title: Perceptions of Unprofessional Social Media Behavior Among Emergency Medicine Physicians.
abstract: Use of social media (SM) by physicians has exposed issues of privacy and professionalism. While guidelines have been created for SM use, details regarding specific SM behaviors that could lead to disciplinary action presently do not exist.
  
  
  
  To compare State Medical Board (SMB) directors' perceptions of investigation for specific SM behaviors with those of emergency medicine (EM) physicians.
  
  
  
  A multicenter anonymous survey was administered to physicians at 3 academic EM residency programs. Surveys consisted of case vignettes, asking, "If the SMB were informed of the content, how likely would they be to initiate an investigation, possibly leading to disciplinary action?" (1, very unlikely, to 4, very likely). Results were compared to published probabilities using exact binomial testing.
  
  
  
  Of 205 eligible physicians, 119 (58%) completed the survey. Compared to SMB directors, EM physicians indicated similar probabilities of investigation for themes involving identifying patient images, inappropriate communication, and discriminatory speech. Participants indicated lower probabilities of investigation for themes including derogatory speech (32%, 95% confidence interval [CI] 24-41 versus 46%,P< .05); alcohol intoxication (41%, 95% CI 32-51 versus 73%,P< .05); and holding alcohol without intoxication (7%, 95% CI 3-13 versus 40%,P< .05). There were no significant associations with position, hospital site, years since medical school, or prior SM professionalism training.
  
  
  
  Physicians reported a lower likelihood of investigation for themes that intersect with social identity, compared to SMB directors, particularly for images of alcohol and derogatory speech.
authors.affiliation: Assistant Professor, Department of Emergency Medicine, Baystate Medical Center
authors.forename: William
authors.initials: W
authors.lastname: Soares
authors.affiliation: Assistant Professor and Assistant Residency Program Director, Department of Emergency Medicine, University of North Carolina at Chapel Hill
authors.forename: Christina
authors.initials: C
authors.lastname: Shenvi
authors.affiliation: Clinical Assistant Professor and Residency Program Director, Department of Emergency Medicine, University of North Carolina at Chapel Hill
authors.forename: Nikki
authors.initials: N
authors.lastname: Waller
authors.affiliation: Assistant Professor, Department of Emergency Medicine, Washington University, St. Louis
authors.forename: Reuben
authors.initials: R
authors.lastname: Johnson
authors.affiliation: J. Allan Gilbert Chair in Medical Education Research and Associate Professor, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
authors.forename: Carol S
authors.initials: CS
authors.lastname: Hodgson
mesh_terms: D000428:Alcohol Drinking; D004635:Emergency Medicine; D006801:Humans; D008007:Licensure, Medical / Q000592:standards; D010820:Physicians / Q000523:psychology*; D028743:Professional Misconduct; D063508:Social Discrimination; D061108:Social Media; D011795:Surveys and Questionnaires