the reactions capture a moment in time.

Speaking of moments in time, I received an email on Saturday from Arash Najibfard, an undergrad at UCSD, who’d found my 2007 interview on NPR, “Patients Turn to the Internet for Health Information,” and asked for a link to the 2001 AMA press release warning people about the dangers of going online for health advice. Happily, I saved a print copy of that release and a PDF lives on the blog:

AMA Suggests Resolutions for a Healthy New Year (December 20, 2001)

One of the recurring themes of my work is to remind people that today is just a moment in time, that things will change — that things have changed even if you personally can’t see it yet.

All of these conversations — this weekend’s tweets, the 2007 NPR story, the 2001 press release — are simply snapshots of a certain population at a certain time. Never assume that what you are seeing or experiencing is everyone else’s reality. Look to data to give you a clear picture. Look to leaders in the field to give you a sense of where things are going. And in the case of online communications about health, that sometimes means e-patients, not clinicians.

I’m not saying who’s right, who’s wrong, or what’s the right policy. I’m saying: Don’t assume. Keep your eyes and ears wide open. That’s what I learned from Tom Ferguson, MD, one of my teachers, and from my grandmother, Rosalie Yerkes Figge, who I talk about at the start of the NPR interview. They passed away the same week in April 2006 and I miss them every day.

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