MDchat Transcript May 24, 2011

#MDchatHealthcare Hashtag Twitter Transcript

From: Tue May 24 18:00:00 PDT 2011To: Tue May 24 19:05:00 PDT 2011

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MD_Chat Welcome to #MDchat - Tonight's chat is moderated by @PhilBaumann We'll fireup the engines in a moment, but first introduce yourselves!Tue May 24 18:00:38 PDT 2011

NateOsit Yello everyone, Nate here- Health IT geek, healthcare chat cheerleaderextraordinaire! #MDchatTue May 24 18:02:18 PDT 2011

hjluks Howard Luks ... Orthopedist from NY Shld be an interesting hour #mdchatTue May 24 18:02:18 PDT 2011

EllenRichter I'm encouraging the #RNchat followers to "tune in" to #MDchat tonite for somethoughts on medical & health professionals & social media useTue May 24 18:03:14 PDT 2011

RichmondDoc Mark, family doc in #RVA, here is a participant (as opposed to moderating); gladas always to be along for the ride. #MDChatTue May 24 18:03:41 PDT 2011

thehealthmaven Hi everyone! #mdchat how are you?Tue May 24 18:03:48 PDT 2011

hjluks @thehealthmaven Lea... how are you... do u ever have chat burnout? :-) #mdchatTue May 24 18:04:22 PDT 2011

thehealthmaven @hjluks @RichmondDoc @NateOsit hi there! are you guys doing ok? #mdchatTue May 24 18:04:30 PDT 2011

EllenRichter Hi! Ellen here, a critical care nurse & legal nurse consultant living in S. Florida. Ienjoy health related social media activities #MDchatTue May 24 18:04:45 PDT 2011

DrJonathan Hi #MDChat! Lurking tonight but wanted to say hello!Tue May 24 18:04:45 PDT 2011

EllenRichter LOL I made my first intro without the hashtag....duh.... #MDchatTue May 24 18:05:06 PDT 2011

ocamsrazor Jon here, "unprofessional" maybe - but stellar internist! #mdchat #mdchatTue May 24 18:05:21 PDT 2011

NateOsit LOL! She's a chat champ! RT @hjluks: @thehealthmaven Lea... how are you... dou ever have chat burnout? :-) #MDchatTue May 24 18:05:24 PDT 2011

jodyms @MJMudd checking the hashtags of topics you're interested in is one way. Upnow is #MDChatTue May 24 18:05:24 PDT 2011

hjluks @DrJonathan shld b interesting chat... u won't be able to lurk for long :-) Congratson graduation! #mdchatTue May 24 18:05:34 PDT 2011

MD_Chat OK, we'll get started in a moment. Two topics are planned, but first one might be arocker ;) Please add T1, etc to responses. #MDchatTue May 24 18:06:04 PDT 2011

DrJonathan @hjluks Haha thank you! It's on Sunday! Maybe I'll join in after my phone call.#mdchatTue May 24 18:06:09 PDT 2011

thehealthmaven @hjluks well, I start to run out of steam around 9:30 pretty consistently :)#worklifebalance :) #mdchatTue May 24 18:06:13 PDT 2011

EllenRichter Thanks for the quick RTs, peeps! @jodyms @Colleen_Young @nickdawson#MDchatTue May 24 18:06:22 PDT 2011

RichmondDoc @thehealthmaven @hjluks @NateOsit Hi, Lea et al. Rocking group, as always.#MDChatTue May 24 18:06:29 PDT 2011

EllenRichter @ocamsrazor LOL I like your intro :) #MDchatTue May 24 18:06:46 PDT 2011

hjluks @thehealthmaven I did note the zzzz's on your post last night :-) #mdchatTue May 24 18:06:46 PDT 2011

MD_chat T1 Standards of Professionalism: See @Doctor_Vʼs http://mdch.at/iteMSJ Whatconstitute “good” and “bad” conduct online? #MDchatTue May 24 18:06:47 PDT 2011

amyrnbsn Amy from NY. Happy to listen, excited to learn, and may share an opinion or two,or three... Hi. #MDChatTue May 24 18:07:18 PDT 2011

EllenRichter @DrJonathan Oh yes! Congrats! How exciting! :) #MDchatTue May 24 18:07:25 PDT 2011

KathyKastner #MDChat such a gr8 topic (TY @Doctor_V) doing dual duty with #mhsmTue May 24 18:07:26 PDT 2011

colleen_young @drpauldempsey Hi Paul do you know about #MDchat? It just started at 9pm ET.Not too late to join in if your interested whilst on staycationTue May 24 18:07:45 PDT 2011

hjluks Number of issues here... nature of post... chronicity or first time blunder, HIPAA,etc... #mdchatTue May 24 18:07:58 PDT 2011

ocamsrazor @EllenRichter it's true, don't judge a book by the cover #mdchatTue May 24 18:07:58 PDT 2011

hjluks @amyrnbsn menu? :-) #mdchatTue May 24 18:08:14 PDT 2011

NateOsit @amyrnbsn Hi Amy! Glad you could make it! #MDchatTue May 24 18:08:53 PDT 2011

NursingCenter @EllenRichter Thanks Ellen ~ will follow along! #RNchat #MDchatTue May 24 18:09:01 PDT 2011

RichmondDoc T1 This post stream was interesting; I think the intro was a bit over the edge butthe follow-up comments pushed it. #MDChatTue May 24 18:09:16 PDT 2011

amyrnbsn @NateOsit Hey. #MDChatTue May 24 18:09:38 PDT 2011

RichmondDoc T1 Talking about patients--specific patients--in such a way that their dignity andtheir privacy are invaded is unprofessional. #MDChatTue May 24 18:09:52 PDT 2011

RichmondDoc T1 But the little back and forth and "fish or cut bait" moved it fully into theunprofessional realm in my opinion. #MDChatTue May 24 18:10:26 PDT 2011

MD_chat @RichmondDoc Lots of comments on it. #mdchatTue May 24 18:10:40 PDT 2011

hjluks I think it was a clear HIPAA issue... everything else aside. Not mny priapism casesin Florida last night... just guessing :-) #mdchatTue May 24 18:10:59 PDT 2011

RichmondDoc T1 *If* we speak about patients, we should ensure to protect privacy and dignity ofpatients, and have a reason for doing so. #MDChat

Tue May 24 18:11:16 PDT 2011

hjluks @RichmondDoc started to feel like a sermo stream #mdchatTue May 24 18:11:21 PDT 2011

JayGordonMDFAAP #mdchat waiting for news from NY's 26th and watching comments here,too.Tue May 24 18:11:28 PDT 2011

RichmondDoc @hjluks Absolutely a HIPAA risk. Anyone with a bit of time and a good browsercould find details about this. #MDChatTue May 24 18:11:45 PDT 2011

NateOsit T1 What concerns me is how ppl who act carelessly online may reinforce theirconduct with patients #MDchatTue May 24 18:12:07 PDT 2011

hjluks @JayGordonMDFAAP what am I missing in NY ??? #mdchatTue May 24 18:12:28 PDT 2011

EllenRichter T1 It's an important lesson to be learned by many of us in the medical community.I'm just not sure it needed to be a trial by fire #MDchatTue May 24 18:12:31 PDT 2011

nickdawson #MDchat interloper here, though curious, is it the choice of venue or culture?Would same comments be questionable at dinner with friends?Tue May 24 18:12:48 PDT 2011

hjluks Agree Ellen... and when I really had the chance to think about it... it would havebeen far more productive as a teaching moment #mdchatTue May 24 18:13:31 PDT 2011

akroundtree Agreed. “@RichmondDoc: T1 The little back and forth and "fish or cut bait" movedit fully into unprofessional #MDChatTue May 24 18:13:51 PDT 2011

