Social media can be rather toxic, giving the full extent of humanity verbal access to you with no restraint on being abusive with no adverse consequences beyond being blocked. Medical care also brings us into the full realm of humanity, mostly delightful people but a few for whom the most enticing response might be Undoctor. But they rarely arrive in the hospital bed or the exam room as your perceived equal, keeping a cap on the abusiveness. But unlike patients who have no obligation to me beyond making an appointment, keeping it, and paying the fee but unchallenged acceptance provided their problem falls within my skill. Social media is a more equal relationship but a more manageable one. First, I am not required to show up. Sermo has been dispatched for cause for some time. After a few misgivings I might have been premature at not wanting to have trolls as my medical colleagues, any urge to reconnect has long since passed. Twitter gives me access to some of the finest minds and most influential individuals around. At that level it is not interactive at all. At least my Congressional delegation sends a computerized thank you note when I comment on an issue, and usually my representative's position on the issue of concern to me. Over the years, though, I've received my share of personal responses including my wording in their response. It is really a forum for me to make a statement, though never to make a difference. I cannot block anyone from hostility to my comments though I'm generally too much of a peasant in a forum where who you are matters more than what you think.
Facebook remains my media of choice, even to quasi-addiction in the absence of formal limitations on my frequency of access. I know all the people designated friends personally. I've largely stopped commenting on organizational sites where loons cannot be regulated away. Most of my cohort comes from high school. Ironically, few of us were close friends at the time but the exchange of comments has been respectful. Each of us have developed over those 50 years certain proficiencies and certain predictabilites of response. I never Unfriended anyone who I knew personally and only unfollow the occasional nudnik who posts ever ten minutes while awake or somebody who bypasses analysis to toss out a slogan. But for the most part, my high school educated us well.
The situation with police misconduct leaves me a little at odds with my friends. We vote the same. We have different experiences. My medical career has required mostly favorable interaction with constables who keep my hospital secure, officers who identify people on the street as needing medical care, prison guards who maintain a three way banter between me and the fellow handcuffed to the bed rail. We agree that targeting Black folks for harshness is unprofessional at best, sometimes criminal or lethal at worst. We analyze the best solution differently. Hang the wrongdoers just doesn't change the culture.
Medicine changed its culture in my professional lifetime. I could not think of people more demeaning of the patient public than officers of the AMA and regional medical societies, who in many ways opposed physician accountability early in my career. The state societies had to divest themselves of a unification requirement with a more haughty AMA just to maintain their own membership. And we got accountability big time, but not objectionable accountability. It came in the form of performance enhancement but without fear of reprisal which too often undermines that goal. We have guidelines for many conditions with compliance of analyzed best practices by physicians. Licensure requires some attention to making medical care safer through risk management. Some of us find analysis of Big Data and institutional reporting requirements objectionable, though nobody objects to the improvement in care these efforts create.
Calls for police defunding or other punitive responses undermine public safety, not enhance it. I already met hundreds of honorable officers as patients or in the workplace. Some of the brutality that makes the cell phone camera exposees may very well be successful implementation of their training. You don't fix that by any measure other than changing the training, establishing best practices, confidential peer reviews, CME appropriate to policing, and public image enhancement because you accomplished things worthy of public image enhancement.
My FB friends are probably no more outraged by events than me. They are considerably less analytical than me and most experienced physicians in addressing it. We've been there ourselves and succeeded but it took a generation.
