Professionalism and social media can be an uneasy mix. In the police force, Freedom of Information data have shown that, in the past four years, two officers have been sacked, seven resigned, and over 150 been disciplined for placing “inappropriate” photographs or comments online.1 Nurses have been sacked after making comments about patients and colleagues online,2 posting photographs of themselves exposing their breasts while in uniform,3 and putting pictures of patients online.4 In the United States, four nursing students were expelled after putting a photograph of themselves with a human placenta on Facebook5; and, in Sweden, a nurse has been disciplined for putting photographs from the operating theatre on the same social networking site.6

Doctors have not been immune. In the UK there have been several high profile incidences of tweets or online interactions that have ended up in the lay press; one Scottish junior doctor was controversially suspended over comments made about senior doctors on a website for doctors and students.7

Meanwhile, the BMA has published guidance for doctors and medical students on how to use social media,8 and the General Medical Council, the UK regulator, is currently consulting on it. There are clear things that doctors should not do, whether online or not—namely, break confidentiality or perform illegal acts. The internet means that it is possible to communicate quickly with specialists or colleagues locally or distantly. But while email is private and can be sent with a high level of security, the trend for online discussion through blogs, discussion forums, or Twitter means that more people can view what doctors are saying to each other about clinical or …