NateOsit @nickdawson I think those in healthcare should strive for compassion whereverthey are, whether on twitter or at dinner #MDchatTue May 24 18:14:13 PDT 2011

RichmondDoc @nickdawson I would be uncomfortable with such language at a dinner w/friends...but more egregious b/c fully public commentary. #MDChatTue May 24 18:14:17 PDT 2011

ocamsrazor @EllenRichter agree, was thrown under the bus #mdchatTue May 24 18:14:37 PDT 2011

hjluks @nickdawson good Q Nick... It wld b in poor taste anywhere... IMHO. On a publicomnipresent stream ... yikes #mdchatTue May 24 18:14:51 PDT 2011

EllenRichter T1 @hjluks Absolutely agree. Almost felt like there was a small amt of bullyingwhich could have been focused on positive learning #MDchatTue May 24 18:15:16 PDT 2011

hjluks @ocamsrazor @EllenRichter good analogy... wld have been a gr8 teachingmoment... and will be for me in future! #mdchatTue May 24 18:15:27 PDT 2011

RichmondDoc T1 Over time, I've been following that account, but haven't learned too much fromit. Tends to be a bit too much pt info there. #MDChatTue May 24 18:15:44 PDT 2011

RichmondDoc T1 Again, how hard would it be to find a hospital doing large #s of livertransplants...not automatic, but not impossible. #MDChatTue May 24 18:16:18 PDT 2011

hjluks Most docs do not realize just how difficult de-identification of patient is! The moreunusual the case, the easier to cross line #mdchatTue May 24 18:16:47 PDT 2011

RichmondDoc T1 I think discussions of patient care should be focused more on the big pictureand what we might learn from working w/ patients... #MDChatTue May 24 18:16:59 PDT 2011

ocamsrazor But, I think skewed view here...plenty of "salty talk" accepted @hosp. we aredoctors not monks! #mdchatTue May 24 18:17:11 PDT 2011

nickdawson @NateOsit @richmonddoc @hjluks - thanks for reaffirming my faith in ethics anddecency! #mdchatTue May 24 18:17:14 PDT 2011

NateOsit T1 I've also seen other examples, and feel bad she was singled out. Let's focuson collective improvement, not blame-game #MDchatTue May 24 18:17:18 PDT 2011

RichmondDoc T1 .... I'm not sure that simply telling us the patients you saw adds much value tothe disucssion. #MDChatTue May 24 18:17:39 PDT 2011

jinpack M1 student jumping in. #MDchatTue May 24 18:17:52 PDT 2011

hjluks @NateOsit vry true... but some, like reporters will seize the moment. #mdchatTue May 24 18:18:09 PDT 2011

MD_Chat T1 Follow-up The public doesn't always have full understanding of what docs do.How best to give "raw" sense w/o violating dignity? #MDchatTue May 24 18:18:10 PDT 2011

hjluks @jinpack jump! #mdchatTue May 24 18:18:17 PDT 2011

RichmondDoc @ocamsrazor I have not doubt these comments happen in real life...but wouldyou do it on the elevator? In the lobby? #MDChatTue May 24 18:18:19 PDT 2011

ePatientDave @hjluks What, are you suggesting there are a lot of OLD people in FL?? :)#mdchatTue May 24 18:18:50 PDT 2011

MD_chat @jinpack Welcome! #MDchatTue May 24 18:19:25 PDT 2011

JayGordonMDFAAP #Mdchat Howard, significant election Polls just closed.Tue May 24 18:19:26 PDT 2011

hjluks @ePatientDave nope... priapism not isolated to older folk :-) #mdchatTue May 24 18:19:31 PDT 2011

jinpack T1 followup: raw sense w/o damage: 1) anonymize patient, 2) think if patient sawcomment would he'sje be hurt? feel betrayed? #MDchatTue May 24 18:19:31 PDT 2011

rlbates Check out @movinmeat 's response http://bit.ly/lThFAQ #MDchatTue May 24 18:19:44 PDT 2011

hjluks @JayGordonMDFAAP oops #mdchatTue May 24 18:19:45 PDT 2011

amyrnbsn T1 True, blog could have been written w/o identifying account, just the tweets fordiscussion. #MDChatTue May 24 18:19:50 PDT 2011

ocamsrazor @RichmondDoc @ocamsrazor No #mdchatTue May 24 18:19:50 PDT 2011

EllenRichter T1 @NateOsit I agree with you abt not singling out 1 culprit when there are many(much worse)...more productive to use examples #MDchatTue May 24 18:19:52 PDT 2011

akroundtree So the same concern if MD made jokes at a social gathering? RT @NateOsit: T1careless action online may reinforce conduct with pts #MDchatTue May 24 18:20:47 PDT 2011

hjluks @rlbates @movinmeat saw that... puttin' gas on the flames :-) But justified from a"shld hv been teaching moment perspective" etc #mdchatTue May 24 18:20:57 PDT 2011

RichmondDoc @ocamsrazor And I think that's where this crossed the line. We are all human,and will say things we regret. Need to be aware. #MDChatTue May 24 18:21:15 PDT 2011

jinpack @NateOsit I agree slingle out ≠ productive, but we tweet at own risk, followingproportional to repercussions #MDchatTue May 24 18:21:34 PDT 2011

ocamsrazor @hjluks @ePatientDave I heard there is a black market for viagra in the nursing

homes #mdchatTue May 24 18:21:40 PDT 2011

hjluks @JayGordonMDFAAP u running for office ? :-) #mdchatTue May 24 18:21:44 PDT 2011

EllenRichter T1 We're all learning how to navigate the social media ocean while maintainingprofessional decorum. It requires constant thought. #MDchatTue May 24 18:22:40 PDT 2011

rlbates @hjluks Should have begun teaching movement privately. #MDchatTue May 24 18:22:52 PDT 2011

RichmondDoc T1 If this were to be considered unprofessional, it would be for the same reasonsthat speaking in the lobby is unprofessional. #MDChatTue May 24 18:23:26 PDT 2011

jinpack @EllenRichter True, and if we give constant thought we avoid thoughtless acts#MDchatTue May 24 18:23:29 PDT 2011

EllenRichter @jinpack Hopefully! :) #MDchatTue May 24 18:23:52 PDT 2011

jinpack @RichmondDoc More like announcing to the world... #MDChatTue May 24 18:23:59 PDT 2011

DrPaulDempsey T1: No shop talk that you wouldn't have with patient in the room with family and afriend or two (of the patient) present #mdchatTue May 24 18:24:03 PDT 2011

thehealthmaven @JayGordonMDFAAP @hjluks that is the underpinning of the entire convo - thedifficulty in de-identifying, uncertain protection #mdchatTue May 24 18:24:13 PDT 2011

RichmondDoc T1 May not be that these things are never said, but shouldn't be said in a publicforum. And the flirt give/take is more unsettling #MDChatTue May 24 18:24:20 PDT 2011

TheNerdyNurse #mdchat T1 - social medial judgment is a skill practiced and learned just likeclinical judgment - some start out better than othersTue May 24 18:24:23 PDT 2011

hjluks @rlbates yes... or generically scrubbed for wider teaching moment. #mdchatTue May 24 18:24:23 PDT 2011

jinpack @TheNerdyNurse so true... #mdchatTue May 24 18:24:47 PDT 2011

hjluks @thehealthmaven @JayGordonMDFAAP @hjluks virtually impossible to de-identify that patient #mdchatTue May 24 18:25:03 PDT 2011

