Doctors aren’t big users of social media—their schedules don’t leave a lot of time for casual status updates, and a state-by-state patchwork of ethics rules limit what they can post and who they can friend, says Toronto critical care physician Dr. Joshua Landy.
But, Dr. Landy says, they are signing up for a specialized smartphone app called Figure 1, created by a company of the same name he cofounded. It’s a specialized photo-sharing hub for physicians and other medical professionals, letting them share photos of medical conditions for teaching and diagnostic purposes while incorporating safeguards to ensure patient privacy and consent.
"From my users' perspectives, the way that privacy gets dealt with in the app is essentially, if you can think of the phrase, the best way to keep a secret is not to have it," Dr. Landy says.
That means doctors are prompted before they share an image to make sure they have proper consent and to delete any identifying features from their photos and captions, like patient faces, tattoos, or potentially unique facts like the dates of a hospital stay. Redacted parts of a picture are actually scrubbed from the image file, not merely obscured, he says.
"After that you submit the images, before they're released for anyone to see, they're reviewed by our privacy moderators, and then once they've been moderated or released, if anyone has any concern about any images, they can be flagged or removed immediately," Dr. Landy says.
Dr. Landy, who as a visiting scholar at Stanford University studied doctors’ use of mobile devices, said health care workers were already snapping and sharing pictures of patients’ medical conditions with their colleagues before Figure 1 launched about a year ago.
"But what they're not doing is saving those pieces of information: those interesting cases, those teachable moments, that sometimes happen at 4 in the morning when you're alone," he said. "There's no current way, or there hadn't been [before Figure 1], any way to archive these great educational assets."
The company formally markets Figure 1 as an educational tool, not a diagnostic one, and, Dr. Landy says he’s seen doctors use the tool to quiz students and residents about medical conditions. About 15% of U.S. medical students use the app, estimates cofounder and CEO Gregory Levey.
Dr. Landy says Figure 1 lets doctors and other medical professionals see a wider range of cases than they might see in ordinary practice.
"There's so much just outside the usual circle of regular diagnoses," he said. "You only learn how to make that diagnosis if you've read a case or seen that case in person."
While the site is open to any licensed medical professional, Dr. Landy says it’s definitely not intended for patients looking to self-diagnose.
"People get called out if it seems like someone's trying to hide their own medical condition as a patient's condition that they're trying to help, and I think that makes sense," he says. "People are here in a professional environment, and they want to talk to each other and learn from each other."
But, he says, patients he’s spoken to are generally okay with doctors anonymously showing their colleagues photos of their medical conditions through the app.
"Almost every patient I've asked is interested in having the images shared as long as they're being shared in the interest of education and being able to help people who are in similar circumstances," he says. "Obviously if someone says no, that's pretty much the end of the conversation; the first principle of medical ethics is pretty much patient autonomy."