One of the problems with social media in the medical field is the federal privacy act known as HIPAA. HIPAA prevents medical providers from publicly disclosing any “protected health information” about patients without the patients’ permission. We can disclose the information among other medical providers providing care to the patient with few limitations, but we can’t disclose the information to the public. A patient can go to newspapers and say that a doctor committed gross malpractice by misdiagnosing her abdominal pain, but the doctor can’t respond by saying “no, actually we treated your gonorrhea appropriately, you just didn’t follow up and you gave us a fake phone number so we couldn’t contact you to tell you that it was resistant to the medications you received.” HIPAA doesn’t allow providers to disclose medical information to third parties without the patient’s permission … which leads to such difficult situations as below.
A patient presents to the emergency department after leaving work for evaluation of “severe” abdominal pain which she was sure was due to a hernia surgery that she had a few months prior. She was laughing and joking in the room, eating Cheetos and watching television. Apparently, the hour or so wait became too long for her. The multiple trauma victims and patients needing mechanical ventilation were much less important than her work note. So, orange fingers and all, she pecks away on her phone and posts on Facebook how crappy the emergency department is because she had to wait.
It just so happens that one of her Facebook “friends” works as a nurse on the medical floor. The nurse happened to glance at her phone between patients, notices the Facebook update, and calls to the emergency department to ask what the problem is.
Emergency department secretary is frazzled by all of the sick patients and tells the floor nurse it isn’t any of her damn business what is going on in the emergency department and to worry about her own patients instead of checking out Facebook during work hours.
That pisses off floor nurse who then calls hospital administration and tells them that the emergency department is slacking off … which prompts a visit from the Director of Nursing.
When DON arrives, she reviews the situation and pulls the charge nurse aside and asks if we can see this abdominal pain patient ASAP.
Charge nurse (who is awesome) briefly educates DON about the concept of triage and asks DON if she can help register and triage continuing influx of patients. DON says that she has a meeting to attend and leaves.
When the more critical patients have been stabilized, we get in to see the patient.
Her abdominal pain has essentially resolved. Actually, it resolved shortly after she arrived. But she has had this lump on her surgical scar ever since her surgery, it has been bothering her more than usual lately, and she really wants to know what the lump is.
The lump is where they tied the knot for the stitches they put in under your skin. May be the mesh as well. No problems with the surgical site that we can see. You’re welcome to make an appointment with your surgeon if you still have questions.
Oh, and by the way, I think I missed my last period.
Oh, I’ll also need a work note.
Your discharge papers will show when you were discharged. Have a nice day.
So about a half hour after the patient is discharged, the unit secretary suddenly blurts out “Oh … My … God!”
If you read Part 1 about being Facebooked, you’ll know that I have no idea how Facebook works. The secretary was apparently friends with the nurse who was friends with the patient and was therefore able to see what the patient wrote on her wall after she left the emergency department. Again, this makes no sense to me, but that’s because I currently do not and never will use Fecesbook. Anyway, suffice it to say that the secretary was able to see the patient’s posts.
“Serious problems with my stomach. Doctor says I may need another surgery.”
The secretary showed that post to everyone, along with the prior post about how the crappiness of the emergency department.
There was talk of posting an anonymous picture of the patient’s diagnosis, but the consensus voted against it.
So I did what every conscientious physician would do under the circumstances.
I had the secretary print screen shots of the two posts and I pasted them into the patient’s medical records.
Then I thoroughly cursed out Mark Zuckerberg.
This and all posts about patients may be fictional, may be my experiences, may be submitted by readers for publication here, or may be any combination of the above. Factual statements may or may not be accurate. If you would like to have a patient story published on Dr.WhiteCoat.com, please e-mail me.