The Not-So-Private Lives of Young Doctors

Why is it so important to scrutinize the social activities of young doctors when so many of them are sacrificing themselves and their loved ones to treat patients with COVID-19? Doesn’t that say enough about their character?

Well apparently, several physicians affiliated with Boston University felt otherwise. After collecting data between 2016 and 2018 about the prevalence of unprofessional social medical content among young vascular surgeons, they felt it necessary to published their findings in the August (2020) Journal of Vascular Surgery.

Worse yet, the journal’s editorial board, representative of the white male dominated medical establishment, saw nothing wrong with the study, which was inherently biased and blatantly sexist, causing a backlash that prompted Thomas Cheng (medical student) and Jeffrey Siracuse (associate professor), two of the study authors, to tweet identical apologies, saying in part:

“Our intent was to empower surgeons to be aware and then personally decide what may be easily available for patients and colleagues to see about us. However, this was not the result. We realize that the definition of professionalism is rapidly changing in medicine and that we need to support trainees and surgeons as our society changes. We are sorry that we made the young surgeons feel targeted and that we were judgmental.”

In this “research” paper, social snapshots of surgical trainees were gleaned from their Facebook, Twitter, and Instagram accounts. Approximately one-quarter of 235 doctors had either clearly unprofessional or potentially unprofessional content, such as profanity, HIPAA violations (discussing patients without their permission), controversial religious, political, or social comments (e.g., abortion), inappropriate attire (OMG, women in bikinis!), and depictions of drug paraphernalia and intoxication. The young surgeons were chided for their inappropriate behavior and warned to exercise caution when posting to public websites. Is this the example they want to set for their peers, patients, and current and future employers?

Several other articles of this sort have previously been published, apparently trying to hold physicians-in-training accountable for their actions. But in the wake of #MeToo Movement and other recent attempts to stamp out racism, sexism, and disparagement of minority groups — LGBTQIA+ people, immigrants, indigenous peoples, people with disabilities — the present study really hit a raw nerve. Reactions to it were swift and overwhelmingly negative.

Medical professionals flooded social media with pictures of themselves in bikinis with the hashtag #MedBikini, accompanied by sharp rebukes calling the article misogynistic, among other things.

The firestorm on Twitter forced the journal editors to retract the article, ironically in a statement posted to Twitter. Following the retraction, retweets and comments came fast and furious, demonizing both the authors and the journal’s editorial team. One physician wrote: “Maybe, instead of apologizing to those offended, you should apologize to the research subjects that you helped exploit. The trainees (in your own field!) that you have an obligation to mentor and support.”

If one’s interest in the private lives of young physicians is to “empower” them, I can think of a half-dozen topics worthy of medical attention deserving further research. None of them involve residents in swimsuits or appearing intoxicated — well, almost none — because although the use of drugs by surgery residents is relatively low when compared to drug use by other types of physicians, alcohol abuse may be a problem, and alcohol is the substance of choice of most residents.

One in five Americans live with a mental illness. Amid the coronavirus pandemic there exists an epidemic of psychiatric disorders afflicting many physicians, not only attending physicians, but medical students and residents as well. Substance use disorders, PTSD, burnout, and depression and suicide lead the list. Approximately one physician per day completes suicide in the United States. The fact is the mental health of American medical trainees and the physicians who train them is a real concern.

Surgical residents have an alarmingly high rate of burnout, and medical students begin to lose empathy as early as the third year of medical school, precisely when they are thrust into the clinical arena and begin to interact with patients. Clinical training appears to have a negative impact on empathy and morale; perhaps the erosion of empathy is a precursor for burnout. We cannot afford to let medical students and residents succumb to apathy and indifference when caring for patients.

Improving the mental health of the next generation of physicians should be the real call to action. Medical trainees are often the front-line healthcare heroes, whether during a pandemic or not. But sometimes heroes need help too. For all we know, social media provides a therapeutic outlet for their pain and woe. The study in question did not even assess whether the social media profiles of doctors had an effect on patients.

It’s time for academic faculty members to stop pimping up-and-coming doctors and shaking their trees. The voyeuristic behavior of medical school professors should be harshly condemned.

*Dr. Arthur Lazarus is adjunct professor of psychiatry at Lewis Katz School of Medicine at Temple University in Philadelphia, Pennsylvania, and a member of the Physician Leadership Journal editorial board. A longer version of this editorial recently appeared online in Medium.