How many patients have you tweeted today?

A good friend of mine, a playwright and all-around brilliant thinker, recently wrote a play in which Facebook features prominently. A young woman, transplanted by her boyfriend from Boston to Phoenix, seeks to escape her malaise by jumping into the Internet. Abetted and accompanied by Keyboard Cat (hilarious -- you must take a minute and watch it if you aren't already familiar), she embarks on some Alice in Wonderland-type adventures and lands back at home. Safe and sound, mostly.

What the play puts in clear relief is how much Facebook and other social networking technologies have changed our world. Friendships are different; dating is different; parenting is different; even death is different.  

Another thing Facebook has changed: nursing and medicine. Our involvement with social media ranges from the benign to the questionable to the truly hideous

My friend Kristi recently told me that her obstetrician had friended her on Facebook. When she later posted a status update about having heartburn, he sent her an emoticon-laden message (hey, at least it wasn't a wall post) about how she should call his office for a prescription. Cute? Friendly? Helpful? Or a step beyond a line we're really not supposed to cross?

The episode led me to revisit Sachin Jain's insightful 2009 article in the New England Journal of Medicine about his experiences interacting on Facebook with a patient. Read it if you haven't already. Jain writes, “The anxiety I felt about crossing boundaries is an old problem in clinical medicine, but it has taken a different shape as it has migrated to this new medium.”

So true. Social networking, while helpful in breaking down the barriers of distance, social awkwardness, shyness, and time, also threatens to break down more functional barriers -- like those between our professional and personal lives. Did Kristi mean to tell her doctor she was having heartburn? No, or she would have called his office.  But by friending and then messaging her, her physician collapsed the symbolic space between them.  

How about you?  Have you become Facebook friends with patients? Why? How has it worked for you and for them? Use the comment space below to tell us how you're navigating social media safely and effectively -- or why you avoid it entirely.
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