NateOsit @MD_Chat T1b Ok to discuss experiences, but show some respect, compassion,and some common sense. #MDchatTue May 24 18:25:20 PDT 2011

RichmondDoc T1 I think the importance of thoughtfulness/carefulness is key. What if the authorwas tired/post-call? Maybe no ill intent ... #MDChatTue May 24 18:25:27 PDT 2011

hjluks @thenerdynurse true... the fear mny of us have is that this will scare lurkers andnewbies (eggs) away. #mdchatTue May 24 18:25:49 PDT 2011

jinpack @hjluks yup. I said, how many 36h priapism were seen by female asiananesthesiologists on 5.22? Totally identifiable #mdchatTue May 24 18:25:55 PDT 2011

RichmondDoc T1 ... but the end results expose too much about an individual's health issues aretoo personal. #MDChatTue May 24 18:26:16 PDT 2011

drpauldempsey T1: I try to give links and resources that I think are accurate, that patients may notcome across on their own. #mdchatTue May 24 18:26:29 PDT 2011

hjluks @jinpack @hjluks in florida in lg hosp that performs ton of liver transplants#mdchatTue May 24 18:26:33 PDT 2011

TheNerdyNurse #mdchat T1 best to discuss PT care based upon collaborative examples to avoidHIPAA violations. Not specific encounters.Tue May 24 18:26:51 PDT 2011

Doctor_V What's the question? #MDchatTue May 24 18:26:58 PDT 2011

rlbates MT @RichmondDoc T1 If this were considered unprofessional, it would be forsame reasons that speaking in lobby is unprofessional. #MDChatTue May 24 18:27:09 PDT 2011

peds_id_doc @NateOsit #mdchat I said my bit on @Doctor_V 's blog, but the only thing trulylacking I saw was common sense!Tue May 24 18:27:10 PDT 2011

NateOsit @akroundtree I'd be concerned that the MDs lack of respect, yes. #MDchatTue May 24 18:27:25 PDT 2011

MD_chat @Doctor_V Main topic http://twitter.com/#!/MD_chat/status/73193260956385280#mdchatTue May 24 18:27:54 PDT 2011

RichmondDoc T1b I think we *can* talk about pts, but carefully, discussing bigger issues througha pt presentation, and upon careful reflection. #MDChatTue May 24 18:27:57 PDT 2011

MeredithGould @Doctor_V To be...or not to be. #MDchatTue May 24 18:27:58 PDT 2011

jinpack @peds_id_doc Yep, sometimes that counts for everythig #mdchatTue May 24 18:28:08 PDT 2011

TheNerdyNurse @jinpack @hjluks how many PTs go online and google Asian anesthesiologistand priapism after their priapism? #MDchatTue May 24 18:28:16 PDT 2011

peds_id_doc @NateOsit #mdchat far worse examples out there to pick on. Why drag HER intopublic forum without notifying (could've contacted her by DM)?Tue May 24 18:28:16 PDT 2011

RichmondDoc T1b comments in the heat of the moment, when tired or not yet fully awake, or w/oreflection, are not the best ways to to it. #MDChatTue May 24 18:28:28 PDT 2011

rlbates @DrPaulDempsey That varies greatly depending on patient and family/friends. :)#MDchatTue May 24 18:28:35 PDT 2011

jinpack @TheNerdyNurse Not sure I understand your Q. Point was, patient identifiable viaMD's twitter profile and other public info #MDchatTue May 24 18:29:07 PDT 2011

ditzydoctor @hjluks I agree! It is very difficult to completely de-identify a patient #mdchatTue May 24 18:29:23 PDT 2011

rlbates & sense of humor? RT @NateOsit @MD_Chat T1b Ok to discuss experiences, butshow some respect, compassion, and some common sense. #MDchatTue May 24 18:29:30 PDT 2011

EllenRichter @Doctor_V We are discussing your very interesting blog post & its repercussionson the Twitter health professionals. Its been good! #MDchatTue May 24 18:29:35 PDT 2011

RichmondDoc @rlbates @DrPaulDempsey Which is why context, understanding, anddiscussion w/ patients/family is important. #MDChatTue May 24 18:29:44 PDT 2011

hjluks @thenerdynurse @jinpack @hjluks doesnt matter... #mdchatTue May 24 18:29:56 PDT 2011

akroundtree Yes. Anonymizing accounts is important. #mdchat | Is it Ethical to Use Public#Twitter Accounts w/o Consent? http://t.co/Wpa6UmBTue May 24 18:30:23 PDT 2011

thenerdynurse @jinpack I see. I'm thinking more tree in the falling. Whether it makes a sound ifno one hears. Guess it does. #mdchatTue May 24 18:30:58 PDT 2011

DrPaulDempsey True but I don't see myself having that convo with family #mdchat RT @rlbates:That varies greatly depending on patient and...Tue May 24 18:31:08 PDT 2011

hjluks @akroundtree that's a vry different issue... If u hit the enter button, all expectationsof privacy go away, #mdchatTue May 24 18:31:25 PDT 2011

nursefriendly @amyrnbsn Hello Everyone, Andrew Lopez, RN from Jersey :) #MDChatTue May 24 18:31:28 PDT 2011

jinpack @akroundtree I would advise against anonymizing one's account. Encouragescarelessness #mdchat #TwitterTue May 24 18:31:33 PDT 2011

NateOsit @akroundtree My 2nd week working in a hospital, I made complaints about MDsand staff saying "crazy","gay","lame". Hurtful, IMO #MDchatTue May 24 18:31:57 PDT 2011

nursefriendly @amyrnbsn Hello Amy, lotsa familiar faces here . . . #MDChatTue May 24 18:31:59 PDT 2011

amyrnbsn T1 Tweets for comedic effect are tricky in the healthcare arena. Compassion first,then humor - if appropriate. #MDChatTue May 24 18:32:02 PDT 2011

hjluks @thenerdynurse yes... the infraction is the event... not if the patient actually seesit... or hears us in elevator, etc. #mdchatTue May 24 18:32:06 PDT 2011

MattMerg T1 Perhaps it is the doctor's anonymity that is the root of the problem here.#MDChatTue May 24 18:32:08 PDT 2011

MD_Chat I think we'll continue with T1 - it's a good flow, and there are rivulets of sub-topics.;) #MDchatTue May 24 18:32:14 PDT 2011

peds_id_doc @RichmondDoc #mdchat unfortunately twitter (and FB statuses) lend themselvesto in-the-moment posts. Certainly seen colleagues slip up.Tue May 24 18:32:24 PDT 2011

EllenRichter T1 It doesnt matter if the patient never sees the comments. We cant make medicalcomments that identify a specific person #MDchatTue May 24 18:32:32 PDT 2011

nursefriendly Anonymous accounts are rarely anonymous to a professional investigator. Theygive a false sense of security. #MDChatTue May 24 18:32:42 PDT 2011

amyrnbsn I think so too. RT @MattMerg: T1 Perhaps it is the doctors anonymity that is theroot of the problem here. #MDChatTue May 24 18:32:59 PDT 2011

hjluks @MD_Chat rivulets :-) ? #mdchatTue May 24 18:33:00 PDT 2011

TheNerdyNurse @akroundtree if you post it on twitter it should be considered public domain.Unless you are copying and claiming to try to sell #mdchatTue May 24 18:33:03 PDT 2011

amyrnbsn @nursefriendly Hello there! :) #MDChatTue May 24 18:33:07 PDT 2011

jinpack @akroundtree @hjluks the intent of Twitter is to publish as widely as can, getretweets/follows. Not privacy #mdchat #TwitterTue May 24 18:33:13 PDT 2011

peds_id_doc @nursefriendly #mdchat I've always posted under real name, sometimes to mychagrin, but that's how you learn.Tue May 24 18:33:34 PDT 2011

