Social Media: It’s Different for Professionals What professional information should you share and seek online? Check out these pointers. Make It Work
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Make It Work  |   July 01, 2018
Social Media: It’s Different for Professionals
Author Notes
  • Robyn Merkel-Walsh, MA, CCC-SLP, is a private-practice clinician in New Jersey who also works for the Ridgefield Board of Education and TalkTools. Robynslp95@aol.com
    Robyn Merkel-Walsh, MA, CCC-SLP, is a private-practice clinician in New Jersey who also works for the Ridgefield Board of Education and TalkTools. Robynslp95@aol.com×
  • Jennifer D. Moore, EdD, CCC-SLP, is a private-practice clinician in New Jersey and an assistant professor at Kean University. jennifermooreslp@gmail.com
    Jennifer D. Moore, EdD, CCC-SLP, is a private-practice clinician in New Jersey and an assistant professor at Kean University. jennifermooreslp@gmail.com×
Article Information
Make It Work
Make It Work   |   July 01, 2018
Social Media: It’s Different for Professionals
The ASHA Leader, July 2018, Vol. 23, 30-33. doi:10.1044/leader.MIW.23072018.30
The ASHA Leader, July 2018, Vol. 23, 30-33. doi:10.1044/leader.MIW.23072018.30
If you need suggestions or guidance for treatment recommendations, or want information about a treatment methodology, where do you turn?
Ten years ago, you might have called a colleague, read a book or journal article, or contacted a college professor. We can still do all of those things—but now we are much more likely to post a question or search on social media for answers.
Interestingly, speech-language pathologists in the 41–50 age group may be more likely to seek treatment recommendations on social media than other age groups, finds a recent Kean University study (see sources). This age group had the highest percentage of participants who reported using Facebook for treatment recommendations for speech sound disorders, as compared with participants 21–40 and older than 51. This group was the only cohort to report posting four or more times per month.
The study also found that the 41–50 age group rated Level 4 evidence (such as case studies and expert opinions) as “most valuable,” when compared to the younger groups, who placed a higher value on Levels 1 and 2 evidence. The study indicates that this age group relies a great deal on accessing social media, case studies and clinical opinions, and highly values the advice.
Facebook business pages and professional discussion groups are changing the way speech-language pathologists interact with one another, share information and discuss cases. There are many benefits to posting on social media: It provides a quick—sometimes immediate—response, it’s easily accessible, it’s a great way to connect and network with other professionals, and it gives us various responses from multiple clinicians.
But beware: There are also many cons to sharing and seeking information on social media. Using Facebook and other platforms as a clinical forum can potentially cause breaches of confidentiality, misrepresentation of evidence-based practices, and potential violations of the ASHA Code of Ethics.
The basics
As of January 2018, Facebook reported an estimated 2.07 billion monthly active users and 42 million pages, with users connected to an average of 80 pages and groups—and these numbers are constantly growing. Many groups and pages related to audiology and speech-language pathology focus on a specific disorder, treatment strategy, practice setting, professional organization or topic area.
If you post to one of these groups when you want to share and seek information, remember that everything that is posted on social media is public. So even though a post might be shared in a “private group,” nothing is really private. Someone could take a screen shot of your post or copy it, and then share it.
And although many of these groups are intended for audiologists or speech-language pathologists, they can include others—parents, graduate students, just about anyone. Some groups have a basic screening process—you answer a few questions that require administrative approval to join—but others require you to simply click “join group” or “like.” There is no way of knowing who is really on the other end of your posts.
One popular Facebook group for SLPs we found has more than 30,000 members—certainly anything posted on this group can influence the public views on our profession. Consider the ASHA Code of Ethics, Rule III-E, which states: “Individuals’ statements to the public shall provide accurate and complete information about the nature and management of communication disorders, about the professions, about professional services, about products for sale, and about research and scholarly activities.” We need to remember this each time we post a public comment on social media.
