The American Society of Colon and Rectal Surgeons (ASCRS) and its journal, Diseases of the Colon and Rectum (DCR), are committed to leveraging Social Media to provide health care professionals with a specific interest in diseases of the colon, rectum and anus with interactive venues for discussion, information and education regarding all aspects of colorectal disease.
Definition of Social Media
The term “Social Media” encompasses a wide variety of online resources for sharing content among users and shall be defined to include video- or picture-sharing sites, forums, blogs, discussion groups and accounts on various social networking sites and social media platforms, including, for example, Facebook, Twitter, YouTube, LinkedIn, Instagram, Doximity, and Tumblr.
Basis of Social Media Policy
ASCRS supports use of Social Media to achieve the following goals:
- To reach a larger audience by disseminating new alerts and scholarly information in a rapid and effective manner.
- To increase and encourage scholarly discussion among medical practitioners with an interest in the disease processes of the colon, rectum, and anus.
- To foster collegiality and camaraderie within the profession.
- To allow personal expression of physician opinions on matters relating to diseases of the colon and rectum, as long as such personal expression is identified as such and is otherwise consistent with the terms of this policy.
- To facilitate collaboration with other organizations, including peer-reviewed journals, to improve the community’s understanding of the research and literature regarding colorectal disease and, thus, ultimately lead to improved patient care.
Although the use of Social Media offers significant benefits, it also raises a number of concerns.
Thus, the following policies shall govern participation in ASCRS Social Media:
- Treat all online communication as public. With paywalls and privacy settings, it is easy to believe that the information one posts will only be viewed by intended recipients. That, however, is not always the case. Inasmuch as one of the main tenets of social media is sharing, friends and followers may share posts and information at will. Moreover, even websites with the best privacy restrictions can be subjected to hackers and unintentional sharing with advertisers or other third parties. Thus, it is important to treat all Social Media as if it is a public communication.
- Patient privacy is paramount. Physicians must comply at all times with state and federal laws regarding the release of potentially identifiable patient information, including, without limitation, the Standards for Privacy of Individually Identifiable Health Information (“Privacy Rule”) and the Security Standards for the Protection of Electronic Protected Health Information (“Security Rule”) established by the U.S. Department of Health and Human Services to implement the requirements of the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), all as applicable and as amended by Subtitle D of the Health Information Technology for Economic and Clinical Health (“HITECH”) Act (Title XIII of the American Recovery and Reinvestment Act of 2009) and as clarified by any and all amendments, regulations, and guidance thereto.
In addition, physicians should exercise caution in relying on general waivers and consents for releasing patient information or photographs online. Unless the waiver explicitly includes the name of the website or online forum where the information or photograph is to be posted, the physician posting such information or photograph may not be protected.
- Respect intellectual property rights at all times. Social media is a place for sharing, but intellectual property rights, including copyright and trademark, still apply. Among other things, scholarly material must be appropriately referenced when used. Users of ASCRS Social Media may not post or distribute files, articles or other information subject to trademark, copyright, or other proprietary rights, except with the express consent of the owner of the rights. For example, one should not copy the text of a newspaper story and post it on a social media site, even if the individual doing the posting is the subject of or otherwise featured in the copied work. The prudent approach is to share a link to the material, rather than copying it.
- Remember that physicians retain their identity as medical professionals on Social Media. A physician retains his or her identity as a medical professional regardless of the social media site to which he or she elects to post information. Thus, anything posted, including articles shared online, products liked or followed on a social media site, or answers to simple questions, can be perceived as medical advice or an endorsement. When sharing online, it is important to provide context about what is posted and why. This is also true when reposting or retweeting something that someone else has shared.
- Consider the effect of posts on physician-patient relationships. On some social media sites, patients may be among the physician’s fans, followers or friends, and they may ask questions. Even answers to simple questions from patients and non-patients can be viewed as medical advice. If one is not sure whether a public post could be construed as medical advice, refrain from posting it. Because physician-patient relationships may be created online, physicians who feel compelled to post an opinion or comment should include a disclaimer to the effect that the post: (i) is offered for informational purposes only; (ii) is not medical advice or a practice guideline; and (iii) does not establish a physician-patient relationship. Be mindful of the line between providing information and engaging in advertising or professional solicitation, both of which are regulated activities.
Physicians connected to a patient online should recognize that the relationship is not an online friendship. Colorectal surgeons who interact with patients on Social Media must observe ethically prescribed physician-patient professional boundaries. The professional ethical guidelines for physicians online are no different from what they are in person. Typical online behavior, such as commenting on a photo, sending direct messages, or writing on a wall may give patients the sense that their privacy has been violated even though they gave the physician the right to view their information. While patients may attempt to connect with their physician on Social Media, colorectal surgeons should not actively seek or pursue those relationships as they make the physician-patient relationship public and put patients in the awkward position of deciding whether or not to block all of their online information from their physician.
- Follow the rules. Most social media sites have their own rules, which are often referred to as “Terms and Conditions” or “Community Guidelines.” It is important to be familiar with and follow those rules. What is allowed on one social media site may not be permitted on another, even if the sites are similar. Users should familiarize themselves with any social media policies adopted by their associations and institutions, with which they are required to comply.
- Do not exceed authority. Except as expressly granted authority on some other basis, no user of ASCRS Social Media has authority to speak on behalf of ASCRS or to make any statement that implies, directly or indirectly, that the user’s opinions are those of ASCRS. In addition, any and all actual, potential or apparent conflicts of interest should be disclosed as they arise.
- Be transparent. Anonymous postings are neither necessary for purposes of ASCRS Social Media nor consistent with the professional level of dialogue expected. Therefore, physicians and other users should include their names with any and all posts and should not falsely portray themselves as anyone else.
- Exercise common sense. All users should exercise both common sense and courtesy in the messages they transmit on ASCRS Social Media and may not use ASCRS Social Media to transmit defamatory, obscene, and otherwise offensive communications, including, without limitation, any discriminatory statements regarding gender, race, religion, nationality, or sexual orientation. ASCRS Social Media is not to be used for posting commercial messages advertising or selling goods or services or for any illegal purpose. In Twitter posts, users should not use the ASCRS handle @fascrs_updates in posts that link to corporations or industry. Users should not use the ASCRS handle to endorse technology with which they have a conflict of interest (COI) without disclosing the COI in the tweet, even if the COI has been disclosed separately with users’ institutions or societies.
- Recognize that deleting a post from Social Media does not necessarily erase it, even if it is no longer visible on the screen. This is especially true as many people use third-party applications or view Social Media on mobile devices that may only capture a site at one point in time. Users should assume that everything posted exists in perpetuity. That said, if one accidently posts something, the post should be taken down and, if appropriate, the mistake should be acknowledged.
The views expressed on Social Media are those of the individual users. They do not and should not be construed as representing the views of ASCRS. ASCRS makes no warranty, guarantee, or representation as to the accuracy or sufficiency of the information posted on ASCRS Social Media, whether posted by ASCRS or any third party, and ASCRS assumes no responsibility or liability regarding the use or misuse of such information for any purpose. ASCRS disclaims any responsibility to maintain copies of any information posted on ASCRS Social Media or to assure that such information is deleted. Unless specifically stated otherwise, ASCRS does not endorse, approve, recommend, or certify any information, product, process, service or organization presented or mentioned on ASCRS Social Media, and information from ASCRS Social Media should not be referenced in any way to imply such approval or endorsement.