MattMerg T1 People tend to watch what they say when their faces and real names areattached to their posts. #MDChatTue May 24 18:33:59 PDT 2011

nursefriendly t1 @RichmondDoc You'd think that doctors could keep it all hypothetical andleave identifying information out of it. #MDChatTue May 24 18:34:01 PDT 2011

akroundtree Yes. Comm 101: different venues /media call for different decorum.“@RichmondDoc: T1 Shouldn't be said in a public forum. #MDChat”Tue May 24 18:34:03 PDT 2011

Doctor_V @peds_id_doc The medium is not an excuse for irresponsible conduct. Veryweak argument #MDchatTue May 24 18:34:13 PDT 2011

Dr_Mum #MDchat T1 So should we go anon or not? Can we just not mention that part ofour lives at all?Tue May 24 18:34:22 PDT 2011

RichmondDoc @peds_id_doc Which I think is why writing about patient issues may be betterdone in a blog or a book. Gawande writes about pts ... #MDChatTue May 24 18:34:23 PDT 2011

drpauldempsey I also give a glimpse of the other stuff I do: committees, CME, legal work etc.Patients seem to like the peak behind the scene #mdchatTue May 24 18:34:30 PDT 2011

RyanMadanickMD Sorry All...coming in late tonight!! #mdchatTue May 24 18:34:36 PDT 2011

EllenRichter Haha...I thought the same thing :) RT @hjluks: @MD_Chat rivulets :-) ? #MDchatTue May 24 18:34:45 PDT 2011

@nursefriendly hypothetical? identifiable? NO matter. If it could hurt patient

jinpack feelings, don't tweer #MDChatTue May 24 18:34:50 PDT 2011

MD_chat T1 How practical is de-identification? Especially if a physician is publishing real-time (or close to it)? #MDchatTue May 24 18:34:51 PDT 2011

RichmondDoc @peds_id_doc ... and he writes eloquently. But he writes upon reflection, and tiespatients' experiences to bigger issues. #MDChatTue May 24 18:35:06 PDT 2011

TheNerdyNurse @MattMerg keeps you honest. And hopefully more accountable #mdchatTue May 24 18:35:09 PDT 2011

peds_id_doc @Doctor_V #mdchat not saying it's an excuse, but there were better ways tohandle it (both sides, before and after).Tue May 24 18:35:15 PDT 2011

RyanMadanickMD @MD_Chat T1: I like to recall the "Flea" fiasco... #mdchatTue May 24 18:35:31 PDT 2011

RichmondDoc @MD_Chat I would never try and de-identify. If I wanted to make a point via pt.presentation, I would invent a patient's case. #MDChatTue May 24 18:35:36 PDT 2011

amyrnbsn @RichmondDoc @peds_id_doc yes, too easy to misinterpret in 140, too easy toexpress wrong tone in 140. #MDChatTue May 24 18:35:38 PDT 2011

peds_id_doc @Doctor_V #mdchat an ideal situation - she gets a private DM, deletes tweets, noone else knows. Instead...here we are on MDchat.Tue May 24 18:35:49 PDT 2011

nursefriendly T1@NateOsit Lotsa examples of HCPs getting careless unfortunately. #MDchatTue May 24 18:35:54 PDT 2011

jinpack @rlbates Yes, but not in medicine where accountability & transparency matter topatient care #hcsm #MDchatTue May 24 18:36:06 PDT 2011

Doctor_V #MDchat Deidentification of pt info hard enough without real time elementTue May 24 18:36:18 PDT 2011

ditzydoctor @rlbates @nateosit @md_chat sense of humour is v impt! :) #mdchatTue May 24 18:36:36 PDT 2011

NateOsit T1 If you note your practicing location, time of tweet + your specialty is plenty ofPHI to constitute HIPAA violation #MDchatTue May 24 18:36:42 PDT 2011

MattMerg De-identification of a patient is near impossible;but promoting a culture of willingself-identification amongst docs O/L is easier #MDChatTue May 24 18:36:42 PDT 2011

hjluks @peds_id_doc @Doctor_V on the other hand... all flames aside... it can be agood teaching moment. #mdchatTue May 24 18:36:47 PDT 2011

TheNerdyNurse #mdchat T1 every time I see someone tweet about a PT they "just saw" I get a littleuneasy. Putting themselves and pts at risk.Tue May 24 18:36:49 PDT 2011

nursefriendly T1 @EllenRichter So much of it is just plain common sense, you wonder whatpeople are thinking at times. #MDchatTue May 24 18:37:02 PDT 2011

PracticalWisdom Lisa Trainer/Public Speaker. Topic was so G8 could not stay away. #MDchatTue May 24 18:37:15 PDT 2011

jackiefox12 I'm a patient, not a health care professional. I would never go near a doc whothinks broadcasting juvenile tweets about pts is ok. #mdchatTue May 24 18:37:35 PDT 2011

jinpack T1 If it really is valuable teaching material, why not involve patient's permission,let them control deidentification #MDchatTue May 24 18:38:00 PDT 2011

Neil_Mehta Professionalism means putting pt's interest above docs personal interest. whoseinterest was served by putting this info on twitter #mdchatTue May 24 18:38:08 PDT 2011

hjluks @jackiefox12 thx 4 joining in Jackie #mdchatTue May 24 18:38:10 PDT 2011

Doctor_V what would Flea do on Twitter, I wonder “@ryanmadanickmd: @MD_Chat T1: Ilike to recall the "Flea" fiasco... #mdchat”Tue May 24 18:38:19 PDT 2011

hjluks @jinpack u can do that... #mdchatTue May 24 18:38:33 PDT 2011

peds_id_doc @doctor_v #mdchat actually, I retract that. Ideal situation is it doesn't get tweetedin the first place. No arguments there :-/Tue May 24 18:38:38 PDT 2011

nursefriendly @peds_id_doc I've been posting to listserv discussion groups for decades, andone of the first things you learn is to say only what #mdchatTue May 24 18:39:18 PDT 2011

TheNerdyNurse @jinpack T1 agree. Many PTs would be honored to be used as a teaching tool#mdchatTue May 24 18:39:21 PDT 2011

PracticalWisdom T1: Even if not giving "real name" this can help increase some Patient Fears re:MD's. @hjluks as U said "don't be stupid." #MDchatTue May 24 18:39:26 PDT 2011

Doctor_V @jackiefox12: I'm a pt, not a health care pro. I would never go near a doc whothinks broadcasting juvenile tweets about pts is ok. #mdchatTue May 24 18:39:33 PDT 2011

MD_Chat T1 Let's assume tweets, etc. are de-identified (*letter* of law (HIPAA)): what aboutthe *spirit* of patient dignity? #MDchatTue May 24 18:39:48 PDT 2011

jinpack @hjluks I know patients already volunteer in teaching, just questioning of tweetsabout them on the fly is wise at all #mdchatTue May 24 18:39:49 PDT 2011

nursefriendly @peds_id_doc to say only what you would in public, because all posts will bevisible and archived for a very long time to come. #mdchatTue May 24 18:40:00 PDT 2011

NateOsit +1 RT @thenerdynurse: @jinpack T1 agree. Many PTs would be honored to beused as a teaching tool #MDchatTue May 24 18:40:00 PDT 2011

