Journal of General Internal Medicine

, Volume 25, Issue 11, pp 1227–1229 | Cite as

Online Professionalism and the Mirror of Social Media

  • S. Ryan GreysenEmail author
  • Terry Kind
  • Katherine C. Chretien


The rise of social media—content created by Internet users and hosted by popular sites such as Facebook, Twitter, YouTube, and Wikipedia, and blogs—has brought several new hazards for medical professionalism. First, many physicians may find applying principles for medical professionalism to the online environment challenging in certain contexts. Second, physicians may not consider the potential impact of their online content on their patients and the public. Third, a momentary lapse in judgment by an individual physician to create unprofessional content online can reflect poorly on the entire profession. To overcome these challenges, we encourage individual physicians to realize that as they “tread” through the World Wide Web, they leave behind a “footprint” that may have unintended negative consequences for them and for the profession at large. We also recommend that institutions take a proactive approach to engage users of social media in setting consensus-based standards for “online professionalism.” Finally, given that professionalism encompasses more than the avoidance of negative behaviors, we conclude with examples of more positive applications for this technology. Much like a mirror, social media can reflect the best and worst aspects of the content placed before it for all to see.


professionalism internet use medical ethics health policy 


Financial disclosure



The authors would like to thank Cary Gross, MD, Howard Brody, MD, PhD, Bernhard Wiedermann, MD, MA, and Larrie Greenberg, MD, for input on earlier drafts of this manuscript.

Conflict of Interest

None disclosed.


  1. 1.
    Ian Shapira. When Young Teachers Go Wild on the Web: Public Profiles Raise Questions of Propriety and Privacy. The Washington Post. April 28, 2008. Accessed June 20, 2010 at:
  2. 2.
    John Schwartz. A Legal Battle: Online Attitude vs. Rules of the Bar. The New York Times. September 13, 2009. Accessed June 20, 2010 at:
  3. 3.
    Nick Valencia, Benjamin Fernandez, Jennifer Deaton. Photos of drinking, grinning aid mission doctors cause uproar. February 3, 2010. Accessed on June 20, 2010 at:
  4. 4.
    Chretien KC, Greysen SR, Chretien JP, Kind TR. Online posting of unprofessional content by medical students. JAMA. 2009;302(12):1309–15.CrossRefPubMedGoogle Scholar
  5. 5.
    Lagu T, Kaufman EJ, Asch DA, Armstrong K. Content of Weblogs written by health professionals. J Gen Intern Med. 2008;23(10):1642–46.CrossRefPubMedGoogle Scholar
  6. 6.
    Thompson LA, Dawson K, Ferdig R, Black EW. The intersection of online social networking with medical professionalism. J Gen Intern Med. 2008;23(7):954–57.CrossRefPubMedGoogle Scholar
  7. 7.
    Board exonerates Haiti mission doctors in controversial photos. Puerto Rico Daily Sun. March 30, 2010. Accessed June 20, 2010 at:
  8. 8.
    Guseh JS 2nd, Brendel RW, Brendel DH. Medical professionalism in the age of social media. J Med Ethics. 2009;35(9):584–6.CrossRefPubMedGoogle Scholar
  9. 9.
    Farnan JM, Paro JAM, Higa JT, et al. Commentary: The relationship status of digital media and professionalism: It’s complicated. Acad Med. 2009;84:1479–81.CrossRefPubMedGoogle Scholar
  10. 10.
    ABIM Foundation, ACP-ASIM Foundation, European Foundation of Internal Medicine. Medical professionalism in the new millennium: A physician charter. Ann Intern Med. 2002;136(3):243–46.Google Scholar
  11. 11.
    Suler J. The Online Disinhibition Effect CyberPsychology and Behavior. 2004; 7: 321-26. Accessed June 20, 2010 at∼suler/psycyber/disinhibit.html.
  12. 12.
    Associated Press. Facebook misconduct: Med students cross line—some broke confidentiality, tried to ‘friend’ patient online, study shows. Accessed June 20, 2010 at:
  13. 13.
    Online public discussion of above AP article on Accessed June 20, 2010 at:
  14. 14.
    Jain SH. Practicing medicine in the age of Facebook. N Engl J Med. 2009;361(7):649–51.CrossRefPubMedGoogle Scholar
  15. 15.
    Pew Internet and American Life Project. Accessed June 20, 2010 at:
  16. 16.
    Chretien, KC. Goldman EF, Beckman L, Kind T. It’s Your Own Risk: Medical Students’ Perspectives on Online Professionalism. Academic Medicine, Research in Medical Education Supplement. Nov/Dec 2010 (in press).Google Scholar
  17. 17.
    Farnan JM, Higa JT, Paro JAM, et al. Training physicians in the digital age: Use of digital media among medical trainees and views on professional responsibility and regulation. Am J Bioethics (in press).Google Scholar
  18. 18.
    Chretien K, Goldman E, Faselis C. The reflective writing class blog: using technology to promote reflection and professional development. J Gen Intern Med. 2008;23(12):2066–70.CrossRefPubMedGoogle Scholar
  19. 19.
    Kind T, Everett VR, Ottolini M. Learning to connect: Students’ reflections on doctor-patient interactions. Patient Education and Counseling. 2009;75(2):149–54.CrossRefPubMedGoogle Scholar
  20. 20.
    Henderson D, Carson-Stevens A, Bohnen J. Check a box. Save a life: How student leadership is shaking up health care and driving a revolution in patient safety. J Patient Safety. 2010;6(1):43–7.CrossRefGoogle Scholar
  21. 21.
    O’Keefe L. Social Media a big part of office ‘toolkit’ for many tech-savvy pediatricians. Am Acad Peditrics News. 2010;31(2):16.Google Scholar
  22. 22.
    Hawn C. Take two aspirin and tweet me in the morning: How Twitter, Facebook, and other social media are reshaping health care. Health Affairs. 2009;28(2):361–8.CrossRefPubMedGoogle Scholar
  23. 23.
    Nirvi Shah. Doctors Embrace Social Media. The Miami Herald, November 9, 2009. Accessed June 20, 2010 at:
  24. 24.
    Jain S. Googling ourselves—What physicians can learn from online rating sites. N Engl J Med. 2010;362(1):6–7.CrossRefPubMedGoogle Scholar
  25. 25.
    Gorrindo T, Groves JE. Web searching for information about physicians. JAMA. 2008;300(2):213–5.CrossRefPubMedGoogle Scholar

Copyright information

© Society of General Internal Medicine 2010

Authors and Affiliations

  • S. Ryan Greysen
    • 1
    Email author
  • Terry Kind
    • 2
    • 3
  • Katherine C. Chretien
    • 4
    • 5
  1. 1.Robert Wood Johnson Clinical ScholarYale University School of MedicineNew HavenUSA
  2. 2.Department of Medical EducationChildren’s National Medical CenterWashingtonUSA
  3. 3.Department of PediatricsGeorge Washington University School of Medicine and Health SciencesWashingtonUSA
  4. 4.Medical Service, Washington DC VA Medical CenterWashingtonUSA
  5. 5.Department of MedicineGeorge Washington University School of Medicine and Health SciencesWashingtonUSA

Personalised recommendations