Train in Vein

Private Practice: When A Doctor Shares Too Much

Amy Dunbar, an OB GYN in the Midwest, has recently come under fire for posting comments about a patient on Facebook. The initial comment was a bit snarky, expressing frustration about the patient’s habitual tardiness for appointments:


“I have a patient who has chosen to either no-show or be late (sometimes hours) for all of her prenatal visits, ultrasounds, and NSTs. She is now 3 hours late for her induction. May I show up late to her delivery?”

After a few comments from friends, she revealed the reason why she has tolerated this patient’s tardiness:

“Here is the explanation why I have put up with it/ not cancelled induction: Prior stillbirth.”

Ohhhh boy. I can see how this has stirred up quite the controversy. Some are insisting that Dr. Dunbar be fired for revealing private patient information on Facebook, while others say she was simply venting about work and never revealed the patient’s actual name. I can see where both sides are coming from.

In terms of confidentiality, I don’t think she technically violated the rules set by the HIPAA (The US Health Insurance Portability and Accountability Act) Privacy Rule against linking Protected Health Information (PHI) to a specific individual. Technicalities aside, while she didn’t reveal the patient’s name, she may have posted too much information after revealing that this patient had a prior stillbirth. Anyone in Dr. Dunbar’s office could potentially identify a woman who was consistently late (not private information) as having suffered a previous stillbirth (very private and devastating information).

The patient would also likely be able to identify herself in reading Dr. Dunbar’s posts and perceive her privacy as having been violated. The original statement about the patient’s lateness, while a bit whiny and maybe not what people want to hear from a doctor, wasn’t revealing any private information. However, mentioning the stillbirth was pretty crass and potentially identifying. Beyond that, mentioning something as heart-wrenching as a woman’s stillbirth on Facebook is something I find extremely crude and unprofessional. Not to mention, maybe the horror of having had a stillbirth is factoring into this patient’s resistance to showing up for appointments. She may be terrified and filled with dread.

I believe the real issue here is that of professionalism. There are strict rules for privacy and confidentiality, but there is nothing set in stone mandating professionalism for doctors or other healthcare workers. Before social media was literally at our fingertips, it was easy to separate the personal from the professional. Do doctors and nurses have the right to a personal life and personal opinions? Yes. Do health care professionals have the right to complain about work and share crazy stories? Sure. Do they have the right to make these things public on Facebook? To that I have to say no, or, only extremely carefully.

As a medical professional, one has a responsibility to the public to uphold a professional image and maintain trust. As medical professionals, we sort of sacrifice the right to be publicly crass, cynical, irresponsible or ridiculous. No one wants to see us drunk at a party knowing we will go to work in the operating room on Monday, and no one wants to hear us rant in detail about our jobs. I try to keep things light, vague, professional and private. I select my audience carefully, and I prefer for people to ask me questions so they can set the limits on what they want to know.

I live in fear of offending or scaring people. Few civilian types want to hear about facial trauma in detail if you know what I mean. I try to leave the drama and humor to Grey’s Anatomy and Scrubs, because that is where it belongs. In reality, we all want to think of the hospital and health care professionals as serious and infallible. Obviously doctors and nurses are human, but unfortunately that human side should be kept mostly private. It’s a tough balance though, as robotic and cold health care workers are equally unappealing. A little bedside manner goes a long way, and a little over-sharing digs a big hole. At the end of the day, no one wants to think about their doctors talking about them on Facebook, revealing details or not.

I believe Amy Dunbar had a right to be annoyed with this patient, but she should have kept that to herself or between her and a friend or colleague in private. Instead, by posting about it on Facebook, she came across as rash, immature, insensitive and unprofessional. I don’t think that she is a bad doctor, though. I sincerely believe that she and other medical professionals can learn an important lesson from this backlash. It is critical that professionals maintain professionalism in the public domain, and this includes online. It is still new territory, and many doctors and nurses may need some training or gentle reminders about what is and is not appropriate. Patient privacy is something that must never be breached, but outside of that there is a lot of gray area in terms of what a health care professional should and should not share.

Above all, one must remember their duty to the public to be professional and trustworthy. That said, I feel sad for Dr. Dunbar. I doubt she meant any harm by her post, and I am willing to bet she feels horrible about her actions. She no doubt became an OB GYN out of love for helping women, and she is likely devastated by how this turned out. I think we can all take this as a lesson in navigating the brave new world of social media. Let’s not burn her at the stake like the poor nurse involved in the Kate Middleton scandal, but let’s make her an example for how health care professionals must never, ever behave.

 Featured image via ShutterStock

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