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among the office staff can access pri- vate health information; and how t he dissemination of requested data should be handled—such as trans- mitting only the data requested and nothing more. Staff should also ap- preciate the difference between pro- tecting privacy and confidentiality: In contrast to confidentiality rules— which forbid a health professional from communicating or transmit- ting information to unauthorized others—privacy rules seek to protect or shield health-related information from prying eyes or ears. If I walk into a clinic and see patients' records on computer screens such that I can just stare at them and read them, that office will have failed to protect the privacy of their p atients' health information. If I overhear staff obviously talking about the patient who just walked out the door, their failure to con- duct that conversation out of my earshot would count as a privacy breach. Social networking technologies, however, will largely be concerned with confidentiality breaches, which is why the health professional who has just learned that something un- flattering about himself or herself has been posted by a patient or fam- ily member must be extremely care- ful and restrained in responding. First of all, the professional should know that in cases where profes- sionals have actually sued patients or their families for making defama- tory comments online, courts have largely ruled that such expressions are protected by the first amend- ment's freedom of speech. Further- more, as much as the professional might be outraged by a posted com- plaint and wants to respond, if he or she mentions a confidential piece of information about the patient or his or her care in that post, that will likely count as a confidentiality breach for which the professional will have to answer. Ultimately, pro- fessionals are better advised to settle these disputes with patients pri- vately and amicably and hope that the offensive materials are removed. Another important considera- tion involves patients "friending" their treatment professionals on Facebook and then using that tech- nology as a platform for acquiring or discussing medical information. A health professional should think twice about discussing confidential health information in such an ex- quisitely public forum and then not d o it, although there isn't anything wrong with a health professional setting up his or her own health advice page. Still, the professional would at least have to exercise cau- tion over ensuring that 1) no clinical information is disclosed in a way that would identify any of his or her patients, and 2) the clinical advice o ffered is within that professional's area of expertise. Obviously, a health professional offering advice that is outside his or her scope of practice could be viewed with considerable skepticism and might result in a complaint to a state licensing board. HIPAA privacy regulations re- quire clinical practices that maintain p rotected health information to have a designated individual knowl- edgeable about HIPAA compliance. Something that office practices can consider is tasking that person with occasional staff training on privacy and confidentiality issues and on developing formal policies about the use of social networking at work. In anything we link, post, distribute, or disseminate, we should ask ourselves if this information got into someone else's possession, would it constitute a grave embarrassment such that you'd immediately want to apolo- gize or retract it? Health profession- als who communicate information should cultivate an obsession with the question of "How can this com- munication be misused, misunder- stood, or misappropriated?" because a few seconds of indiscretion can ruin a career. Alternatively, one has only to ask if the protected informa- tion was about him or her, how much protection it should be af- forded. Putting oneself in the place of others who entrust health profes- sionals with confidential informa- tion is an excellent psychological starting point for developing staff sensitivity to these issues. EW STRONG ophthalmic WOMEN make for STRONG ophthalmic COMPANIES Ophthalmic Women Leaders (OWL) helps women navigate the pathway to a successful career in ophthalmology. We connect women within the ophthalmic community to enable the sharing of insights and development of alliances. OWL also provides opportunities for professional recognition to foster a supportive environment, celebrate success, ǯ Ƥ Ǥ OWL is a natural partner for women's leadership programs within ophthalmic companies. We provide education and training to help women in partner companies Ƥ Ƥ ǯ Ǥ Individual memberships are also available. To learn more, visit www.owlsite.org. Social continued from page 93 ABOUT THE AUTHOR Dr. Banja is a professor and medical ethicist at Emory University, Atlanta, and the public member of the ASCRS Governing Board. Readers are invited to send comments or cases to him at jbanja@emory.edu. 91-97 OB_EW February 2014-DL2_Layout 1 1/30/14 11:51 AM Page 94