Dos and don’ts
So keeping in mind that nothing is really private, and that we must comply with the Code of Ethics and privacy laws, here are some dos and don’ts of professional social media use.
Can I post to get treatment or diagnosis recommendations?
Do post your question to a small, specialized group. For example, if you have a client with a feeding issue, post in a small group of feeding specialists rather than in a general speech-language group. You are more likely to receive a more effective response from those who have experience in this area and who can support methodology with ASHA’s Evidence Maps.
Don’t post a picture and ask for a diagnosis. We recently came across a picture of a baby’s mouth posted with the caption “Tongue tie?” A picture is not an accurate portrayal of any disorder. We need to look at function. Use your own clinical judgment and expertise to diagnose, or refer to a specialist if you feel a case is out of your scope or you do not have enough training. In addition, any photo may inadvertently indicate the patient’s identity—a violation of the Health Insurance Portability and Accountability Act (HIPAA).

Don’t post antagonistic statements that you would not want your supervisor, clients/patients or colleagues to see. It is inappropriate to “shame” other clinicians, given that professional decorum is part of the ASHA Code of Ethics.

How do I protect my patient’s confidentiality when posting a case-specific question?
Do post a question asking for resources, workshops and research on a specific diagnosis or methodology. Once again, posting your question to a smaller, specialized group may yield a more helpful response.
Also, ask for a reply by phone or to a HIPAA-compliant email address. Facebook messenger is not HIPAA-compliant. It is generally safer to broaden your question when posting. Instead of writing, “I have a 3-year-old client with a hearing loss who is in a regular classroom, has difficulty with production of /s/, and receives speech therapy three times a week,” you should post a request for helpful resources for articulation treatment for children with hearing loss. Keep your post general.
Don’t be case-specific. Even when you think you are leaving out identifying information, others may find out who your client is. Your profile can have public information—such as where you live and where you work—that may provide clues to a client’s identity and, therefore, violate HIPAA.
For example, an administrator posted an “anonymous” question to a large speech-language pathologists group. The post described a local prominent figure who had a stroke and whose higher-level cognitive deficits went untreated. A second stroke left him with memory loss and problem-solving deficits. The administrator feared that the person was unfit to serve the public in his role, and wondered if it was unethical to reveal his private medical information.
This post fails to protect a patient’s confidentiality, which falls under the ASHA Code of Ethics. The code allows access to medical records if “necessary to protect the welfare of the person or of the community, is legally authorized, or is otherwise required by law,” but certainly not in a public forum. One could easily identify the patient by researching the name and location of the clinician and cross-referencing local stories of prominent figures and hospitalizations. Many SLPs in the group posted this concern and stated that the group administrators were violating confidentiality.
How can I use social media for help with ICD-10 (International Classification of Diseases, 10th edition) coding?
Do research the ICD-10 codes on the ASHA website or take a course in medical coding. You are providing the services; you ultimately need to code the diagnosis appropriately.
Don’t give a scenario and ask for others to give you guidance on which code to use. This can result in significant malpractice. If an audited claim is coded incorrectly, the insurance company will have the provider (if in-network) or the family repay each claim. In addition, your m edical records need to reflect the proper treatment for the code selected—lack of a strong, validated connection can result in reimbursement denials.
Seeking coding advice on social media, especially if you are asking what codes get paid and which ones don’t, can be considered engaging in insurance fraud.
If you see a question asking for this information, refrain from responding with specifics—but you can provide resources to help the clinician find the answer.
How can I use social media for guidance regarding evidence-based practice (EBP)?
Do reference ASHA’s Evidence Maps. You can further research methodology by using web searches, reading journal articles and attending workshops. There are many approaches that may help your client. Also, join a supportive clinical research group for SLPs in which research is discussed in a positive, unbiased and supportive manner.
