When 99nicu opened in 2006, we were adopters of the main idea with Internet, the power of dialogue and sharing.

Why not use that for professionals? And, we saw lots of possibilities and the sky was the limit.

Today, professional social networks directed to staff in health care are becoming increasingly common and popular, and some of them have grown huge! Like www.sermo.com. (If you want to read an over-view of the largest sites, read this blog post by David Isaacson, community manager at doc2doc.)

But, what responsibilities do individuals have, when experience and opinions from clinical scenarios are shared?

I came across a thoughtful blog post by Bryan Vartabedian, pediatrician writing the blog www.33charts.com. He wrote:

...Open communication among physicians is critical for the dissemination of medical information. As technology advances and physicians evolve in how they interact, it’s critical that we not confuse the message with the medium. At some point the courts will test the limits of physician dialog on physician networks. And hopefully fear of legal retribution won’t hobble these new forms of interaction which stand to improve the quality and efficiency of patient care.

So if you are concerned about dialog on a medical web 2.0 platform, you should be just as concerned with dialog around the water cooler.

But, individual patient integrity comes above all, and as medical professionals, we need to take that integrity into consideration when we interact with colleagues on-line.

How could we do this? My top list:

1. ask the parents for consent
   
2. anonymize all information
   
3. change clinical details (or make new up) without significance for the question asked
   
4. ask someone else (such as a friend working on the other side of the world) to submit the question
   
5. report back to the parents about the "outcome" of your online consultation