This post is the result of a conversation I had with David Doherty (3G Doctor), Dawson Costello (Medical Student Blog) and Rob Navarro (Sapior) on my birthday. I know I should have been discussing more entertaining topics but when faced by three incredibly bright and interesting people I cannot help but try and learn from them. They certainly got me thinking and any errors below are due to my thinking.
The other day I saw a Facebook status update for a medical student saying that he was “Hating patients”. When someone tried to teach the student that this was a foolish sentence to write the student said he thought no one would find his writing interesting. This is a serious error of judgement.
I am not a fan of Facebook’s founder, and one of the things that trouble me the most about the site is that it encourages a mental model of privacy but has a business model of publicity. In other words, people are comfortable sharing information because they have the impression of private conversations with friends, but fundamentally Facebook benefits from spreading your messages as far and wide as possible. This is why they ban applications that reduce the number of “friends” you have.
The comfort you should feel in Facebook is the same you should feel about picking your nose while in your car: it feels private, but everyone can see you. And with video phones, if you are famous enough, someone will record you.
In the long run, this will not be a problem for most people. First, as everyone gets caught doing something stupid in a social network website, legislation will arise to minimize the fallout, just as politicians step in when everyone makes financial mistakes by borrowing too much or saving too little. Second, and more significantly, people will be more forigiving as they see that everyone is falliable. In 2005 there was a witch hunt over a South Korean woman caught on video phone failing to clean up after her dog in a railway carriage appeared on the internet. In 2015 there will be no such recriminations, in South Korea at least, as such an incident will no longer be news.
But there will never be such clemency for doctors. For example, the public reaction to an NHS manager getting in touch with her friends on Friends Reunited has been severe:
Eastern and Coastal Kent PCT assistant director of strategic partnerships Caroline Davis wrote on Friends Reunited: “I now live in Dover, where I work for the NHS, bullshitting for a living, no change there then.”
I found out recently about discplinary action the trust was compelled to take. The reaction towards doctors will be even more severe. Partly this is because there are so few of us, but mainly because we have a duty to society. We receive heavily subsidized training, the public trust us with their lives, and accords us the respect of professionals.
My advice to medical students is simple: assume everything you write today will be read in 20 years’s time. John Steinbeck has a good line on this:
It seems to me that if you or I must choose between two courses of thought or action, we should remember our dying and try so to live that our death brings no pleasure on the world
What you write will definitely be availabe in that time because Google, and its more powerful successors, index and archive everything. And because storing old data costs less than the revenue from putting advertisments around those data, no matter how trivial the data seems to be. And people will definitely read what you wrote because in 20 years you will be a doctor with status in your community. Members of your community – including patients, journalists and lawyers – will regularly study your older writings to look for patterns of behaviour. Do not give them a reason to think badly of you.
If that means not using Facebook, then stop using Facebook. The privilege of being a doctor is far more significant than anything a free website can offer you.