How (Not) to Twitter Your Professional License to Death

Are you a nurse? A doctor? A lawyer? A CPA? Do you make a living protecting, defending and fighting for the confidence, dignity and honor of others? Do you Twitter? When Twitter asks “What are you doing” do you know what you’re doing? That is, do you know how to use Twitter to convey your professional experiences without betraying your sworn duties or breaking enforceable laws?

Online, there are millions of ways to breech confidentiality, compromise protected information, humiliate your fellow human beings, cast doubt on your profession, emit regrettable thoughts…jeopardize your license.

For those of you in health care, there is of course HIPAA to follow. HIPAA, however, isn’t the be-all-end-all of patient protection. Doctors and nurses aught to realize that they can harm patients even without violating federal law. A bit of common sense and courtesy is probably enough to keep the risk of harm as low as possible:

  1. Don’t Twitter or use social media when you’re angry. Go get a milkshake.
  2. If your case is fascinating then reflect on it, find an eternal truth and then Twitter your revelation instead of the details. Write a short story.
  3. Assume that anonymity is an illusion. If you believe that you can achieve absolute anonymity online then go work for the NSA (apply here).
  4. Even if you don’t disclose identifiers, or if you conceal them behind fiction, be aware of triangulation. Temporal proximity and one detail might be just enough to cause embarrassment.
  5. Don’t dismiss patient dignity. You protect your patients from physical harm, so why not do the same for their dignity?
  6. Ask yourself: if I came accross a Tweet in TwitterSearch that sounded suspiciously familiar, how would I feel?
  7. Ask yourself another question: if I came across a Tweet from a patient about me (and it wasn’t nice), how would I feel?

Of course, these guidelines work for any profession, not just health care. Confidentiality and dignity are universal human needs. Entire economies depend on them. Without trust, what’s money worth?

Beyond patients or clients, you also need to consider: your co-workers, your bosses, your facility’s administration and other professionals who you might feel tempted to discuss on Twitter.

Don’t assume that just because most of the health care industry is stuck in 1953 that you won’t be located. If anything, one of the first uses of social media by the industry will probably be to hunt down employees. (I hope I’m wrong but…I digress.)

We deal with stupid, annoying and dangerous people all the time among our work settings. You can talk about them online. But what does that accomplish? Is it free, or might that cost you something valuable? Just because you can, do you have to say what you want to say?

Think about how you use Twitter. There’s a lot you can reveal in 140 characters or a tiny url. Perhaps a more secure analog to Twitter will come around. Until then, be mindful of how Twitter might affect your licensure.

You worked hard to get through school, pass ridiculous exams, get through your first few years to get this far. If you got through critical care, endocrinology or the U.S. tax code, you’re smart enough to use Twitter without killing your license, aren’t you?