Thursday, 2 June 2011

Digital professionalism... if only it were that easy

Doctor Reading Articles
Image: Doctor reading articles by rosefirerising

The longer I am online and the more I become immersed in being online the more complex this existence seems.

I want to talk about some principles for "Digital Professionalism" which have been put forward by Rachel Ellaway in the journal Medical Teacher last year. The journal is paywalled so I am going to give the principles here.
The 7 principles are:

Principle #1: establish and sustain an on online professional presence that befits your responsibilities while representing your interests. Be selective in which channels and places you establish a profile.

Principle #2: use privacy controls to manage more personal aspects of your online profile and do not make anything public that you would not be comfortable defending as professionally appropriate in a court of law.

Principle #3: think carefully and critically about how what you say or do will be perceived by others and act with appropriate restraint in online communications.

Principle #4: think carefully and critically about how what you say or do reflects on others, both individuals and organizations, and act accordingly.

Principle #5: think carefully and critically about how what you say or do will be perceived in years to come; consider every action online as permanent.

Principle #6: be aware of the potential for attack or impersonation, and know how to protect your online reputation and what steps to take when it is under attack.

Principle #7: an online community is still a community and you are still a professional within it. The call for ‘is there a doctor. . .’ may come online as well as on a ‘plane or in a theatre’.
 To me these are good starting points, but as someone active in the space, I can see that these principles only take me so far. I'll write more in my next post but I wonder what you think of them now. Please comment.


  1. With the Internet being a global community and open to many vulnerabily I think we need better safeguards to protect not only patient privacy concerns but also limit exposure to practioners. In the US recently a congressmens twitter and flickr Accts were hacked. What is to stop a disgruntled patient from hacking a providers account to ruin their reputation. You already see this in rating sites where providers have low ratings because of one or two vad reviews . One intrusion from a hacker or even a comment on a site like this cod potentially damage a practice. Also concerns against privacy of patients. Maybe a limitied "intranet " like community amongst established patients to a practice or network of practices with qpporporuatw"signature" verification and scription of data?

  2. I would insert between 1 and 2, strict separation of personal & professional profiles.

    3 & 4 are redundant, 5 is rather vague. I mean, could something professionally acceptable today become unacceptable in the years to come? How many years ahead should we think? It's a tall order. With respect to 6, key is being proactive about managing and cultivating your positive image and good patient relationships, if you wait until you must react to bad press you've missed the bus...

  3. Miguel A. Mayer3 June 2011 at 22:50

    I see very important to point out that personal and professional profiles must be clearly "split up". Just as it's mentioned, we are also a medical doctor online, but sometimes, how to manage that? I think we should be aware that it may affect our patient-relationships on-line and off-line.

  4. Rachel Ellaway4 July 2011 at 20:45

    Thanks for posting the original framework - I'm enjoying the discussions around this blog so keep the thinking going. When the DP principles were developed they were (and remain) a work in progress. The latest iteration which has had many inputs from folks around the world is as follows:

    1. establish and sustain an on online professional presence that befits your responsibilities while representing your interests … but be selective where you establish a profile
    2. your professional identity extends into all online communities you join, and you are still a professional there
    3. use privacy controls to manage more personal parts of your online profile and do not make public anything that you would not be comfortable defending as professionally appropriate in a court of law or in front of a disciplinary panel
    4. think carefully and critically about how what you say or do will be perceived by and reflect on others, including individuals and organizations. Act with appropriate restraint.
    5. almost everything online can be monitored, recorded or data mined. Consider every action online as permanent. Think carefully and critically how what you say or do online today will be perceived in years to come.
    6. pretence and deceit are inappropriate behaviours for health professionals. Do not impersonate or seek to hide your identity for malicious or unprofessional purposes.
    7. be aware of the potential for digital attack or impersonation. Know how to manage and protect your reputation and what steps to take when it is under attack.
    8. theft and piracy are not acceptable for any professionals - work within the law.
    9. curation of information is a serious responsibility. Do not expose information to unnecessary risk and consider wisely the potential impact of any use or exchange of information you make
    10. behave professionally and respectfully in all venues and using all media and take responsibility for modeling positive digital professionalism to others.

    The basic idea is to set a perimeter within which the use of the digital is not only legitimate but also beneficial to patients and providers. At present and in the absence of a solid framework it's much more about misdemeanours and punishment and everyone feels at risk.

  5. Hi Ann-Marie
    I've just found this and am interested as the same debate is starting in nursing (or at least I hope it is :) ). The issue I have with debating this is I think the whether 'to' or whether 'not to' debate is futile now as its happening around us in society and we need to be able to work out what might be a new version of 'professionalism' looks like taking account of this. This is a real challenge for many nurses - who seem to stick to the 'don't do it as its not safe' mantra. I'm speaking about this to lots of senior nurse leaders next week! Wish me luck :)

  6. Hello Annie,

    I think that Rachel's list is really good, and I am sure is still being refined. I think that as health professionals we are all individuals and we all need to come to our own conclusions about what might be an appropriate online professional presence. If people think that is not relevant to them they may be right.
    Yesterday I heard a story about an experienced committed nurse inserting an IV canula to a frail patient. A family member pulled out a phone and said that he was going to video this and complain if it took any longer. The nurse felt violated and disturbed. Where would this end up? Youtube? Could they refuse permission for this to happen?
    These are the sort of stories out there. And they make people afraid and nervous. How do we support colleagues to deal with situations like this?

    So usually I tell people about what I learn through my engagement. If this means something to them then I will try and help them. But I rarely say that anyone SHOULD establish a digital presence.

    Is that helpful?


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