Pharmacists on Facebook: Online social networking and the profession

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COMMENTARY

Pharmacists on Facebook: Online social networking and the profession T. Joseph Mattingly II, Jeff Cain, and Joseph L. Fink III

Received December 3, 2008, and in revised form March 22, 2009. Accepted for publication July 8, 2009.

Abstract Objective: To provide a brief history of Facebook and online social networking and discuss how it has contributed and can contribute in the future to a paradigm change in social communications. Summary: When student pharmacists complete school and enter practice, they encounter enhanced expectations to act appropriately and professionally. Facebook expands the dilemma of separating private and public life—a challenge for individuals in all professions. From the standpoint of a professional association, Facebook provides a tremendous opportunity to reach out to members in an unprecedented way. Pharmacy organizations are beginning to use these new tools to increase communication and dissemination of information. Conclusion: The popularity of Facebook has brought the issue of online social networking to the forefront of professional and organizational discussions. The issues of privacy, identity protection, and e-professionalism are likely to reappear as pharmacists and student pharmacists continue to communicate via online networks. The potential exists for organizations to harness this organizational and communication power for their own interests. Further study is needed regarding the interaction between online social networking applications and the profession of pharmacy. Keywords: Facebook, Internet, networking, professionalism, privacy. J Am Pharm Assoc. 2010;50:424–427. doi: 10.1331/JAPhA.2010.08174

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T. Joseph Mattingly II, PharmD, MBA, is Pharmacy Manager, Kroger, Louisville, KY. Jeff Cain, EdD, MS, is Director of Education Technology, College of Pharmacy, University of Kentucky, Lexington. Joseph L. Fink III, BPharm, JD, is Professor, College of Pharmacy, University of Kentucky, Lexington. Correspondence: T. Joseph Mattingly II, 11007 Indian Legends Dr., Louisville, KY 40241-3447. Fax: 859-323-0069. E-mail: [email protected] Disclosure: The authors declare no conflicts of interest or financial interests in any product or service mentioned in this article, including grants, employment, gifts, stock holdings, or honoraria.

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pharmacists on facebook COMMENTARY

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ecent developments in Web-based technologies are beginning to alter how individuals and organizations communicate. Applications such as Facebook (the fifth most visited website in 20081) are mediators for building and maintaining social capital and have the potential to increase communication and organizing capacity for groups and organizations. The popularity and ease of use of this social networking application creates a low barrier to entry for individuals and organizations who want to broaden communication and organization opportunities.

Objective The objective of the current work is to provide a brief history of Facebook and how it has contributed to changes in social communications. Basic background on this application will be provided, and this work will briefly address some of the negative issues surrounding it, emphasizing the potential it offers for pharmacists and pharmacy organizations. To explain some of the concepts associated with Facebook and online social networking, a metaphor of the high school yearbook is used.

Brief background In February 2004, Harvard University sophomore Mark Zuckerberg launched a website, now known as Facebook, to allow interaction among Harvard students.2 Originally designed for

At a Glance

Synopsis: The current work describes how the social networking website Facebook has contributed to changes in social communications. The popularity of Facebook has brought the issue of online social networking to the forefront of professional and organizational discussions. The application raises issues regarding privacy, identity protection, and eprofessionalism, and these issues are likely to persist as pharmacists and student pharmacists continue to communicate via online networks. Facebook also gives individuals and organizations the ability to harness the application’s organizational and communication power for their own interests. Analysis: Further study is needed to clarify the relationship between online social networking applications and the profession of pharmacy. The separation of private and public life will continue to be a topic of debate for professionals. The delineations between private and public boundaries may vary for different generations. As students develop and are socialized into professionals during an era of online social networking, social norms and acceptable online behaviors may change. For many years, professors and practitioners have mentored students regarding professionalism and the attendant expectations. By understanding these new technologies, they may be better suited to guide future practitioners.

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college students on the same campus to connect, Facebook was limited in scope because only students with valid university e-mail addresses could register. The popular online network quickly spread to practically every college campus around the country and eventually expanded to allow anyone with a name, birth date, and e-mail address to join.3 Now, less than 5 years since its creation, it is estimated that four of five (82%) undergraduates have a Facebook profile.4

