Social media and privacy.

Air Medical Journal 29:3 In 1980, Tim Berners-Lee, a 25-year-old engineer, was doing computer modeling for CERN, the particle-physics laboratory in Geneva, Switzerland, and began the work that was the conception of the World Wide Web. His goal was to find a better way to organize files and link related documents on his hard drive on his computer in a “brain-like way.”1 He wanted a program that could “keep track of all the random associations one comes across in real life”1 and create a system that would facilitate sharing and updating information among researchers. Although the web was conceived as a tool for researchers and academics to share information, the uses and even the focus of the web are a part of everyday life for many people. It is estimated that the web contains at least 25.21 billion pages on an estimated 110 million websites.2 Never before have individuals had so much information at their fingertips, and never have people had such an opportunity to share information that they would never have considered sharing with strangers before. The explosion of social and professional networking sites such as Facebook and LinkedIn; media-sharing sites such as Flickr and YouTube; blogging sites such as Blogger and WordPress; and even forum sites such as Flightweb and JustHelicopters has created an attractive means for both purposeful and accidental dissemination of damaging, harmful, and possibly illegal information on the World Wide Web. These virtual communities allow people to interact over the Internet in a way that is far beyond the static web pages, text messages, and email of the 1990s.3 The social media communities have forged groups on nearly any topic, from cancer care to cooking, dating to depression, and workplace gripes to restaurant reviews. Each community can be reached on multitudes of platforms from PCs to PDAs. A two-sided conundrum exists. First are the issues facing employers—from the failure of policy and appropriate education for employees to keeping pace with the rapid growth of social networking media. Second are the issue of employees recognizing and understanding their heightened responsibility in our digitally driven world. A recent study in the Journal of the American Medical Association (JAMA) assessed the experience of US medical schools regarding online posting of unprofessional content by students.4 The researchers found that 60% (47/78) of US medical schools that responded reported incidents of students posting unprofessional online content. Violations of patient confidentiality were reported by 13% (6/46). Student use of profanity (52%, 22/42), frankly discriminatory language (48%, 19/40), depiction of intoxication (39%, 17/44), and sexually suggestive material (38%, 16/42) was commonly reported. The issue here is not just patient privacy, but also the portrayal of organizations in the public eye. The widespread use of social media raises privacy implications for both employees and employers. Most individuals view their personal pages as private; however, the reality is far different. The online name of “HeliRN” easily identifies an individual and has a connotation for the reader. A searcher of career information on becoming a flight nurse may find this name and click on it, leading to a social networking site that has information about a career—and a photo of “HeliRN” wearing a camouflaged jacket over a low-cut T-shirt with a large collection of dog-tags around her neck and a plastic cup of beer in her hand while an unknown male is playfully sticking his tongue into her ear. The posted material can be accessed by people for whom it was never intended, and that is where the harm often begins. Regardless of the privacy settings set by the individual user, personal information and communications posted may be read by nearly anyone and everyone. Although many employers have guidelines and codes of conduct for e-mail and internet use, social networking and media-sharing sites pose different privacy challenges that should be specifically addressed in a similar guidelinesbased manner. The crafting of policies that establish best practices and outline expectations for acceptable use both in and away from the workplace and set out the consequences of misuse are paramount for any employer. Employers should inform employees in plain language why it is important to keep some personal and corporate information confidential—about themselves, their coworkers, patients, and the organization. This seems like a commonsense approach; however, as with all of the issues in the accompanying sidebar, none of the individuals thought they were doing anything wrong. Clarity in expectations could well have kept these people out of trouble. Although the medical community became very “privacy aware” in the age of the Health Insurance Portability and Accountability Act (HIPAA), it has not done a very good job of defining acceptable behaviors relative to personal behavior. Lawyer jokes aside, ethics and accountability are centerpiece to the legal community. The Model Rules of Professional Conduct5 provide a framework for the professional conduct of all lawyers. Specifically, Rule 8.4 (g) states: “It is professional misconduct for a lawyer to: (g) engage in conduct, in a professional capacity, manifesting, by words or conduct, bias or prejudice based upon race, gender, religion, national origin, disability, sexual orientation, age, socioeconomic status, or similar factors.” Recent Legal Matters John R. Clark, JD, MBA, NREMT-P, FP-C, CCP-C, CMTE