Social media has become ubiquitous as sites like Facebook and Twitter allow users to stay in touch with friends and many others.
But for professionals like teachers, police officers and doctors, there are ethical issues to consider before sending out a tweet or accepting a friend request. For some, navigating the virtual and real worlds can be a challenge, as well as a risk.
To get a sense of how Rochester's doctors and medical professionals are using social media, I spoke with my own dentist, Kevin Kopper. He and his wife own a small practice, and they've taken to Facebook to connect with patients.
"To be honest, there's a set of patients that prefer to contact you about appointments and things just through Facebook, rather than call, rather than e-mail," Kopper said.
The couple's practice has a business page, kind of like an ad, with office hours, and general business information. But most of the real interaction — the private messages, the liking, the scheduling — all that happens from their personal accounts.
Kopper says because they're a private practice, those online conversations are extensions of the small talk that happens inside the office. He emphasizes that it's all small talk — and nothing that reveals private patient information.
"I think people like the personal contact. And we're a small practice. It's just my wife and I, and one employee. And you could say there's private things you should keep private," Kopper said. "But honestly, here, when we're working, we generally talk about our lives anyway, so we don't really have anything to hide that way. So I guess it's okay."
Some patients think that's just fine. They include Matthew Clark, a 30-year old nursing assistant in Rochester who is a friend of the Koppers on Facebook.
"We have a lot of stuff in common. We like a lot of the same music. I didn't see a provider-patient conflict," Clark said. "It's not like we hang out outside of it. It's Facebook, it's just Facebook. You know, you don't really get that super close to everyone you're friends with on Facebook."
Clark said virtual connections work for some but certainly not all medical professionals. In 2009, after he received a heart transplant at Mayo, he wanted to friend his doctors but he knew he shouldn't. His training as a health care worker at Mayo helped him understand why he shouldn't blur that line with his own doctors.
"You have someone save your life, you want to be friends with them," Clark said. "I mean, you want to have interactions with them and that was a really important person to you and it's hard to delineate the difference between their taking care of you versus they're your friend."
In the digital age, the biggest concern for doctors is maintaining patient confidentiality.
Mayo Clinic has a social media policy that discourages friending patients online. It also reminds doctors never to practice medicine in public. But those are professional expectations that shouldn't scare doctors from using platforms like Twitter to interact with patients, said Lee Aase, director of Mayo Clinic's Center for Social Media.
"The reality is that the patient and consumers have been online doing these discussions for a really long time," Aase said. "And it's just a matter of whether the professionals join them and provide their perspective and expertise in the discussion as well."
One safe bet, Aase says, is for doctors to let patients follow them first.
"That's probably a safer way too of doing it," he said. "That way, if the patient is initiating it, you're clearly complying with what the patient's interest is and that initiation probably is safer."
The clinic's center for social media has trained about 350 employees in voluntary social media boot camps since 2011.
Among them is 31-year-old Angela Mattke, a general pediatrician. She stopped using Facebook after some of her patients' parents started to friend her. But in the last year, she's used Twitter to share her expertise to a broader audience — including her young patient's parents.
"Your office visit is so short, 15 minute visits for a full well-child check," Mattke said. "This way, we can continue the conversation and I can give them more resources that way. I'm not able to e-mail patients currently, but this is a way I can send that information out to them."
Mattke said Twitter lets her maintain an appropriate level of distance. She's slowly building her following, sharing links and joining virtual chats. But she's still cautious about engaging with patients, and she'll never answer patient-specific questions on social media. For that, she said, a doctor's visit will still have to do.