Physical therapists (PTs) and physical therapist assistants (PTAs) use e-mail to communicate with each other, with patients, and with other health care professionals. Students interact with each other using Twitter and instant messaging. It seems nearly everyone has a blog and an account on Facebook. PTs post videos not only on their own Web sites but also on YouTube and elsewhere, often invite comments, and then respond to those comments. PTs, PTAs, and students post questions and suggestions--often about patient care--on LinkedIn, Yahoo!, and other Web sites. APTA has created a number of online "communities" to allow members with similar interests to communicate with each other.
All these actions are aspects of social networking--using the Internet to connect with others. (See "What Is Social Networking?") Some clearly are related to a PT's or PTA'S professional activities. Other networking, equally clearly, deals with that person's personal or social interests. Much is used for both professional and personal interests. These multiple uses, and especially when they overlap, can raise both serious professional and legal concerns.
Public, Permanent, and Powerful
One challenge involves establishing boundaries between professional and personal activities. Blurring that line can trigger moral, ethical, and legal concerns. Technology has made such communications possible, but there's no accompanying rule book on how to separate the two.
Part of the difficulty arises because even the definition of boundaries is evolving. Nancy Kirsch, PT, DPT, PhD, observes, "The problem has intensified with the difference in generations and how we consider personal information." Kirsch, a former member of APTA'S Ethics and Judicial Committee, is a professor of physical therapy in the University of Medicine and Dentistry's School of Health Related Professions in Newark, New Jersey.
Professionalism, one of the 6 elements of APTA's Vision 2020, is defined as: "Physical therapists and physical therapist assistants consistently demonstrate core values by aspiring to and wisely applying principles of altruism, excellence, caring, ethics, respect, communication, and accountability, and by working together with other professionals to achieve optimal health and wellness in individuals and communities. (2)"
"Ask yourself if what you are putting on your social media site is professional and whether it exemplifies the professional image you want to have out there," suggests Paul Welk, PT, JD.
That applies not only to text, but to photos and videos as well. "Sharing photos of oneself in a not-so-professional way--being inebriated or perhaps not using the good body mechanics you preach in your practice--could be harmful. Also, sharing too much personal information on your profile, such as address, e-mail, sexual orientation, or relationship status, may invite more attention from patients than you want to reveal," says Nancy Brox Koftan, PTA. Koftan is a clinical practice improvement coordinator and a member of APTA'S Committee on Risk Management and Member Benefits.
Because social networking and communications occur online, those communications--which might have been private if conducted using other forms of technology such as telephones--now are public and can affect patient safety, privacy, and the PT's professional image)
The majority of Facebook accounts (83.3%) listed at least one form of personally identifiable information, and some accounts displayed material that could be considered potentially unprofessional, according to a recent study. (4) In another recent study--this of incoming pharmacy students' Facebook activity--approximately one third admitted posting information that they would not want faculty, patients, or prospective employers to see. (5)
PTs and PTAs may consider having two social networking sites or accounts--one for social interactions (such as Facebook or MySpace) and one for professional interactions (such as LinkedIn). …