Interactive yearbook Facebook users begin registration by creating a profile page that includes their name, date of birth, and hometown. The options beyond that basic information are quite extensive and typically include personal information such as activities, interests, and favorite music, TV shows, books, movies, and quotations. Users can also upload and provide access to photos, contact information, and education and work background. After a Facebook profile is created, users can add others as “friends,” which creates a link between the profiles. The link between friends may vary based on individual privacy settings that the user controls. The term “friend” for many Facebook users is applied to anyone with some connection to the user and may differ somewhat than the traditional use of the term. Profiles are linked in a simple binary relationship, friend or not friend, on Facebook, with no indication of the magnitude or depth of the relationship.5 For example, two people who may only be mere acquaintances in a physical social setting may consider each other friends on Facebook. Users have an option to categorize friends to help define their association with individuals, but this is not a required step when adding a friend. Facebook also allows users to create and join “groups,” which enables multiple users to organize around common hobbies, affiliations, social causes, or a host of other shared interests. The group function provides a place to recognize specific associations, similar to the pages of an old high school yearbook that included pages for an athletic team, marching band, or glee club. Group pages may contain discussion boards, photographs, designated officers of the group, pictures or logos for the group, and information or background about the group. Any user may create a group and adjust the settings to allow open access to the public, require invitations for membership, or keep the group completely private.6 A popular feature of the website is the “wall” function. The wall is a discussion board available on a user’s profile. Similar to messages left within the pages of a yearbook, wall posts are typically messages that are meant to be more public. Depending on individual privacy settings, wall posts on a person’s profile may be accessible to anyone or limited only to friends. Facebook friends are able to communicate via wall posts, private messages, and a private real-time chat tool. The multiple communication vehicles within the website enable users to connect to friends with ease. The popularity of communicating in this fashion and maintaining social ties is contributing to the changing nature of social communications among younger generations.

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pharmacists on facebook

Organization in the blink of an eye One of the most useful functions of Facebook is the ability for a person to join groups with other Facebook users. Organizations such as the American Pharmacists Association (APhA) have taken advantage of this new tool in order to reach more members. APhA launched a Facebook group during summer 2008 and within a few months attracted more than 2,500 members nationwide.7 Facebook’s ability for dynamic growth and connections transcends its organizing potential well beyond those of traditional forms of group affiliations such as yearbooks and organizational directories. Pharmacists hold leadership positions in and have responsibility for managing many different organizations and groups. Managing any organization with numerous members can be an expensive undertaking. When group size increases, the cost of coordinating efforts and communicating with members grows substantially.8 Leaders of large organizations must weigh the benefits of strategies against all the costs associated with implementing those strategies. New tools like e-mail and online social networks have dramatically reduced the costs to communicate with members of large organizations. With little effort and technical skills, anyone can create a group on Facebook with a fully functional discussion board, a member roster, and an electronic mailing list to reach all of those who join. Facebook provides an opportunity for people with similar interests to connect quickly and easily, making it a very valuable tool for groups of any size. One study of 684,505 requests sent to Facebook users found that the average response time for a request was less than 17 hours.9 Groups that depend on rapid response from their members, such as political advocacy groups, could benefit from the quick response time from users. These instant organization benefits were exemplified during the 2008 presidential campaign when Barack Obama won a large majority of young voters and support from the “Facebook generation” with a strategy that included the use of several online social networking websites.10

Privacy dilemma Although the increased use of online social networking has benefited users by strengthening friendship ties, these potential rewards come with some risk. By creating a profile on Facebook, users are voluntarily providing some of their personal information to the public. A yearbook could contain private messages left by friends within the physical pages but would only enter the public realm if the contents were published in some form of publicly accessible media. Facebook essentially publishes everything in a public domain. Privacy settings can be used, but the default settings allow many parts of one’s profile to be viewed by other members in the same network. For example, the initial profile of an individual in the University of Kentucky network would provide others in that network access to more information than someone who is randomly searching outside of that institutional network. Privacy settings can be adjusted to only allow friends to see specific parts of a profile and prevent open public access to Facebook profile information.11 Access to information on a profile may also be limited to 426 • JAPhA • 50 : 3 • M ay / J u n 2010

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specific individuals or groups defined by the user. This provides the option to control who has access to material on a person’s profile. One of the major issues surrounding the use of online social networking is the consideration of personal privacy. The Fourth Amendment to the U.S. Constitution, which pertains to illegal search and seizure, has inspired much debate about obtaining information that people perceive as private. For information to have privacy protection, the person sharing the information must have exhibited an expectation for privacy and that expectation for privacy must be reasonable.12 One can argue that users who post information on their Facebook profile yield their right to privacy. Facebook users appear to be generous with the personal information they provide and do not use the privacy settings in many cases.13 Many students who use Facebook express little concern about privacy, and despite familiarity with the privacy settings, choose not to use them.14 A study at the University of Florida found that through Facebook, medical students and medical residents provided personal information not typically disclosed in a traditional physician–patient relationship.15 The availability of private information has led to instances of school or employer action based on personal information viewed on an online social networking site.16–18 Institutions such as a colleges of pharmacy or professional organizations are now faced with a dilemma regarding the appropriateness of using information found on Facebook when making student or membership decisions about individuals.

