Medics posting messages on networking websites like Facebook and Twitter are breaching¹ patient confidentiality², a leading journal reveals.

一本主流杂志透露，医学工作者在诸如Facebook和Twitter之类的网站上发布信息会违背病人的保密协议。

Twitter content is user-generated

Research in the Journal of the American Medical Association found examples of web gossip by trainee³（练习生，新兵） doctors sharing private patient stories and details.

Over half of 78 US medical schools studied had reported cases of students posting unprofessional content online.

One in 10 of these contained frank violations⁵ of patient confidentiality.

Most were blogs, including one on Facebook, containing enough clinical detail that patients could potentially be identified.

'Blue' blogs

Many postings included profanity（亵渎） and discriminatory language.

Sexually suggestive material and photos showing drunkenness（醉态，放荡） or illicit⁶（非法毒品，违禁药物） drug use were also commonplace.

While most incidents resulted in informal warnings, some were deemed serious enough to lead to dismissal from medical school.

But few of the medical schools had policies that covered online social networking and blogging.

The investigators⁷, led by Dr Katherine Chretien of the Washington DC VA Medical Center, said medical students may not be aware of how online posting can reflect negatively on medical professionalism or jeopardise（使……遭遇危险） their careers.

Similarly, patient confidentiality breaches⁸ may be unintentional.

"Sharing patient stories that are de-identified and respectful, as health professionals might do on personal blogs, can encourage reflection, empathy and understanding.

"However, content may risk violation⁴ of patient privacy, even without using names or other identifiers," they warned.

Also, the line separating freedom of speech and inappropriate postings can be unclear - for example, derisive⁹（嘲弄的） comments about a student's institution or profession might not be considered unprofessional by some, they said.

Dr Chretien's team say medical students should be taught as part of their training about the risks associated with making postings on the Internet.

As a matter of course, students should be shown how to elect privacy settings on social networking sites and should be told to perform periodic（周期的，定期的） Web searches of their own name to vet¹⁰（诊疗） listed online content.

A spokesman for the British Medical Association said: "Patient confidentiality is paramount¹¹（极为重要的） and medical students and doctors obviously need to be very careful about any information they post online."

The UK's regulator of doctors, the General Medical Council, does not have guidance that covers medics' blogging.

But a spokeswoman advised doctors: "You must make sure that your conduct at all times justifies¹² your patients' trust in you and the public's trust in the profession."