Don’t let blanket statements such as “______ is not EBP” deter you from making your own clinical judgments. Remember that evidence-based practice has various components and levels. There are many Facebook arguments on the efficacy of various approaches—but many variables involved in evaluating research cannot be fully discussed on a thread. Clinical evidence and patient feedback are just as valuable as Level 1 research; therefore, it is a misrepresentation of the ASHA Evidence Maps when clinicians give advice in absolutes.
What can I do if another clinician engages me in an antagonistic manner?
Do refrain from engaging in unprofessional discourse. If you must respond, graciously decline from discussing the topic in a public forum, private message the clinician directly, and state your concerns.
Don’t post antagonistic statements that you would not want your supervisor, clients/patients or colleagues to see. It is inappropriate to “shame” other clinicians, given that professional decorum is part of the ASHA Code of Ethics (Principle IV): “Individuals shall uphold the dignity and autonomy of the professions, maintain collaborative and harmonious interprofessional and intraprofessional relationships, and accept the professions’ self-imposed standards.”
Overall, using social media for sharing and seeking information for clinical practice has definite advantages—but also serious implications if misused. As professionals, we need to abide by our code of ethics, scope of practice and privacy laws.
Sources
Adams, S., Van Veghel, D., & Dekker, L. (2015). Developing a research agenda on ethical issues related to using social media in healthcare: Lessons from the first Dutch twitter heart operation. Cambridge Quarterly of Healthcare Ethics, 24(3), 293–302. doi:10.1017/S0963180114000619 [Article] [PubMed]
Adams, S., Van Veghel, D., & Dekker, L. (2015). Developing a research agenda on ethical issues related to using social media in healthcare: Lessons from the first Dutch twitter heart operation. Cambridge Quarterly of Healthcare Ethics, 24(3), 293–302. doi:10.1017/S0963180114000619 [Article] [PubMed]×
American Speech-Language-Hearing Association. (2016). Code of ethics [Ethics]. Available at https://www.asha.org/code-of-ethics
American Speech-Language-Hearing Association. (2016). Code of ethics [Ethics]. Available at https://www.asha.org/code-of-ethics×
Antheunis, M. L., Tates, K., & Nieboer, T. E. (2013). Patients’ and health professionals’ use of social media in health care: Motives, barriers and expectations. Patient Education and Counseling, 92(3), 426–431. doi:10.1016/j.pec.2013.06.020 [Article] [PubMed]
Antheunis, M. L., Tates, K., & Nieboer, T. E. (2013). Patients’ and health professionals’ use of social media in health care: Motives, barriers and expectations. Patient Education and Counseling, 92(3), 426–431. doi:10.1016/j.pec.2013.06.020 [Article] [PubMed]×
Hackworth, B. A., & Kunz, M. B. (2011). Health care and social media: Building relationships via social networks. Academy of Health Care Management Journal, 7(2), 1–14.
Hackworth, B. A., & Kunz, M. B. (2011). Health care and social media: Building relationships via social networks. Academy of Health Care Management Journal, 7(2), 1–14.×
Kramer, M., Bilinski, B., Ducsak, T., Herridge, K., Maina, S., Mastalski, N. … Weiss, S . (2018). Uses, experiences, and perceived values of EBP by SLPs on Facebook Poster presentation, Kean Research Days 2018, Union, New Jersey.
Kramer, M., Bilinski, B., Ducsak, T., Herridge, K., Maina, S., Mastalski, N. … Weiss, S . (2018). Uses, experiences, and perceived values of EBP by SLPs on Facebook Poster presentation, Kean Research Days 2018, Union, New Jersey.×
Ramsey, M. (2010). Social media etiquette: A guide and checklist to the benefits and perils of social marketing. Database Marketing & Customer Strategy Management, 17, (3/4), 257–261. [Article]
Ramsey, M. (2010). Social media etiquette: A guide and checklist to the benefits and perils of social marketing. Database Marketing & Customer Strategy Management, 17, (3/4), 257–261. [Article] ×
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July 2018
Volume 23, Issue 7