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.