A few days ago I was sitting in the endoscopy unit working on some notes, when one of my fellows walked into the physician's room to speak to one of her patients over the phone. The patient evidently had a lot of complex questions about her condition that she didn't quite comprehend. The fellow took her time to respond calmly and in straightforward language. She didn't rush and never became flustered or frustrated. After about 15 minutes or so, their discussion ended and the fellow left the room.
Why am I telling you this story? To illustrate an important point.
I was all the way on the opposite side of the room, and the fellow probably didn't consciously notice me. While I was sitting there, I was not intending to judge her on her patient interaction. While she was talking to her patient, she didn't necessarily think (or care) that she might be getting "graded" on her conversation. Nonetheless as I was working I was quietly taking in my surroundings and her conversation happened to catch my ear. Without even realizing it, I was making an informal mini-assessment of her knowledge, skills, attitudes, and behaviors.
Why is this example critical?
The interaction registered in my perception of her overall ability to be a gastroenterologist, and maybe one of my future colleagues. I am pretty sure that she wasn't thinking that the phone call would make or break her ability to get hired. Most people wouldn't. But add up lots of mini-assessments, outside of the context of a formal job interview, and an opinion about you has been formed. For all intents and purposes, everything you do that someone else could perceive (see, hear, or read), could be used as a mini-assessment, and you might not even have realized it. And that time you flippantly yelled at a nurse and then laughed about it later with your colleagues might come back to haunt you.
How has Social Media changed this paradigm?
Social media such as Facebook and Twitter provide a means for rapid communication with virtually anyone, anywhere, at any time. Such platforms have changed the model for the expectation of privacy. The younger generation will grow up with Social Media so entrenched in their lives that they may not recognize all the ramifications of a single reckless post. Information can now become disseminated faster and more broadly, sometimes even ruining people's lives with just a single action, post, or tweet.
The topic of professionalism has been receiving more and more importance within medicine and medical training. For those who have a hard time understanding its importance, I would tell you this:
Professionalism is the 24-hour-a-day job interview.
And now that social media has entered the mainstream, we (as parents, teachers, doctors, etc.) need to educate everyone about its potential. Medical students, college students ... even high school students. Certainly, actions in childhood have little effect on one's professional life as an adult. However a professional and courteous attitude toward others does not begin overnight.
If you care about young people, whether your own children, students you are mentoring, or trainees, take the time to remind them that their actions, both in the real world and the virtual world, have the potential for consequences. Let them know their job interview doesn't just begin when they walk through the door of a potential employer, it begins right now.
Ryan Madanick, MD, is an ACP Member, a gastroenterologist at the University of North Carolina School of Medicine, and the Program Director for the GI & Hepatology Fellowship Program. He specializes in diseases of the esophagus, with a strong interest in the diagnosis and treatment of patients who have difficult-to-manage esophageal problems such as refractory GERD, heartburn, and chest pain. This post originally appeared at his blog, Gut Check.