Are We Losing Our Boundaries?

Guest Post by Diana Raab

Before the internet, we would write in our journals or notebooks for our eyes only. Back then, we were more private. The advent of the blog in the mid-1990s drove many devoted journal writers to the public forum. They blogged about anything and everything from their husbands, kids, lovers and even what deodorant they preferred. We were all exposed. More recently, however, I’ve noticed a trend towards more universal blogs and the subjects have wider appeal.  In many ways they are more interesting to read.

Even if blogs are more universal in nature, we are still left with the philosophical question of  “Where are the boundaries between the personal and the professional? Do they continue to be blurred? To help answer the fate of this question, I’d like to turn to a compelling editorial in USA Today on June 10^th, called, “ A Doctor’s Request: Please Don’t Friend Me.”

The author, Dr. Katherine Chretien, a professor of medicine at George Washington University deftly put words to an issue we will all have to address in the years to come as social media forums become even more commonplace. One of the many problems is that social media makes us all feel that we are not alone and we get immediate approval for what we are doing or saying. In many ways, it’s attention-seeking behavior and at times can be seductive.

Dr. Chretien was particularly addressing the facebook issue, but the editorial’s focus really has an even wider appeal and presents some deeply philosophical questions.

The editorial begins like this, “As your doctor, I might sit on the edge of your hospital bed and try to quell your fears and anxieties of being ill. Or, I might bounce into the examination room with a bright smile and try to make you laugh with one of my very funny (read: corny) jokes. We might sit together and catch up on your life over the past six months since we last saw each other. In fact, we might have a patient-physician relationship that makes other patients and physicians utterly jealous…. But please, don’t ask me to be your friend. That is your Facebook friend.”

As a former nurse, I completely understand what she’s saying. I remember meeting a patient in the grocery story and her wanting to show me how nicely her wound was healing and I had to say, “Sorry, not here.” More recently, I have been asked to be friended by people who work for me or who I have worked for in the past. It seems to me that some people are clearly more sensitive to personal boundaries than others, but if we all honor one another’s privacy it will be easier and less stressful to adapt to these changes.

Dr. Chretien makes the point that having a so-called dual relationship with a patient can lead to serious ethical issues and potentially impair professional judgment. She says, “we need professional boundaries to do our job well.”

I bow to Dr. Chretien’s courage for writing this editorial and also for her personal integrity and ability to draw this professional line—something many people have difficulty doing, as much as they might try.

Diana Raab is a memoirist, essayist, poet and author of seven books and editor of two essays collections, including the latest, Writers and Their Notebooks (2010) with an introduction by Phillip Lopate. She is a journaling advocate and teaches in UCLA Extension Writers' Program and in various conferences around the country. Her forthcoming book, Healing With Words: A Writer's Cancer Journey is forthcoming from Loving Healing Press in June 2010. Visit Diana Raab.