Sunday, March 31, 2013

Addendum for Blog Post September 2012

Addendum 31 March 2013 to September 2012 Blog Piece

The main reason I have decided to put this up on my blog is that the issue of anonymous tweeting is running riot in doctor circles over recent GMC-UK recommendations. Rather considering this a new piece in isolation, I regard it more as an addendum to my blog post from September 2012.  If you read the earlier blog, this will make a lot more sense.

A doctor on twitter who had read this blog piece recently, sent me the following cropped mobile phone screenshot by email (easy to track down via either one of my publications or through the University of Sydney website - you see, I don't try to hide) that was taken of a tweet made about 10 days ago - comment was made that it was seen from a re-tweet as this person like myself, does not follow @otorhinolarydoc.  It wasn't sent to me anonymously but there is nothing to be gained by mentioning who that person was.  Interestingly, it is noted that he has since changed his user name and from this I gather that he is perhaps no longer a trainee and now a qualified ENT surgeon.  Whilst we can say it is a bit of harmless banter, it is essential that readers understand that M & M are an essential form of quality control and good clinical unit governance that must be taken seriously.  The purpose is not to chastise this tweeter but raise the question as to whether anonymous tweeting for entertainment purposes potentially undermines public confidence in the medical profession.  Whilst it might seem minor, you can give an inch and before you know it, you have a mile.  Once we lose public opinion, it is something unlikely to be regained.  Another issue is that of mentorship - registrars often copy the behaviour of their mentors - perhaps there is some shared responsibility between himself and his former mentors if these are the attitudes with which he has been raised as an ENT surgeon.  Let you be the judge on this.  

Tuesday, March 26, 2013

Doctors on Twitter

This blog piece is on my thoughts about Australian doctors on Twitter using their real names or pseudonyms. Those of you who follow me on twitter may have observed how I rant and rave on this issue.  I have had this blog piece on the subject sitting incomplete for a number of months, mainly for the reason that I have not had time to finish it.  The impetus to get on and finish this blog piece came about when one of my favourite twitter colleagues, Dr Gerry Considine, tweeted me to inform me that the General Medical Council in the UK has formulated recommendations on this very matter.  He was well aware of my views on the matter and I appreciate being given the heads up. It is always good to hear that a well respected professional body is aligned with your own thoughts on a matter.

What we say on Twitter as doctors, particularly with medically related topics, carries a lot more weight than might always be recognized.  By saying we are doctors gives our tweets a greater level of authenticity that is not commonly afforded to other users. By virtue of what we do and who we are, we enjoy a level of respect, trust and admiration that is not generally held for many of the other professions. 

All of this stems from the fact that medical practitioners have a privileged position in society.  Not only do we hold power with knowledge, we are respected for the judicious use of our knowledge which has been painstakingly acquired over many years and enhanced by a responsibility for life long learning. 

It is incumbent upon us to not abuse this privilege and for this reason, professional organisations such as the Australian Medical Association has a Code of Ethics . Whilst this Code expresses how we should behave in the interests of the public, I see it as a manner by which we as doctors should expect of ourselves.    The Australian Health PractitionersRegulation Agency (APHRA)  also maintains a Code of Conduct for Doctors in Australia

More recently APHRA has moved to develop a policy on Social Media behavior for health professionals. I do not wish to get into a discussion on the deficiencies of the draft documents that have been publically available but it does provide a timely reminder that there is increasing interest on how we as doctors behave on Social Media.

In my personal experience, the vast majority of doctors who declare themselves as such, will either use their real name or have reference to easily attribute their real name to what is written on their tweets.  Personally, I make the choice to use my real name “Henry Woo” as my Twitter Name and for my Twitter User Name, a short form of my name “@DrHWoo”.  My bio indicates that I am a doctor.  My website link would give reference to my real name even if my Twitter Name and Twitter @ User Name did not have such information.  I don’t think it really matters if it is your user name or bio or link that has your real name as a doctor, as long as what you say is easily attributable to you as a real person.

If you are a doctor hiding under a pseudonym, why is it that you need to hide your real identity?   If there is a specific issue that you wish to remain anonymous for, why not create a separate identity and state that this is the case.  If you really wish to remain anonymous on Twitter, then may I suggest that you do not say that you do not mention that you are a doctor in your bio – the only reason we mention that we are a doctor in our bio because we know it adds to the authenticity and respectability of what we tweet on medical matters, so do not abuse this privilege.  I know of a number of doctors who tweet but do not make any mention that they are doctors - I have no concerns about this – in fact I respect these doctors for not abusing the privilege of what the title doctor means. 

