Social+Media

toc =Social Media for Medical Students= As you prepare to enter a career in the health professions, it is a good time to consider what sort of online identity you are projecting. Your colleagues and potential bosses will be looking online before they meet you, and you don't want the first thing they find to be you doing a keg stand; you don't want them to find that at all.In addition, for those of you who may someday have a disgruntled patient who wants to come after you personally, (and this is pretty much everyone except the pathologists, at least until the Zombie apocalypse) online privacy is important to protect yourself and your family. This means more than hiding "unprofessional" content, extending into anything related to your personal life, your family, and your habits. If you enter private practice after residency, your online presence will also be important because you want potential patients to find your practice when they Google your medical specialty.

So how can you keep using social media to connect with your friends and family? An Annals of Internal Medicine article, "[|Professionalism in the Digital Age]" advocates for a "dual citizenship" approach to social media, in which you maintain your personal profile but set extremely strict privacy settings such that no one can search for you unless you are already friends. In addition, because a sufficiently determined person can still find ways in (or interviewers may simply require you to log in and show them) you have to create a large volume of professional content that projects only the pieces of identity that you want it to. This serves a dual purpose as it is fine if patients friend or follow your public profile, which you can use to post public health messages, interesting articles, and updates on your professional development.

Even if you do pursue this strategy, it is important to remember that no matter your privacy settings, content posted to the internet should be considered to be there forever and for anyone to see. This means that even on your private sites, maintain high standards of professionalism. Another Annals of Internal Medicine article, "[|Online Professionalism Investigations by State Medical Boards:First, Do No Harm]," gives some guidance as to the bare minimum of behaviors to avoid online. The authors surveyed state medical boards about online actions they would investigate, using 10 hypothetical vignettes. Over 75% of those surveyed would investigate: "Citing misleading information about clinical outcomes (81%; 39/48), using patient images without consent (79%; 38/48), misrepresenting credentials (77%; 37/48), and inappropriately contacting patients;" 50-75% would investigate "depicting alcohol intoxication (73%; 35/48), violating patient confidentiality (65%; 31/48), and using discriminatory speech (60%; 29/48)" (Greysen et al., 2012).

=How-To Guide=

Guidelines for Use

 * [|Official UC Denver social media policy], including on use of the University's name and image.
 * A 12 Word Social Media Policy - from The Mayo Clinic Center for Social Media
 * Avoid giving medical advice. Consider putting a disclaimer in your profile along the lines of: Opinions are mine and do not necessarily represent those of institutions with which I am affiliated. Medical topics I discuss are not meant to be specific guidance and you should discuss medical decisions with your physician.
 * Don't be a jerk - Avoid sarcasm, cynicism, and off-color humor. As a general rule, avoid topics you wouldn't discuss with your supervisor.
 * Don't post identifying information about patients - no names, no photos, no anecdotes. Remember that HIPAA covers any personally identifying information, and if a patient has a rare disease or unique story even a small tidbit can be identifying.
 * Don't post proprietary information. Always cite your sources and give credit where credit is due.

Getting started

 * 1) Tighten up to privacy settings on your personal sites that you don't want people to find. Make sure to disallow showing your profile in searches or indexing your page for search engines.
 * 2) Create a new email address (Gmail suggested). Make it your full name if you can; at the least you obviously want it to be professional.
 * 3) Create a new user account for yourself on the major social networking sites: Facebook, Google+, LinkedIn, Twitter, and others that strike your fancy such as Flickr, Pinterest, and Path (See Sites to consider, below). Stay away from location-based sites like Foursquare; they're pretty much a stalker's wet dream.
 * //Put thought into your profile username.// It is not professional to go by pixygurl23^. Try to be consistent by using the same username across sites (e.g., mikepascoe vs. pascoe vs. mpascoe vs. mikepascoePhD). You can use this website to check availability of usernames across 159 social networks to inform your decision. Don't include elements like "MS1" in your username as you do not want to change your username once you begin and you will be a student for a relatively short amount of time. You probably should disclose in your bio that you are a student, and you can update this every year if you'd like (e.g., I'm a second-year MD student @CUDenver, or, I'm a third-year PT student @CUDenverPT).
 * 1) Put links to all your other profiles in the profile of each site - Google results are partly ranked by how many other webpages link to a result, and you want to drive yourself up the list. In the privacy settings for these new profiles, enable any features to make the profile more publicly viewable (except consider keeping your friends list to yourself only). //Dis//able any location-based services.
 * 2) Submit the URLs of your new social media sites to Google and Bing to get them indexed faster (Google requires a login, Bing has an anonymous URL submittal form):
 * []
 * []

