This week's episode of WCBA presents a cutting edge look at social media and health care.  We led the show with Dr. Jennifer Dyer, a diabetes specialist who texts and 'friends' her hard-to-treat diabetic teens with great results.  I then made the point that when it comes to social networking and medicine, Dr. Dyer is the exception and not the rule.  Informal surveys suggest that most med students and residents have Facebook accounts but would never friend their patients.

Then, I got this email from Dr. Bruce Geller, a family physician in Meadow Lake, a small town in rural Saskatchewan.

"Thank you for your program on interacting with patients via social networks.  I was very interested in the angst the MDs on the program had over this.  I am a small town family doctor and socially interacting with patients is a day-to-day reality for me.  There is not a day that I do not interact with a current or former patient in a social manner.  I have difficulty understanding why this in-person interaction is different from an interaction on Facebook. 

Personally, I never refuse a patient request to be a friend on Facebook.  I have never had this abused by a patient.  Nobody has ever asked for medical advice or revealed any personal information.  However, if a patient did ask a personal medical question on Facebook, how would that be different than asking a medical question in the supermarket?  Ultimately, I would not feel I was violating that person's privacy, as they would be the one asking me the question about their health in public.

I think the angst over 'friending' patients is not inappropriate.  However, I would think it is mostly confined to urban MDs who are accustomed to a large (metaphorical) distance between their professional and personal lives.  In rural areas, MDs are much more accustomed to blending the two.  We are often friends our patients in the real world and not just the virtual world.  Had you interviewed rural and small town doctors, your show would have been different."

Thank you, Dr. Geller, for bringing a rural perspective to the discussion.

Is he right?  If you live in a small town, let us know what you think.