AANS Neurosurgeon | Volume 27, Number 3, 2018

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Neurosurgeons and Social Media

Snapchat. Twitter. LinkedIn. Facebook. Compared to these and other platforms for instantaneous electronic communication, email seems as antiquated as a horse and buggy. Who could have predicted that we would one day live in an age in which the best way to call attention to your message is to send it by old-fashioned snail mail?

The exponential growth of social media in medicine and the resulting complex issues make this edition of AANS Neurosurgeon important for all of neurosurgery. Whether to use social media in one’s personal life is a choice that bifurcates largely along generational lines. Relatively few older people use social media, but younger generations are digital natives who have never known life without it. For one’s professional life, however, it is difficult for neurosurgeons to be as successful as they can possibly be without having a social media presence. Private practitioners need to have maximum visibility so that their practices will grab the attention of patients and referring physicians. On the other hand, academic or hospital-employed physicians are at the mercy of their employing organizations when it comes to crafting a social media presence. Such employers frequently choose to emphasize the brand of the entire organization, rather than the expertise of specific specialties. Given the positive impact that neurosurgery has for a hospital’s bottom line, organizations that promote a generic corporate presence would be wise to rethink a decision not to highlight their neurosurgeons. 

The fact that social media has become a necessity for younger neurosurgeons comes with a few downsides. These are exacerbated by the limited experience that trainees have with the norms and expectations of physician-patient interactions and of safeguarding confidential medical information. An example is failure to turn off or ignore social media when talking to patients and their families, especially older patients. A medical student’s or resident’s friends may think nothing of it when their companions constantly pull out smart phones to chat, message or tweet in the middle of face-to-face conversations. Patients and families may be less understanding, especially because it is the middle-aged and elderly generations that tend to develop neurosurgical problems (pediatric neurosurgeons excepted), and those age groups are less likely to live in the social media world. We have had complaints from families about trainees who could not stay off their smartphones during rounds. They were not using their phones to look up a patient’s diagnosis, therapy, medications or other information that could be shared with the team and/or the patient. Instead, they were texting or chatting.

Another important boundary issue is using social media to broadcast confidential medical information. Examples may include images of celebrities undergoing treatment, graphic pictures of unusual injuries or other emergency conditions – even videos from the operating room or other parts of the hospital. Posting such information online is never a good idea. Most health care organizations have policies that ban such practices, in part because of the legal liability that is created. More important is the very high potential for violation of patient confidentiality, either directly by uploading images of someone’s face or other identifying data, or indirectly, such as transmitting images of a trauma patient’s injuries just a short while after a motor vehicle collision occurred in the community.

Despite these concerns, social media has been a very positive game-changer in medicine. The best recent examples are the rapid spread of information about the Ebola and Zika viruses. Less urgent, but still important, medical news is sent out constantly by many outlets. Health care policy is a favorite topic in the social media world.

The impact of social media on medical education has been no less than dramatic. This is especially true for the surgical specialties. Reading a description of a surgical procedure is not the same as seeing how it’s done. Just a few decades ago, the only way to broaden one’s neurosurgical skills was to visit other neurosurgeons to observe their surgical techniques in the operating room. Later, filming of surgeries opened up educational opportunities to a much wider audience, as did courses that offered hands-on experience using cadavers and anatomic models. Today, it is possible to compare and contrast how different surgeons perform the same procedure, not by tracking down book chapters or review articles written by different surgeons, but by accessing their social media pages. Those same experts can now provide instantaneous updates or commentaries on new developments in their fields.

Despite these exciting changes in how information is delivered and accessed, it is crucial to remember that social media cannot replace the interpersonal interactions that are essential for collegiality, professional friendships, mentoring, creation of multi-institutional projects, unified approaches to problems that confront our specialty and our profession, along with many other efforts. The AANS will always be committed to communicating with its members and to meeting their needs in whatever format they choose, including email, Twitter, Facebook, LinkedIn, physical mail, electronic journals like AANS Neurosurgeon and Neurosurgical Focus, print journals with online accessibility like the Journal of Neurosurgery publications … and whatever new formats take hold in the world of tomorrow.

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