RN_ing Nurse comment here: twitter is for democratization of the message ....considerthat, and not policing the talk...#mdchatTue May 24 18:40:05 PDT 2011

hjluks @PracticalWisdom my own personal filter... :-) #mdchatTue May 24 18:40:09 PDT 2011

JayGordonMDFAAP #mdchat I ask pts to follow me on Twitter. Give them heads up about kids' tummybug of the week. MD anonymity is not good.Tue May 24 18:40:36 PDT 2011

jinpack T1 what about "spirit": I'm pretty sure our JOB is to look out for pt's best interest...#MDchatTue May 24 18:40:53 PDT 2011

Doctor_V We have a commitment that goes well above HIPAA #MDchatTue May 24 18:40:54 PDT 2011

nursefriendly @RichmondDoc Ha, ha, you don't have lunch at the nurses station too often doyou Mark? Laypeople lose their appetites. #MDChatTue May 24 18:40:57 PDT 2011

RichmondDoc @MD_Chat T1 The spirit of our responsibility and professionalism should trumpHIPAA; this stream shouldn't have come out at all IMO. #MDChatTue May 24 18:40:58 PDT 2011

hjluks @MD_Chat no brainer... every post I place on Tw/blog/FB I assume the nextpatient is seeing.... #mdchatTue May 24 18:41:18 PDT 2011

NateOsit T1 Docs not respecting patients should be subject to community response. Callout bad apples. #MDchatTue May 24 18:41:33 PDT 2011

RyanMadanickMD Good advice Howard RT @hjluks: @MD_Chat no brainer... every post I place onTw/blog/FB I assume the next patient is seeing.... #mdchatTue May 24 18:41:35 PDT 2011

jinpack Good tip: RT @hjluks: @MD_Chat no brainer... every post I place on Tw/blog/FB Iassume the next patient is seeing.... #mdchatTue May 24 18:41:40 PDT 2011

peds_id_doc @hjluks @doctor_v #mdchat I think it has been a teaching moment for all. Don'tmean to flame - diff of opinion not necc disrespect.Tue May 24 18:41:45 PDT 2011

rlbates Humor and respect are mutually exclusive RT @jinpack: @rlbates Yes, but not inmedicine where accountability & t.... #hcsm #MDchatTue May 24 18:41:59 PDT 2011

RyanMadanickMD T1: "In order to care FOR people, you first have to care ABOUT people." -- ClaudeBotha (conference @UNC_Health_Care 05/24/11) #mdchatTue May 24 18:42:05 PDT 2011

Doctor_V “@NateOsit: T1 Docs not respecting patients should be subject to communityresponse. Call out bad apples. #MDchat”Tue May 24 18:42:08 PDT 2011

akroundtree Thanks for sharing that. We need more "do unto others" filters. “@NateOsit: MDsand staff saying "crazy","gay","lame". Hurtful, IMO #MDchat”Tue May 24 18:42:21 PDT 2011

hjluks @peds_id_doc understood :-) I'm calm :-) LOL #mdchatTue May 24 18:42:31 PDT 2011

macobgyn Act like you do all day everyday. Be normal. #mdchatTue May 24 18:42:43 PDT 2011

thenerdynurse #mdchat T1 transparency on twitter encourages greater thought and bettertweets. Be true to yourself, honest, it's just easier.Tue May 24 18:42:46 PDT 2011

nursefriendly @jinpack You would think people would be more sensitive. If they think -anonymous, they may feel there is no risk/repercussions #MDChatTue May 24 18:42:51 PDT 2011

jinpack @rlbates not neccesarily, humor to cheer up patient =professional. laughing atpatient's expense =Not #MDchatTue May 24 18:43:19 PDT 2011

NateOsit Well said! RT @Doctor_V: We have a commitment that goes well above HIPAA#MDchatTue May 24 18:43:40 PDT 2011

PracticalWisdom @Doctor_V @NateOsit: She also states she is an anesthesiologist. What mightshe say when they are asleep. Pt Very Vulnerable. #MDchatTue May 24 18:43:42 PDT 2011

RichmondDoc T1 We can laugh and share *with* patients, but necessary to know them well, andto have a long-term relationship. #MDChatTue May 24 18:43:49 PDT 2011

rlbates In a respectful manner @NateOsit T1 Docs not respecting patients should besubject to community response. Call out bad apples. #MDchatTue May 24 18:44:12 PDT 2011

RichmondDoc T1 At the end of the day: what would this patient think if/when they saw their caseinvoked in public? Would they be OK with this? #MDChatTue May 24 18:44:14 PDT 2011

Doctor_V Patient input sorely missing in this dialog #MDchatTue May 24 18:44:19 PDT 2011

PracticalWisdom @doctorakerkar @jinpack @rlbates Laughing At now with the Patient. #MDchatTue May 24 18:44:39 PDT 2011

ryanmadanickmd @PracticalWisdom *SHE* interestingly doesn't think she's being unprofessional#MDchatTue May 24 18:44:40 PDT 2011

DotWonder “@PhilBaumann: Tonight on #MDchat we'll talk about @doctor_v'sUnprofessional Physician Behavior on Twitter http://t.co/23FhQrs”Tue May 24 18:44:40 PDT 2011

DrSnit @Doctor_V Patient input sorely missing in this dialog -> because it is called#MDchatTue May 24 18:45:05 PDT 2011

hjluks @Doctor_V we have one patient, Jackie with us tonight... shld b many more@epatientdave #mdchatTue May 24 18:45:06 PDT 2011

jinpack @Doctor_V Agree, if worth public discourse, worth patient involvement. #MDchatTue May 24 18:45:13 PDT 2011

RyanMadanickMD Oh shush Snit :-) RT @DrSnit: @Doctor_V Patient input sorely missing in thisdialog -> because it is called #MDchatTue May 24 18:45:36 PDT 2011

jinpack @RyanMadanickMD Even more troubling, many MDs agree with her that it's OK#MDchatTue May 24 18:45:56 PDT 2011

nursefriendly @hjluks Most docs don't realize who might be in earshot of the conversation atthe nurses station, or lounge area. Family members..#mdchatTue May 24 18:45:57 PDT 2011

rlbates Agree. See -- not mutually exclusive. RT @jinpack: @rlbates humor to cheer up pt=professional. laughing at p's expense =Not #MDchatTue May 24 18:46:03 PDT 2011

NateOsit Exactly RT @jinpack: @rlbates not neccesarily, humor to cheer up patient=professional. laughing at patients expense =Not #MDchatTue May 24 18:46:04 PDT 2011

RichmondDoc @ryanmadanickmd @PracticalWisdom It's similar to how some docs think Sermois unprofessional; others OK w/ it. #MDChatTue May 24 18:46:14 PDT 2011

ryanmadanickmd Not just her...also @BurbDoc RT @jinpack: @RyanMadanickMD Even moretroubling, many MDs agree with her that it's OK #MDchatTue May 24 18:46:25 PDT 2011

drpauldempsey @mindthecompany Ha! Listen in on #mdchat. Started at 9 pm. Compellingenough to interupt my staycation for...Tue May 24 18:46:26 PDT 2011

KathyKastner I'm a (largely lurking but read post) pt. Made me right uncomforable. RT@Doctor_V: Patient input sorely missing in this dialog #MDchatTue May 24 18:46:35 PDT 2011

XMRV_GA @Doctor_V we Re a patient org #MDchat but sadly we don't have healthcare for#mecfsTue May 24 18:46:37 PDT 2011

hjluks @nursefriendly they should :-( #mdchatTue May 24 18:46:41 PDT 2011

rlbates Wrong -- we are all patients RT @hjluks: @Doctor_V we have one patient, Jackiewith us tonight... shld b many more @ePatientDave #mdchatTue May 24 18:46:56 PDT 2011

philbaumann @DrSnit There are patient perspectives - but physicians and nurses do need theirplace too!! And it's open, so nobody's excluded ;) #MDchatTue May 24 18:46:56 PDT 2011

ryanmadanickmd @RichmondDoc @practicalwisdom I haven't yet used sermo #MDChatTue May 24 18:46:59 PDT 2011

