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Your dopamine-thirsty mind projects into the future, thinking about how many likes will get generated, how many friends will think you’re fantastic. No amount of consequence, no matter how severe, can stop you now. And at this point, with your witty message articulated to perfection, complete with hashtags and a fun .gif, your post is already stimulating your reward pathway; your poor, forgotten prefrontal cortex, the voice of reason, has been silenced.

Too many times, a singular message, tweet, photo, or comment has brought heavy repercussions on it’s author. To make matters more difficult, the message from the poster can be seemingly innocuous. It only takes one person, over-sensitive or not, to get offended or find something “disrespectful,” and the author has a scar, a non-healing suppurative scar that can mar their reputation forever.

And no one is immune. Journalists, politicians, teachers, police officers...people from every walk of life have had their careers ruined by one false move. A Google search “careers ruined by social media” renders not just single examples, but multiple lists of the self-afflicted.

It seems like the solution is simple. Don’t publish anything that might be misconstrued as offensive by anyone. But, we see these missteps happen time and time again.

Your duty to protect patient privacy

Irrespective of our own reputations, patients’ rights and safety stand above all else. As a health-care provider, you are mandated by federal law to protect patients’ health information. HIPAA violations are common on social media. Even without identifiers, it is not permissible to share photos of patients without patient consent. A more subtle violation: the computer screen with patient names, or charts and files that you didn’t notice, in the background of the photograph.

Just a few years ago, a Texas nurse was fired for posting a comment about a patient with a rare disease. While she didn’t use any patient identifiers, mentioning the disease, a general patient demographic (i.e., “young boy”), along with having her employer listed on her profile, gave enough information about the patient that he might have been able to be identified.

More egregious offenses can result in criminal charges. A Wisconsin nursing assistant was charged with a felony after she took and shared a video of her nearly-nude elderly patient with Alzheimer’s disease, claiming she wanted to show a supervisor how the patient was uncooperative with getting dressed.

Trouble even without identifying a patient

In 2014, when there were roughly one billion less users of social media worldwide, a New York City nurse was fired after posting a picture of an empty trauma bay after a patient resuscitation. There was nothing to identify any patient, nobody in the photo at all; simply a dirty trauma bay that was yet to be cleaned. And this photo led to her termination, as hospital administrators deemed it insensitive. Remember - you only need offend one person, regardless of your intention, to be at risk for extreme ramifications. She was trying to capture the stresses and hard work of a well-functioning trauma team, and instead, was forced to find a new job, carrying a recent administrative termination in her history.

At-risk youth

In the words of Crosby, Stills, and Nash, “Teach your children well.” Teenagers, a group who by nature is starving for social acceptance by their peers, are particularly vulnerable when it comes to writing something on the internet that they will grow to regret. And the medical community is certainly not immune, as evidenced by a recent Cleveland Clinic resident who had a history of repeated racist attacks before her entrance into the realm of medicine.

With great power, the power to say something that the entirety of the world can hear, comes great responsibility. And as smartphones and social media find themselves in children’s hands at younger and younger ages, the filter between thought and message-to-the-world grows thinner.

Don’t put it in writing

Suppose you have the most brilliant and witty thing to say, and sharing it with others will elevate your social status immeasurably, but you’re not sure if it’s 100% acceptable. If you absolutely must, share it in real life and avoid potentially everlasting internet infamy. If you aren’t completely sure if it’ll fly, then someone out there can certainly find issue with it.

It sounds obvious, but I hope this painfully simplistic piece of advice saves someone out there from making a grave mistake. If you have any reservation about sharing something online, even in a small (and believed to be protected) group, just don’t do it. Impress those around you with your clinical acumen, your fund of knowledge, and your enjoyable company, not with an off-color message.

This article was originally published by Doximity. 

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Brian Radvansky

Brian Radvansky

Brian believes that excellence comes from never taking "no" for an answer, and putting as much work into organizing one's studying as into studying itself. After producing an incredibly average MCAT score, he decided he was going to quadruple his efforts in preparing for Step 1. His greatest successes have brought students who were going to drop out of medicine altogether for fear of not matching to matching into their specialties of choice. He reminds students the importance of performing well on a single test, or even learning how to sell themselves can make an extreme difference in their futures. Students can rely on Brian to hold them accountable and make sure that they don't sabotage themselves with excuses. He can help them to totally reevaluate their approach to USMLE questions in a methodical, protocolized way that ultimately leads to more correct answers and a higher score. With his help, you will trim the excesses, and put all of your collective efforts into only the work that will improve your score. Through his residency admissions consulting, Brian has consistently revamped students applications by helping them to highlight their best (and sometimes hidden) characteristics, and get them to match into the programs they had ranked number one. He can help you to master your personal statement, and craft the story as to why your program of choice needs to have you as a resident. Brian will help you find that all too difficult balance of being proud of and selling your accomplishments, without coming forth as someone who is merely checking boxes to bolster their application.
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