Next Steps

 * Sign up for [|Klout] to help monitor your social media presence and impact. Don't be discuouraged if your influence number is low when you are starting out - it can take years to thoroughly establish online relationships with your new identity.
 * Looking for some friends online? Add your medical school classmates, professors, and professionals whose work influences you. Also feel free to add Forrest Monroe and Mike Pascoe (see below for our profile info).
 * Download smartphone apps for as many of your social networks as you can. Twitter is one of the most useful because you can upload interesting and informative tidbits as you go about your day.
 * Add the Twitter app to Facebook and LinkedIn so that your Twitter posts are automatically syndicated to those sites. Add Flickr to Twitter so that when you post a photo you alert people via tweet.
 * Set up Google Reader with medical journals and blogs that interest you. In addition to staying informed, this gives you a rich source of articles that your friends might like to know about.

Other useful links

 * [|Guide to Managing Your Facebook Privacy] - from LifeHacker
 * [|How to use social media and look like a rockstar on a recruiter's radar] - Geared toward business people, but still relevant
 * [] - Article analyzing the use of Social Media to counter anti-vaccine sentiment. Take this into account when using your social media for patient education (again, do not give out medical advice, but advocating for public health messages is highly advisable).

Network-specific Privacy Precautions
A few site-specific things to watch out for:
 * On Facebook, set the privacy of your friends list to "Only me" - this makes it more difficult for people to find your personal profile, and improves privacy for colleagues you add. Find the Facebook app settings and disable sharing information with your friends' apps. Comb through the privacy settings and disable anything else that sounds intrusive, such as "Instant Customization." Disable any location-based services.
 * On Google+, be sure disable automatic photo uploading from your smartphone.
 * On Flickr, disable uploading of geotagged/location information, and set the default sharing of that info to private/only me on the site.

Sites to consider
(don't forget: you should create clean new profiles in each of these attached to your new email address, even if you already use the website for personal content). Try to use the same username across all the sites. [|Facebook] [|LinkedIn] [|Google+] [|Twitter] [|Doximity] [|About.me] [|Youtube] [|Flickr] [|Vimeo] [|Instagram] [|Pinterest] [|Path] [|Zerply] You can also use [|Klout] to track your social media influence.

=Example Profiles=

Mike Pascoe
Profiles for selected social networks of Mike Pascoe (to give you an example of how faculty are leveraging social media). Notice I did not practice good planning when choosing my account usernames, they are all of the place! LinkedIn Twitter Flickr about.me Google+ YouTube Vimeo Klout

Forrest Monroe
[|www.facebook.com/forrestmonroe] [|www.linkedin.com/profile/view?id=175519611] [|www.twitter.com/frmonroe] [|www.flickr.com/photos/frmonroe] [|about.me/forrestmonroe] [|plus.google.com/u/0/103011540802373995067] [|www.klout.com/frmonroe] [|zerply.com/forrestmonroe]

=Other Privacy Tools=

People Search Engines
Sites such as whitepages.com, peoplefinder.com, and spokeo.com frequently contain your name, address, home phone, and family members (Google "find person" or something similar to pull most of them up). Go to these sites and look on their privacy page for instructions on how to remove your listing. Most have a simple online web form, while some are a pain and require you to submit a written request with a picture of your drivers' license.

Targeted Advertising
There are several "services" which track your behavior online through cookies and use your browsing habits to target advertising to you. While this is not necessarily relevant to social media privacy, it is another step you can take to protect your privacy online. Note that these opt-outs are by the device and browser you are using. You will have to do it for each device and each browser you use on that device. If you erase your cookies or reset your browser you will need to do it again. [] - Opt out of a slew of tracking cookies all at once [] - Information on Google's behavioral tracking Additionally, Google tracks every page you visit unless you tell it not to at []