DrSnit @jinpack WHICH pts do you want? The ones who *like* doctors or the one's whohave a grudge a mile long? I know both. ;) #MDchatTue May 24 18:47:05 PDT 2011

RichmondDoc @ryanmadanickmd @PracticalWisdom She can think that she isn'tunprofessional; I can disagree. And would teach students accordingly. #MDChatTue May 24 18:47:05 PDT 2011

Doctor_V @rlbates @nateosit Doc loses right to public respect when exhibiting grossdisregard for patients and profession #MDchatTue May 24 18:47:17 PDT 2011

RyanMadanickMD MT @rlbates: Wrong -- we are all pts @ePatientDave #mdchatTue May 24 18:47:28 PDT 2011

EllenRichter T1 So everyone seems to agree. Tweets discussing identifyable patient specificsis unprofessional & inappropriate. We can all learn. #MDchatTue May 24 18:47:35 PDT 2011

RichmondDoc @ryanmadanickmd @practicalwisdom Not sure that you'll find value...dependswhat you're looking for. #MDChatTue May 24 18:47:42 PDT 2011

TrishaTorrey OK #MDchat just home after speaking to large group of patients and see you'relooking for an additional patient voice. What's the question?Tue May 24 18:47:53 PDT 2011

jinpack @DrSnit Of course I prefer happy patients but my duty to them is all the same, I tryto keep in mind #MDchatTue May 24 18:47:56 PDT 2011

hjluks @rlbates @hjluks @Doctor_V @ePatientDave that was my mantra for the longesttime... until Phil pounded it :-( #mdchatTue May 24 18:47:59 PDT 2011

PracticalWisdom Don't understand?RT @RichmondDoc: @ryanmadanickmd @practicalwisdomNot sure that youll find value...depends what youre looking for. #MDchatTue May 24 18:48:21 PDT 2011

RichmondDoc @ryanmadanickmd @practicalwisdom Sermo is largely an anti-healthcarereform, anti-Obama venue, w/ some health care discussion. #MDChatTue May 24 18:48:26 PDT 2011

colleen_young @drpauldempsey I agree. I appreciate your "Behind the scenes" commentary. Ithink it makes you "real" to your community. #MDchatTue May 24 18:48:29 PDT 2011

amyrnbsn @NateOsit @jinpack @rlbates "Put-down" humor isn't funny anyway. #MDChatTue May 24 18:48:33 PDT 2011

hjluks @TrishaTorrey discussing Bryan's blog post #mdchatTue May 24 18:48:39 PDT 2011

hrana @Doctor_V U wrote a blog post about me on a topic where I stood up againstdiscrimination. Was that also "disregard for profession?" #MDchatTue May 24 18:49:07 PDT 2011

rlbates I disagree. No one loses right to public respect RT @doctor_v: @rlbates@NateOsit Doc loses right to public respect .... #MDchatTue May 24 18:49:13 PDT 2011

TrishaTorrey #MDchat - wrong wrong wrong - doctors can never see thru eyes of a 'regular'patient - you can't subtract what you know, or who you know.Tue May 24 18:49:26 PDT 2011

peds_id_doc @TrishaTorrey #mdchat guess! The @Doctor_V blog post today. Lots of thoughtshere too.Tue May 24 18:49:29 PDT 2011

ePatientDave @hjluks Did @PhilBaumann post his "pounding" for future reference? #mdchatTue May 24 18:49:44 PDT 2011

rlbates No, it isn't. Anywhere. Anytime RT @amyrnbsn: @NateOsit @jinpack @rlbates"Put-down" humor isn't funny anyway. #MDChatTue May 24 18:49:45 PDT 2011

NateOsit Word! RT @amyrnbsn: @NateOsit @jinpack @rlbates "Put-down" humor isntfunny anyway. #MDchatTue May 24 18:49:48 PDT 2011

Doctor_V Beautiful “@jinpack: @DrSnit Of course I prefer happy patients but my duty tothem is all the same, I try to keep in mind #MDchat”Tue May 24 18:49:51 PDT 2011

MattMerg It doesn't even need to be a specific patient. Doc expressing immature attitudetowards pts abstractly is just as bad @EllenRichter #MDChatTue May 24 18:49:58 PDT 2011

ryanmadanickmd T1 MT @awakeningaimee If u must speak ill of another, do not speak it, write it insand near the water's edge - Napoleon Hill #mdchatTue May 24 18:50:05 PDT 2011

hjluks @ePatientDave yup a few months back... #mdchatTue May 24 18:50:26 PDT 2011

PracticalWisdom When I read @docotor_V pieces today first thought You are what you tweet.Clearly this was disrespectful. Patient in pain=Not funny #MDchatTue May 24 18:50:36 PDT 2011

Doctor_V @hrana let the crowd decide. #MDchatTue May 24 18:50:44 PDT 2011

jinpack Keeper! RT @RyanMadanickMD: If u must speak ill of another, do not speak it,write it in sand near the water's edge - Napoleon Hill #mdchatTue May 24 18:50:58 PDT 2011

thenerdynurse @TrishaTorrey disagree. When you're on the otherside of the fence you feel justas vulnerable, if not more so. #mdchatTue May 24 18:51:02 PDT 2011

EllenRichter @DoctorClarkson What would be a good reason to tweet about patient specifics?I'm curious to hear your thoughts? #MDchatTue May 24 18:51:17 PDT 2011

RyanMadanickMD @jinpack I kept it as a favorite from her just the other day #mdchatTue May 24 18:51:19 PDT 2011

DoctorClarkson @rlbates @doctor_v @nateosit that doesn't mean that they won't loose publicrespect anyway. #MDChatTue May 24 18:51:22 PDT 2011

EllenRichter @MattMerg Good point! Agreed! #MDchatTue May 24 18:51:38 PDT 2011

ePatientDave @hjluks @rlbates @Doctor_V IMO nobody counts as a "patient" unless they getwhy hospital rooms are horrible places to try to heal :) #mdchatTue May 24 18:51:42 PDT 2011

hrana @Doctor_V The crowd has no place to decide when & where I stand up againstdiscrimination. You were out of line on that blog post. #mdchatTue May 24 18:51:51 PDT 2011

rebeccatrocki #MDchat I am both a pt. and gov. prof. Rand study on patient experience.http://www.randcompare.org/us-health-care-today/patient-experienceTue May 24 18:52:07 PDT 2011

TrishaTorrey #mdchat - haven't read posts since early afternoon, but struck me that the femaledoc did a good job of proving a stereotype -highly unprof.Tue May 24 18:52:07 PDT 2011

TheNerdyNurse @MattMerg @ellenrichter that is perspective. Hard to decipher snark fromimmaturity at times. #mdchatTue May 24 18:52:29 PDT 2011

rlbates But we should not be disrespectful in our response @DoctorClarkson @doctor_v@nateosit #mdchatTue May 24 18:52:32 PDT 2011

TrishaTorrey @thenerdynurse #mdchat - we'll have to agree to disagree. When you get sick,who do you call? Someone who's rep you know? or a stranger?Tue May 24 18:52:51 PDT 2011

nursefriendly Best bet :) RT @DrPaulDempsey: T1: I try to give links and resources that I thinkare accurate, that patients may not come across #mdchatTue May 24 18:52:58 PDT 2011

