LETTER TO THE EDITOR Author Reply L. A. Thompson, MD MS, E. W. Black, MA, K. Dawson, PhD, R. Ferdig, PhD, and N. P. Black, MD Division of General Pediatrics, University of Florida, Gainesville, Fl, USA.

To the Editor:—We thank Dr. Gorrindo, et al. for their insightful letter urging broader action regarding the appropriate use of online social networking. We agree that addressing Facebook through the ACGME and medical schools is only one step in what should eventually become an ongoing, national discussion within and beyond academia. We also concur with the authors’ predictions that user demography will ‘age-up’ and subsequently self-adjust for use and content. However, as a team of interdisciplinary authors representing both medicine and education, we recognize the opportunity to be among the first to provide direct and concrete advice for future practitioners. At our institution, simply telling students to increase their privacy settings on Facebook yielded an 80% reduction in publicly visible accounts1. Also, informing students that the contents of the entire Internet are continuously recorded can be a powerful intervention. (For example, www. archive.org contains old versions of Internet sites from more than ten years ago.) This holds immediate salience to the Facebook discussion, as future pediatricians may not want others to know they once belonged to the “Party of Important Male Physicians (PIMP)” social group2. As such, we are continuously developing curriculum to educate about these circumstances. We have previously made the argument that no technology is good or bad in and of itself; rather, it is the use of that technology which determines its value or harm in and on society3. In light of this, we are concerned with connotations of the word ‘policing’ in the letter from our colleagues. ‘Policing’ suggests that with the right policies, Facebook as a specific technology could be controlled. In reality, Facebook represents a specific type of tool much like Kleenex represents tissues. We want to become engaged with technologies so that what we Published online October 7, 2008

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understand the pedagogy and practice behind the tool, not just the tool itself. If Facebook changes what it does, or if something replaces Facebook tomorrow, we can still be prepared to educate and inform our future practitioners. In short, we completely agree that there is a need for a national conversation about online identity and professionalism. This should include not just the American Medical Association, but other professional organizations such as the American Bar Association, the American Academy of Pediatrics and the National Education Association. Online professionalism is an issue that must be addressed by all facets of the professional spectra, not just physicians. L. A. Thompson, MD MS; Division of General Pediatrics, University of Florida, 1701 SW 16th Ave, Bldg A, Room 2103, Gainesville, FL 32608, USA (e-mail: [email protected]).

REFERENCES 1. Coutts J, Dawson K, Boyer J, Ferdig R. Will you be my friend? Prospective teachers’ use of Facebook and implications for teacher education. Paper presented at: Proceedings of Society for Information Technology and Teacher Education International Conference 2007; Chesapeake, VA. 2. Thompson L, Dawson K, Ferdig R, et al. The intersection of online social networking with medical professionalism. J Gen Intern Med. 2008;23(7) 954–7. 3. Ferdig R. Assessing technologies for teaching and learning: Understanding the importance of technological-pedagogical content knowledge. Br J Educ Technol. 2006;37(5)749–60.

J Gen Intern Med 23(12):2156 DOI: 10.1007/s11606-008-0816-5 © Society of General Internal Medicine 2008