You have got an excellent point there. I have a good friend who is recruiting people for a large Hi-tech. company. He told me that they do a full Cyber-space profile on every one of their candidates. Even if you use a pseudonym it is possible to find who you are if one truly wishes to do so.

On the other hand-a 20 year old that does not have any internet community appears peculiar. (just like someone that age 20 years ago would appear if he/she never went out with people). There is really no turning back. It is just learning the ethics and rules of those societies. And we are obviously not there yet.

For instance, I recently saw an interesting discussion regarding if it is OK for a physician and his/her patient to be "friends" in face-book, and what should you do if your patient asks you for advice on the internet. Are you obliged to his confidentiality? Is it OK for you to refuse to give medical advice and just socialize? I believe similar concerns would be for lawyers, social workers or any one who has a profession that involves delicate matters.

I see two opposing trends in response to this relatively new communication avenue. On the one hand everything is open for everyone to see. On the other hand people are much more concerned regarding confidentiality issues and their privacy. I think both are reasonable responses. I believe that the pendulum will eventually bring a new balance between those two, but for now we are still in the infancy of this tool.

A few days ago, I wanted to see one of my patient's file in the computer, as she wanted me to give her advice on the phone. When I got into her file, I got a message that I do not have permissions to see her results. I can only see results of patients who have been in my clinic within the last 30 days.
on the one hand this protects the confidentiality of patient's files, so that only those who are actively taking care of a patient can go into their files. On the other hand it seriously jeopardizes patient care. I ended up asking her to fax me her lab results. It became even more ridiculous when I tried to see my own lab results, as I got a message-this is not your patient!

I wanted to tell the stupid computer- what do you mean this is not my patient? who do you think found the best management approach for this patient? Who consulted multiple experts around the world? who read everything that was ever written about this illness to figure it out? If you are not going to let me see her lab results I am going to send you back to the computer ware-house and never talk to you again.

Of course there was no one to say this to, and even if there was, I know what his response would be-he would laugh at me and say-Go on, return me to the computer warehouse. I want to see you manage without me for one day.

alice