PracticalWisdom @TrishaTorrey: Here you go.http://33charts.com/2011/05/unprofessional-physician-behavior-twitter.html #MDchatTue May 24 18:53:10 PDT 2011

AriKaplan Great discussion about transformations in the medical profession w/@EllenRichter @amyrnbsn @Doctor_V @RichmondDoc at #MDchat#reinventionTue May 24 18:53:16 PDT 2011

rlbates @ePatientDave Then I count as one. :) #mdchatTue May 24 18:53:36 PDT 2011

TheNerdyNurse @hrana @doctor_v link to post? #mdchatTue May 24 18:53:44 PDT 2011

hjluks @PracticalWisdom I'll show u how to shorten those links later :-) !! LOL #mdchatTue May 24 18:53:47 PDT 2011

cmeadvocate Amen....RT @Neil_Mehta: Professionalism means putting pt's interest above docsinterests #mdchat

Tue May 24 18:53:48 PDT 2011

macobgyn @hrana @Doctor_V Which blog post are you referring to? #mdchatTue May 24 18:53:50 PDT 2011

DrSnit @ePatientDave this is why I love you. #MDchat Patient means vulnerability.Patient means loss of control. Patient means SUFFERING VISIBLY.Tue May 24 18:54:06 PDT 2011

akroundtree Fr the link I shared: tweeters don't consent to tweets being dissected by others,commentary. @thenerdynurse #mdchatTue May 24 18:54:10 PDT 2011

XMRV_GA #mdchat we are patients. yearning for #healthcareTue May 24 18:54:14 PDT 2011

EllenRichter @AriKaplan Glad to see you are following it! Thanks! :) #MDchatTue May 24 18:54:20 PDT 2011

NateOsit @TrishaTorrey I thought that it would've been good to point out male docs who'vedone the same. Shouldn't reinforce stereotypes #MDchatTue May 24 18:54:24 PDT 2011

ryanmadanickmd BTW she did say "In any case, I've learned my lesson and will tone it down.Some." today #mdchatTue May 24 18:54:40 PDT 2011

hrana @macobgyn @TheNerdyNurse This is the blog post and my response...http://bit.ly/bRlTDT @Doctor_V #mdchatTue May 24 18:54:52 PDT 2011

MeredithGould @DrSnit @ePatientDave Patient means dealing with a system that is anything butuser-friendly & can be life-threatening. #MDchatTue May 24 18:55:05 PDT 2011

thenerdynurse @TrishaTorrey depends on the scenario. If you go the ER it's luck of the draw whotakes care of you. #mdchatTue May 24 18:55:06 PDT 2011

MD_Chat Fast fast chat - could go on for hours. We'll have to wrap up in a few moment.s#MDchat Do we want to return to this in future chats?Tue May 24 18:55:07 PDT 2011

Health_Techie Tune in to #mdchat...pretty interesting!Tue May 24 18:55:10 PDT 2011

cmeadvocate Anonymity and professionalism are incompatible. RT @Doctor_V: T1 ....is thedoctor's anonymity that is the root of the problem. #MDChatTue May 24 18:55:23 PDT 2011

MeredithGould @DrSnit @ePatientDave Thanks a heap you two, I vowed not to jump into#MDchat tonight!!!Tue May 24 18:55:44 PDT 2011

MD_Chat Before we leave, let's hear your closing thoughts on tonight's topics. #MDchatTue May 24 18:55:44 PDT 2011

jinpack @MD_chat Certainly worth mroe spinoff topics in the future #MDchatTue May 24 18:55:46 PDT 2011

TrishaTorrey #mdchat - no room for disrespect OR egos in HC relationships - that's part of whathas gotten us into communications probs to begin with.Tue May 24 18:56:01 PDT 2011

RyanMadanickMD To all, check out @mommy_doctor posts today after. Sometimes a blog can be ateaching moment to an individual #mdchatTue May 24 18:56:04 PDT 2011

MeredithGould @cmeadvocate Really? You might want to mention that to the gazillions of peoplein 12 Step programs of recovery. #MDChatTue May 24 18:56:12 PDT 2011

RyanMadanickMD @awakeningaimee Good good thanks...doing the #mdchat 2niteTue May 24 18:56:24 PDT 2011

PracticalWisdom You just earned http://bit.ly/kopZUC Points. Nice! @hjluks: @PracticalWisdom Illshow u how to shorten those links later :-) !! LOL #MDchatTue May 24 18:56:35 PDT 2011

TrishaTorrey @practicalwisdom thanks for the link :-) #mdchatTue May 24 18:56:41 PDT 2011

jinpack @MeredithGould I think he means HC professionals are held to a standard ofethics and accountability #MDChatTue May 24 18:56:51 PDT 2011

Doctor_V Yes “@cmeadvocate: Anonymity and professionalism are incompatible.@Doctor_V is the doctor's anonymity that is the root of the prob #MDChatTue May 24 18:56:53 PDT 2011

nursefriendly @akroundtree Anonymizing accounts can give a false sense of security. End upin more careless discussions, violations. #mdchat #TwitterTue May 24 18:56:54 PDT 2011

ryanmadanickmd MT @hrana: @cmeadvocate y does something anonymous automatically meanit'll be unprofessional? The link is questionable at best. #mdchatTue May 24 18:56:54 PDT 2011

thenerdynurse @akroundtree why would they need to consent? If you make a public statementit's up for public discussion #mdchatTue May 24 18:57:03 PDT 2011

MeredithGould @TrishaTorrey Alas, hard to tell from whence 1st came the disrespect. At thispoint, pts are often at war with docs. Everyone loses. #mdchatTue May 24 18:57:17 PDT 2011

DrSnit @MD_chat Thank you for allowing us to sit in on your #MDchat today. And for thelovely discussion. Cheers all you sassy cats!Tue May 24 18:57:27 PDT 2011

ePatientDave #mdchat Okay, that's not "we are NOT all pts" in the way I meant it, but it's valid tooRT @PhilBaumann: http://pbau.co/lixnlCTue May 24 18:57:30 PDT 2011

TrishaTorrey @nateosit #mdchat - stereotypes become harmful to everyone - and createbullying atmostphere. All this reminds me of NYTimes/ Theresa BrownTue May 24 18:57:39 PDT 2011

RyanMadanickMD @DrSnit Love ya! #MDchatTue May 24 18:57:42 PDT 2011

EllenRichter Terrific chat. We all grew an inch today. Great to share thoughts/ feelings aboutsocial media & its place in health care. Learning! #MDchatTue May 24 18:57:46 PDT 2011

NateOsit Final thoughts: Be respectful, think about how your words effect others, and showcompassion to patients #MDchatTue May 24 18:57:57 PDT 2011

jinpack @MeredithGould Yet docs and nurses are ultimately responsible for tone ofrelationship with patient #mdchatTue May 24 18:57:57 PDT 2011

Neil_Mehta Society requires a superego. Does wearing a white coat require asupersuperego? #mdchatTue May 24 18:58:06 PDT 2011

macobgyn @hrana Thanks. Interesting discussion from that post. #mdchatTue May 24 18:58:09 PDT 2011

rebeccatrocki @TrishaTorrey trust is very important and fragile on both sides #mdchatTue May 24 18:58:14 PDT 2011

akroundtree @TheNerdyNurse Yes. I'm not sure where I stand on it. But the link I sharedmakes good points on both sides. #mdchatTue May 24 18:58:25 PDT 2011

