Why HIPAA doesn’t (and will never) have a Twitter account | #MedEd

Lately, I’ve noticed a slew of articles and online conversations about doctors needing to be on Twitter.

It all makes sense. I mean, healthcare has been lagging behind in digital communications for some time, so it’s only natural that we’re seeing a spike in discourse related to how to improve it and improve it quickly.

The suggestion is basically that without Twitter, a physician is missing out on a now-essential part of medicine.

To which I say ‘Ya…but.” (And the ‘but’ is a big ‘but’. Sir Mix A Lot fans, unite. Wait for it.)

Now, Twitter is a fabulous tool. I love it. I use it every single day. It is a source of immediate information from traffic and weather, news headlines, the latest movie reviews, uplifting quotes, hilarious random observations — basically everything is on Twitter, including medical professionals.

In essence, I do agree that physicians should be on Twitter.

And not as a lurker.

What’s that?

That’s when you sign up for a social media account and then decide to be anti-social.

Instead of posting and conversing, you just sit there and read what everyone else says and does.

You can be a lurker if you want, but just know that you’re the social network equivalent to that person at the cocktail party who just stands in the corner and nurses a beer and only occasionally makes eye contact. No one really likes him because he makes everyone else feel weird and uncomfortable.

Don’t be a lurker on Twitter. Don’t be a lurker anywhere.

I digress.

I do think physicians should be on Twitter, if only to gain a complete understanding of what it’s used for and the type of reach it can have.

But I feel like I’m sort of preaching to the choir here. All odds suggest you likely found this blog post because you follow The Rounds or me on Twitter. So I’m going to go out on a limb and assume you already understand what a RT is versus a DM and you are already fairly adept at parsing your thoughts down to 140 characters or fewer.

What I really want to talk about is what you should and should not be using Twitter for — whether you are being a lurker or being an active participant — and whether that justifies the blanket assertion that all physicians need to be on Twitter.

You see, physicians are a special group. They fulfill a specific role in society and are bound by a very particular set of rules and standards — moral and legal codes, if you will. And those rules aren’t all rose coloured glasses, Platonic-turn-into-the-sun, kind of rules and moral codes — there are actual LAWS that govern what you can and cannot do on social sites.

One of those laws is the HIPAA.

Don’t believe me? Here it is.

If HIPAA had a Twitter account it would be @HIPAAcrates, don’t you think? (Pats self on back for clever social media digital punnery and the personification of a piece of legislation.)

BUT (← there is is!)

HIPAA doesn’t have a Twitter account because Twitter is NOT HIPAA compliant.

They are like oil and water.

They are like Kirk and Khan.

They are like the dude from the Polka Dot Door and the Polkaroo.

They just aren’t meant to be together.

Here’s what I mean:

If you’re a family doc and you’re on Twitter, fabulous! If you talk about the movie you saw last night, cool beans. If you chat about your upcoming family trip to Myrtle Beach, bon voyage! Enjoy!

But, if you’re the doctor Tweeting about patients, hospital stuff, lamenting a bad day at work, asking for practice management advice or talking about anything at all that can be traced back to your job and, more importantly, your patients?

You’re at risk of severely ticking off the HIPAA powers that be.

Twitter is not an encrypted service.

I’m not a techie, but I can tell you that means the information you share using Twitter ceases to belong to you and ends up transmitted across any number of digital channels that are likely unsecure.

HIPAA requires your communications to remain 100% secure at all times.

That’s why HIPAA doesn’t play nicely with Twitter.

All this to say, if you’re looking for a social media experience that permits you to act like a physician in every sense — Twitter isn’t it.

Given that, how are physicians supposed to capitalize on digital communications without risking a giant HIPAA-sized scar on their professional records?

The solution is not avoidance. It’s never avoidance.

Think about it. When in the history of all things has a hero become a hero by avoiding the problem?


What responsible physicians are doing is setting up a Twitter account to talk about Myrtle Beach. Jurassic Park and the great food they ate at the farm market and they are taking their professional communications into a secure, HIPAA-friendly environment — like The Rounds.


No doctors lurking on Twitter.

No HIPAA deities ticked off with Dr. Tweeters.

Instead, healthy, professional, clinical discourse in a safe, engaging digital space, where the HIPAA deities eat peeled grapes because they don’t have to worry about a thing.

Problem solved.

Back to the original assertion.

Do physicians need to be on Twitter?


Can physicians be physicians on Twitter?

No. No, they cannot.

Erin Trafford is an award-winning broadcast journalist and holds an Hon BA from the University of Toronto in Political Science and Bioethics and an MA, Journalism from Western University. She also proudly represents The Rounds as the Manager of Marketing and Communications.

To see her last post about Imagining a World with No Doctors, click here.)

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