I never set up a Facebook page. When Facebook arrived I was still in active practice. My concern was what would I do if a patient tried to friend me. If I said yes, it would be inappropriate. If I said no, it might upset them and impact the doctor-patient relationship. So I avoided the entire thing.
In the intervening years social media has grown exponentially. There are a lot of opportunities for physicians to help educate patients through it. That is similar to what I try to do with my columns.
This month the American Academy of Pediatrics published a set of rules for pediatricians and social media.
The first one has to do with the fact that pediatricians should maintain two separate presences on social media. One would be personal.
The other would be professional. Any patient who attempted contact with the personal presence could simply be asked to use the professional presence instead.
The personal pages should have adequate privacy settings. This would prevent unauthorized access. The professional pages should be set to prevent tagging.
The third suggestion is true for everyone who posts on social media. Before posting, there needs to be a pause.
The planned post should be looked at to see if there is a way of interpreting it incorrectly. We have to be careful about the cancel culture.
Privacy laws are important. There is the Federal HIPAA law. There are state laws. Professional organizations have privacy requirements.
Physicians in private practice need to set policies for their staff to follow. That will prevent each individual from doing different things. Patients should be informed of restrictions that are present.
Any conflicts of interest need to be disclosed. If a physician is doing paid research for a drug company, that should be disclosed.
There should be a method of encryption present. That will allow patient specific medical advice to remain private. If there is specific information it should be de-identified if possible.
Friend requests need to have boundaries. At no time should a pediatrician accept a friend request from a current patient. That might be acceptable for former patients if they have reached adulthood.
Friend requests from patient parents should be limited to those parents with whom there is a relationship that is community rather than practice in nature.
Patient information should not be sought on the Internet. That is not appropriate. If there is a need to do so, the patient needs to be informed.
There is a need to monitor the profile online. That will avoid inaccurate postings. Setting up an account and forgetting to check it is just asking for trouble.
There needs to be care taken if someone asks for advice who is not already a patient. Giving advice may be considered setting up a physician-patient relationship. That could create medico-legal problems. That is especially true if the physician may not know the entire patient history.
It would appear to me that my decision to not set up a Facebook page when I was actively practicing was a good one. It is not something that can simply be done in a vacuum.
The number of daily new cases both nationally and locally have continued at about the same level since the middle of February.
The number of completely vaccinated individuals nationally is at 13 percent. Delaware sits at 14 percent. That is a 2 percent increase for both of them. That increase will need to improve. A 2 percent per week increase will take a long time to get where we need to be.
One might ask the question what numbers we actually need to get herd immunity. The answer is that we have no clue. The 70 percent-85 percent vaccine level has been used for several months. However, we do not know the level needed for sure.
In addition, we do not know how the people who have already recovered from the infection will affect that. Those individuals might include school children who frequently have no symptoms or mild symptoms.
They now might include the college spring breakers who will likely see an uptick in infections.
A third factor is how the new strains will affect long-term immunity. These are all unanswered questions. They will likely remain unanswered for an extended period of time.
The bottom line is that we will know that we have achieved herd immunity when the number of new cases start to disappear. We know we have achieved herd immunity for measles. However, there are still cases that pop up in un-immunized individuals. The same can be said for things like whooping cough.
We will look for a significant decrease in positive test results. We will look for a significant decrease in hospitalizations. We will look for a significant decrease in deaths. Time will tell the story.
All we can do in the meantime is to continue the process of protecting as many people as we can.