XMRV_GA #mdchat Patients with #MECFS would wish doctors could follow @WPInstituteand learn about neuro-immune disease http://t.co/F5KT5SWTue May 24 18:58:30 PDT 2011

MattMerg When I hear a doc talk like a high-schooler, I wonder if my own docs will bethinking of me same way @TheNerdyNurse @ellenrichter #MDChatTue May 24 18:58:31 PDT 2011

MeredithGould @jinpack Really? Ultimately responsible? Maybe. I need to contemplate this one.#mdchatTue May 24 18:58:43 PDT 2011

nursefriendly Great topic tonight, think we'll be hearing lots more about it. #mdchat #TwitterTue May 24 18:58:46 PDT 2011

ePatientDave @PhilBaumann Interesting foundation - we should get some pts to add theirpoignant perspectives too #mdchatTue May 24 18:58:50 PDT 2011

jinpack @MeredithGould Yeah, sadly we dont always have control, but that doesntabsolve our duty... #mdchatTue May 24 18:59:06 PDT 2011

TrishaTorrey #mdchat - Just FYI - I used to follow three docs that I stopped following b/c of thissame kind of stuff. Disrespectful and arrogant.Tue May 24 18:59:08 PDT 2011

TheNerdyNurse #mdchat closing thought: Use twitter to be an advocate for your profession andyour patients. Tweet with integrity.Tue May 24 18:59:19 PDT 2011

EllenRichter The dreaded "enter" key. It should have a default "are you SURE you want tosend that?" window pop up each time! #MDchatTue May 24 18:59:20 PDT 2011

Doctor_V “@MattMerg: When I hear a doc talk like a high-schooler, I wonder if my own docswill be thinking of me same way @TheNerdyNurse #MDChat”Tue May 24 18:59:28 PDT 2011

RobinPregnancy Me too! RT @TrishaTorrey: #mdchat - I used to follow three docs that I stoppedfollowing b/c of... Disrespectful and arrogant.Tue May 24 18:59:44 PDT 2011

doctorakerkar can one get patient's trust remaining anonymous? #MDchatTue May 24 18:59:56 PDT 2011

macobgyn @TrishaTorrey I will have to check if you still follow me :) #mdchatTue May 24 18:59:58 PDT 2011

RyanMadanickMD I keep following...important to see what NOT to do! RT @RobinPregnancy: Metoo! RT @TrishaTorrey: #mdchat - … (cont) http://deck.ly/~hV3lwTue May 24 19:00:14 PDT 2011

jinpack Straight-up, NO. RT @doctorakerkar: can one get patient's trust remaininganonymous? #MDchatTue May 24 19:00:17 PDT 2011

RichmondDoc Final thought: our commitment to patients extends to protecting their well-being atall times. Be mindful, be careful, & be caring. #MDChatTue May 24 19:00:21 PDT 2011

XMRV_GA #mdchat me as a pt I would like to present my case in front of an auditorium if itmeant dr would learn about my condition and no stigmatizeTue May 24 19:00:32 PDT 2011

TrishaTorrey @meredithgould #mdchat - I think most patients begin by trusting and respectinga new doc - until something sours relationship.Tue May 24 19:00:37 PDT 2011

RyanMadanickMD #mdchat RT @RichmondDoc: Final thought: our commitment to patients extendsto protecting their well-being a… (cont) http://deck.ly/~6qPqITue May 24 19:00:42 PDT 2011

Preparing4Birth Ditto RT @RobinPregnancy: Me too! RT @TrishaTorrey: #mdchat - I used tofollow 3 docs that I stopped followin… (cont) http://deck.ly/~ysi2QTue May 24 19:00:46 PDT 2011

drseisenberg Final thoughts: Connect with respect = compassion. #mdchatTue May 24 19:00:48 PDT 2011

RyanMadanickMD @XMRV_GA this is totally different than someone else doing it w/o consent#mdchatTue May 24 19:01:19 PDT 2011

ePatientDave @MeredithGould @DrSnit So, I just suggested we add such thoughts ascomments on @PhilBaumann's post http://pbau.co/lixnlC Gonna? #MDchatTue May 24 19:01:20 PDT 2011

MeredithGould @TrishaTorrey Probably right about that. #mdchatTue May 24 19:01:29 PDT 2011

PracticalWisdom Closing Thoughts: If you are not going to be transparent why be on Twitter in theFirst Place? It takes courage to be Real. #MDchatTue May 24 19:01:50 PDT 2011

TrishaTorrey @macobgyn yes! I still follow you! #mdchat! LOL!Tue May 24 19:01:52 PDT 2011

jackiefox12 I've read some very funny, earthy ER "war stories" (they put WHAT WHERE?) butthey were past, masked & not immediate & specific #mdchatTue May 24 19:02:18 PDT 2011

ePatientDave yes yes yes yes: RT @mommy_doctor: I stroked your arm as you went to sleep.#DearPatient // #MDChatTue May 24 19:02:22 PDT 2011

RyanMadanickMD @hrana policeman? #mdchatTue May 24 19:02:25 PDT 2011

macobgyn My final thoughts: Be normal. #mdchatTue May 24 19:02:37 PDT 2011

jinpack #MDchat final thoughts: leave amusement to TV dramas.Tue May 24 19:02:46 PDT 2011

akroundtree I meant removing name of MD who made the remark fr the blog post to make auniversal teachable moment. “@nursefriendly: @akroundtree #mdchatTue May 24 19:02:48 PDT 2011

MeredithGould @macobgyn Define "normal"??? #mdchatTue May 24 19:02:51 PDT 2011

ePatientDave victim mode detected! :) RT @MeredithGould: @DrSnit @ePatientDave Thanks aheap you two, I vowed not to jump into #MDchat tonight!!!Tue May 24 19:03:00 PDT 2011

EllenRichter @TrishaTorrey LOL oh Trish, everyone is checking to see if you are still followingthem! :) #MDchatTue May 24 19:03:07 PDT 2011

XMRV_GA #mdchat again, personally i wouldnt mind if anyone discussed my case withprofessionalism in order to gain advice or teach someone elseTue May 24 19:03:16 PDT 2011

MeredithGould @ePatientDave I'm going to quote you to you: punk. #MDchatTue May 24 19:03:26 PDT 2011

TrishaTorrey #mdchat If I knew real names of those docs I've unfollowed, and someoneneeded a doc in their loc. + specialty, I would tell them to avoid.Tue May 24 19:03:30 PDT 2011

ePatientDave (Pardon my butting in; is there a curator for #MDChat? Have a topic to propose)Tue May 24 19:03:34 PDT 2011

RyanMadanickMD @ePatientDave @mdchat #MDChatTue May 24 19:03:54 PDT 2011

TrishaTorrey @ellenrichter LOL! #mdchat - it DID slow down the tweetstream, didn't it? LOL!Tue May 24 19:04:02 PDT 2011

PracticalWisdom Red Flag Foul- Teasing!!!RT @MeredithGould: @ePatientDave Im going to quoteyou to you: punk. #MDchatTue May 24 19:04:05 PDT 2011

MD_Chat THANK YOU everybody - a great chat again. Here' the transcripthttp://mdch.at/kVLaW7 #MDchatTue May 24 19:04:12 PDT 2011

macobgyn @MeredithGould Docs know should know how to act in "real" life. Do the sameonline. Don't overthink it - be normal. #mdchatTue May 24 19:04:25 PDT 2011

jackiefox12 That sums it up perfectly. RT @drseisenberg Final thoughts: Connect with respect= compassion. #mdchatTue May 24 19:04:30 PDT 2011

RyanMadanickMD whoops @md_chat @ePatientDave #MDChatTue May 24 19:04:35 PDT 2011