Let me say up front that I do not have a Facebook or MySpace page and have never thought about putting a video clip on YouTube. I have been tempted to respond to e-mails inviting me to join social networks. Many of these invitations appear as though they are generated by friends who have established their accounts and sincerely want me to participate in the process. These come across as being “personal” invitations, but are really generated by network-determined connections that reveal the capacity of Internet networks to bring people together. This matchmaking may be unknown to the parties themselves.

I recently attended our annual surgical program directors meeting and heard a presentation dealing with the social networking dalliances of surgical residents and attendings at a reputable academic institution. The researchers reviewed the Facebook pages of both residents and attendings to get a flavor of material that appears in these sites. I gather that because Facebook is open to most for perusal, the need to have Institutional Review Board approval to search and report material from these sites was moot.

The essence of the above-mentioned study was that on more than one of these sites, information relating to patients and patient encounters were described in some detail. It appears that most of these references were meant to either impress or inform the friends of surgical residents about the important or remarkable work in which they were involved. The conclusion of the study was that rather innocent references on social networking sites could have potentially unsavory consequences and, although deemed harmless, indicated a severe departure from the core competency of professionalism.

We are witnessing an entire new generation that is wedded to electronic gadgetry and who spend, as estimated by the Kaiser Family Foundation, an estimated seven to eight hours a day using some sort of electronic device. The social networking interaction represents only a morsel of the texting, sexting and twittering that is pervasive. The use of these technologies has now transcended generational boundaries and is not limited to those other, less professional groups! In this realm where private and public are conflated and where intersections between people are identified and contacts misrepresented, how can we understand or hope to regulate or control how information is used or shared?

There also is no doubt that employers are combing these sites looking for submissions by potential hires. Some have suggested that the resident selection process should include a check of social networking sites created by medical students seeking postgraduate training. This review may give further insight into the attitudes and professionalism of future trainees. My message is that although sharing thoughts may be both therapeutic and wholesome on social networking sites, the urge to reveal all, especially about our patient encounters, is ill-advised. I have not heard specifically about plaintiff attorneys introducing material gleaned from a review of Facebook pages, but I am sure the day is coming.