What is rather interesting is that the pseudonym doctors tend to gravitate to each other and engage each other moreso than those of us who use our real names – take a closer look at this next time you look at pseudonym doctors.

In a free and open society, there is should only be very exceptional circumstances in which doctors in Australia should feel the need to use a pseudonym – this might include whistleblowing, a commercially sensitive employer, risk of identifying healthcare workers and patients with uncommon diseases/conditions and there may be others.  But to hide because the individual wishes to publish inappropriate or controversial medical tweets indicates a lack of courage or conviction in their thoughts to use their real name.

One example of inappropriate behavior is here where a user made a comment that undermines what we are trying to achieve in improving cancer care and this is not the type of cynicism about medicine that should be promoted -  the vast majority of us take cancer care very seriously since lives are at stake.  Some have an agenda to undermine the profession by pointing out our mistakes with references to already published news articles – as they are not the authors, there should be nothing at stake by using their real names.  Just today, I saw one of our pseudonym doctors giving personal medical advice on an ultrasound result without having taken a full history or even having seen ultrasound images (allowing for the fact that real time ultrasound visualization is the optimal approach).

To conclude, I confirm that I do not have a problem with doctors being on Twitter nor do I have a problem with any individuals using pseudonyms on this public medium.  I do have concerns when a doctor declares themselves as such and then tweets on medical issues or topics and then hides under a pseudonym.  

Saturday, March 16, 2013

OMICS Publishing - pseudo-academia? predatory?

Is the Hyderabad based OMICS publishing group a pseudo-academic and predatory organisation?  I have done a little bit of digging around and have made up my own mind. I am interested to know what you think.

The Spam into my inbox from the OMICS publishing group seems to becoming a tidal wave.  So far I have had 5 emails this month about some conference or journal associated with OMICS and we are barely half way through the month - I have heard of some academics who are getting them on a daily basis so I count myself lucky.  I had not placed emails from the automatic send to junk email because they actually did have one, yes just one, journal that might be of interest but now I do not care, it is all going to go the junk folder.  That journal is called Medical and Surgical Urology and having looked at what they have published, I would never have given them a recommendation for publication if I was the manuscript reviewer - if you are a urologist, have a look for yourself and you can see why publication there would not be positive for your cv - well that's my opinion on it!

The company creates a front of respectability and sends you a ‘personalised’ email with your name cut and pasted in the appropriate sections and starts with a sweetener as to how you are an eminent person in your field.  You are then invited to submit a paper to one of their many junk journals or to submit an abstract for consideration at one of their conferences.  Of course you have to pay to have this privilege.  Apart from repeatedly sending you emails, the problem is that almost all of these conferences have absolutely nothing to do with your field of interest.

The only problem is that they are getting smart and now sending many of these requests using gmail accounts to avoid them going straight to spam folders - some of the emails have no reference to OMICS until you check out the links.

Problem is that as a urologist, I have no expertise in immunology as per request above and below, I have nothing to do with analytical pharmacy.  These are a few examples of numerous such requests all received just recently.

The company OMICS is a professionally run predatory publishing company from India.  Often addresses and telephone number contacts are in the USA to hide this fact.  Often, but not always, the names of academics they use to be the face of their conference or journals are those who have little if at all any academic presence in their fields.  The more you dig, the more that you find that you do not like about OMICS. The most comprehensive discussion on OMICS is on Richard Poynder's blog site  – it describes many of the frustrations contributors have had with the company.

Another interesting article on predatory publishing by OMICS is at the following link and is worth a read.

OMICS will continue to 'prosper' because unwitting researchers continue to respond to their email spam and they must be making money.  If you email enough people, somebody is going to contribute to their income stream whether it be by manuscript publication fees or conference attendance (your paper or abstract will be accepted - if anybody has ever had one rejected, now that would be too embarrassing to admit)

My personal thoughts on this company are

1. do not fall for the opening 'pick up lines' of how are eminent you are in your field
2. do not submit a manuscript to any of their journals
3. do not accept an editorial board position - you are giving them credibility and put your reputation on the line
4. do not submit an abstract to attend their conferences
5. do not perform peer review of articles for them
6. direct their emails to your junk folder

I am not against open access publishing and in fact support it.  I have in fact published in two manuscripts in open access pubmed indexed journals by choice.

On a moderated forum specifically discussing OMICS, it is interesting to see that the reputation of this publishing machine is under question with comments such as :-

"I'd trash the cv of anyone who had an OMICS publication”
“The only thing to do with OMICS is avoid, avoid, avoid.”