Online professionalism investigations by state medical boards: first, do no harm. 2013

S Ryan Greysen, and David Johnson, and Terry Kind, and Katherine C Chretien, and Cary P Gross, and Aaron Young, and Humayun J Chaudhry
University of California, San Francisco, School of Medicine, USA. Ryan.Greysen@ucsf.edu

Despite recent guidelines promoting online professionalism, consequences for specific violations by physicians have not been explored. In this article, the authors gauged consensus among state medical boards in the United States (response rate, 71%) about the likelihood of investigations for violations of online professionalism by using 10 hypothetical vignettes. High consensus was defined as more than 75% of respondents indicating that investigation was "likely" or "very likely," moderate consensus as 50% to 75% indicating this, and low consensus as fewer than 50% indicating this. Four online vignettes demonstrated high consensus: Citing misleading information about clinical outcomes (81%; 39/48), using patient images without consent (79%; 38/48), misrepresenting credentials (77%; 37/48), and inappropriately contacting patients (77%; 37/48). Three demonstrated moderate consensus for investigation: depicting alcohol intoxication (73%; 35/48), violating patient confidentiality (65%; 31/48), and using discriminatory speech (60%; 29/48). Three demonstrated low consensus: using derogatory speech toward patients (46%; 22/48), showing alcohol use without intoxication (40%; 19/48), and providing clinical narratives without violation of confidentiality (16%; 7/48). Areas of high consensus suggest "online behaviors" that physicians should never engage in, whereas moderate- and low-consensus areas provide useful contextual information about "gray areas." Increased awareness of these specific behaviors may reduce investigations and improve online professionalism for physicians.

UI MeSH Term Description Entries
D010820 Physicians Individuals licensed to practice medicine. Physician
D004995 Ethics, Professional The principles of proper conduct concerning the rights and duties of the professional, relations with patients or consumers and fellow practitioners, as well as actions of the professional and interpersonal relations with patient or consumer families. (From Stedman, 25th ed) Professional Ethics,Ethic, Professional,Professional Ethic
D006625 Hippocratic Oath An oath, attributed to Hippocrates, that serves as an ethical guide for the medical profession. Oath, Hippocratic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013044 Specialty Boards Organizations which certify physicians and dentists as specialists in various fields of medical and dental practice. Board, Specialty,Boards, Specialty,Specialty Board
D014481 United States A country in NORTH AMERICA between CANADA and MEXICO.
D020407 Internet A loose confederation of computer communication networks around the world. The networks that make up the Internet are connected through several backbone networks. The Internet grew out of the US Government ARPAnet project and was designed to facilitate information exchange. World Wide Web,Cyber Space,Cyberspace,Web, World Wide,Wide Web, World
D032921 Consensus General agreement or collective opinion; the judgment arrived at by most of those concerned. Consensus Development,Development, Consensus

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