By A. Minicozzi
On May 1, 2013, I began to work as a Director for a company that specializes in bioethics software and related consulting services. In short, my job is to improve healthcare delivery by educating healthcare professionals how to be better clinicians. When I began my new position, I thought I was well informed of many aspects of bioethics, particularly areas surrounding clinical practice.
For the last nineteen years, I have studied and researched the training process of physicians from a sociological perspective. During this educational journey, I acquired a Master’s degree in Bioethics, which gave me a deeper understanding of the fundamental ethical approaches to patient care.
As Director of a bioethics company, I realized I would face contemporary topics that physicians encounter when providing care to patients, and, in turn, I would produce or review material that discusses these relevant issues. Nothing prepared me for my first assignment: to write about the association between the Health Insurance Portability and Accountability Act (HIPAA) and social media.
Of course, as a bioethicist I have a foundation of knowledge regarding HIPAA, but I was perplexed by the correlation between these two concepts. Not only are these two concepts related, they also have a real impact on the way physicians practice. When HIPAA became a federal law in 1996, the use of social media (Facebook, Twitter, LinkedIn, and YouTube) was not prevalent.
Today, this form of communication is not only used in a personal way, but also in a professional capacity. Nurses text family members as a way to update them on the status of the patient. Physicians post information to the treatment team as a way to keep everyone current on a patient’s progress. This form of communication is commonplace in a clinical setting and can lead to some concern regarding a patient’s privacy. Who knew that such a form of communication would became so ingrained into the clinical setting?
As I did more and more research, I realized a major problem had begun to appear. Physicians who had graduated prior to the use of social media were poorly informed of the HIPAA violations that they may unknowingly commit when using this form of communication within a clinical setting. In fact, I found extreme cases where physicians were incarcerated and/or made to pay major fines. Professional organizations such as the American Medical Association and the American Nurses Association have created guidelines that assist the clinician to follow HIPAA laws when using Social Media. However, they assume that physicians are aware that these guidelines exist and that they take the time to review these suggestions.
Physicians are sometimes placed in situations where they are violating a federal law but not given the proper support to remedy this occurrence. Many people expect that physicians stay current on all the latest clinical treatments, be available when patients need them, and always demonstrate ethical behavior. Unfortunately, physicians are often placed in precarious positions because they are the most senior clinicians involved. This is not to say that nurses have not inadvertently violated HIPAA laws and paid heavy fines. However, there is a level of responsibility placed on physicians to be “God-like” that is not placed on other healthcare workers. Physicians are placed on high pedestals. And when there is blame to be placed they tend to become the fall guys.
As I completed my first assignment, I felt extremely concerned, yet optimistic. My concern stemmed from the lack of instruction physicians receive from colleagues and the way in which this knowledge is delivered. But, as I thought further on this concern, I realized that I am in an extremely unique position to address this concern. My mission in life is to provide support and be an advocate for the physician in his training process. As an employee of a leading bioethics information company, I am providing vital knowledge that is accessible in a convenient and tangible manner. I continue my campaign for physicians to feel safe to practice medicine ethically, and I am optimistic about the outcomes.
A. Minicozzi is the Director of Content Development at ICB. She holds her doctorate in medical sociology and masters in bioethics, both from the University of Pennsylvania. For more information, visit icbioethics.com.