Discussion Pharmacists are arguably the most accessible health professionals in the United States and practice in the spotlight of the public on a regular basis. When students leave school and enter practice, they encounter enhanced expectations to act appropriately and professionally. Facebook expands the dilemma of separating private and public life—a challenge for individuals in all professions. Addressing this issue has created a professionalism topic termed “e-professionalism,” which specifically applies to online personas.19 The separation of private and public life will continue to be a topic of debate for professionals. The delineations between private and public boundaries may vary for different generations.20 As students develop and are socialized into professionals during an era of online social networking, social norms and acceptable online behaviors may change. A few students have refused to join online social networking sites or have deleted their profiles after graduation in order to avoid any potential questions of privacy and professionalism. Although this is a safe approach, it removes the potential benefits of being a member of an online community. A better alternative for protecting one’s personal privacy and professional image may include enhanced education and informed guidance. Professors and practitioners have mentored students along the traditional lines of professionalism and the attendant expectations for many years. By understanding these new technologies, they may be better suited to guide future practitioners. Journal of the American Pharmacists Association

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pharmacists on facebook COMMENTARY

From an organizational standpoint, Facebook provides a tremendous opportunity to reach out to members in an unprecedented way. Pharmacy organizations are beginning to use these new tools to increase communication and dissemination of information. These efforts are focused on reaching younger generations (mainly student pharmacists and new practitioners) who spend more time using Facebook. However, online social networking is spreading to older demographic groups,21 and this form of communication could potentially reach all types of members. The ability to maintain and enhance social and professional ties is a compelling reason for adoption by individuals of all ages.

7. Facebook. American Pharmacists Association. Accessed at www.facebook.com/APhAPharmacists, December 3, 2008.

Conclusion

12. Hodge MJ. The Fourth Amendment and privacy issues on the “new” Internet: Facebook.com and MySpace.com. Southern Illinois University Law Journal. 2006;31:95–123.

The popularity of Facebook among college students and other members of younger generations has brought the issue of online social networking to the forefront of professional and organizational discussions. The issues of privacy, identity protection, and e-professionalism are likely to reappear as pharmacists and student pharmacists continue to communicate via online networks. The potential exists for organizations to harness this organizational and communication power for their own interests. Further study is needed with regard to online social networking applications in the profession of pharmacy. References 1. Alexa. Top 100 sites in the United States. Accessed at www.alexa.com/topsites/countries/US, October 20, 2008. 2. Phillips S. A brief history of Facebook. Accessed at www.guardian.co.uk/technology/2007/jul/25/media.newmedia, October 20, 2008. 3. Facebook. Company timeline. Accessed at www.facebook.com/ press/info.php?timeline, October 20, 2008. 4. Kolek EA, Saunders D. Online disclosure: an empirical examination of undergraduate Facebook profiles. NASPA Journal. 2008;45:1–25. 5. Boyd DM. Friendster and publicly articulated social networking. Conference on Human Factors and Computing Systems, Vienna, Austria, April 24–29, 2004. 6. Facebook: Product overview. Accessed at www.facebook.com/ press/product.php, October 20, 2008.

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8. Shirky C. Here comes everybody: the power of organizing without organizations. New York: Penguin Group; 2008. 9. Nazir A, Raza S, Chuah C. Unveiling Facebook: a measurement study of social network based applications. Proceedings of the 8th ACM SIGCOMM conference of Internet measurement. 2008;Oct:43–56. 10. Fraser M, Dutta S. Obama and the ‘Facebook effect.’ Accessed at www.mediapost.com/publications/?fa=Articles. showArticleHomePage&art_aid=94861, November 19, 2008. 11. Facebook: Privacy policy. Accessed at www.facebook.com/policy.php?ref=pf, October 20, 2008.

13. Gross R, Acquisti A. Information revelation and privacy in online social networks (the Facebook case). Proceedings of the ACM Workshop on Privacy in the Electronic Society. 2005:71–80. 14. Jones H, Soltren JH. Facebook: threats to privacy. Accessed at http://groups.csail.mit.edu/mac/classes/6.805/student-papers/ fall05-papers/facebook.pdf, November 5, 2008. 15. Thompson LA, Dawson K, et al. The intersection of online social networking with medical professionalism. J Gen Intern Med. 2008;23:954–7. 16. Kornblum J, Marklein MB. What you say online could haunt you. USA Today. March 9, 2006:A1. 17. Brown L. Student faces Facebook consequences: freshman hit with 147 academic charges for online study network at Ryerson University. Accessed at www.thestar.com/News/GTA/article/309855, November 5, 2008. 18. Cannon R. Caitlin Davis prank photos: Patriots cheerleader fired. Accessed at www.postchronicle.com/news/original/article_212183968.shtml, November 5, 2008. 19. Cain J. Online social networking issues within academia and pharmacy education. Am J Pharm Educ. 2008;72:article 10. 20. McCleary L. What was privacy? Harvard Business Review. 2008(Oct):123–31. 21. Facebook. Statistics. Accessed at www.facebook.com/press/info. php?statistics, November 14, 2008.

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