Figures compiled by the Medical Defence Union (MDU) show that the number of cases of doctors seeking its help because they are being pursued by a lovestruck patient rose from 73 in 2002-06 to 100 in 2007-11. Patients are increasingly using social media rather than letters or flowers to make their feelings clear, such as following a doctor on Twitter, "poking" them on Facebook or flirting with them online.
A female GP was asked out for a drink by a male patient as she left her surgery. When she declined, he began to pester her via Facebook and sent her a bunch of lilies, which she had listed as her favourite flowers on her Facebook page. On MDU advice, she changed her security and privacy settings on the site so that only chosen friends could view her postings.Of course, it is unreasonable to ask doctors (and, indeed, other public-facing professionals; teachers, police, social workers and legal aid workers come to mind) to delete their Facebook accounts and not use social software. For one, in this day and age, disconnecting from social software means virtual exile; Facebook refuseniks find themselves out of the loop, relying on the charity of friends with Facebook accounts and free time to keep them informed of everything from party invitations to when mutual friends friends had a baby, got divorced or moved abroad. And then there is the increasing public expectation that well-adjusted citizens have a Facebook profile, and one with normal activity patterns. Already there is talk about governments requiring citizens to log in with Facebook/Google identities to access services, so a normal Facebook record, with the requisite casual-though-not-debauched photos and history of social chatter is increasingly starting to look like a badge of good citizenship, well-adjustedness and general non-terroristicity. And having two accounts, one for your professional persona, and one for your personal life, is expressly verboten by orders of Mark Zuckerberg and Vic Gundotra, as mandated by the advertisers who demand accurate records of eyeballs sent their way and the shareholders who demand steady advertising revenue.
So now, by the immutable facts of neoliberal capitalism in the internet age, we have a world where people have only one face they present to the world, one with their wallet name, career record, list of friends and social activity attached. This face is visible to everyone from old friends to employers to any members of the public one has a professional duty of care to. Perhaps there's a Californian jeans-and-T-shirts casualness to forcibly unifying these facets; to not allowing a distinction between the uniform of professionalism one wears in one's career and the accoutrements of one's casual, personal life; to knowing that your doctor's favourite flower is the lily, your geography teacher was in a moderately well-known math-rock band, or the police officer you reported your lost phone to is an Arsenal fan and known to his mates as Beans; though the downside of the casualisation of professional life is the professionalisation of casual life, a sort of Bay Area take on superlegitimacy. And while in Britain today, that may take the form of doctors self-censoring to avoid the possibility of obsessive patients, in parts of the US, where employers can fire workers for their political or personal views, sexual orientation or even sporting loyalties, the stakes are higher.
Whether the Zuckerberg Doctrine is the inescapable future, in which everyone is coerced into an endless, joyless social game of simulating a model citizen as if under the watchful eyes of an outsourced Stasi, however, is another question. Facebook's unquestionable hegemony is starting to show its first cracks. For now, it remains the default grapevine, the standard channel of social chatter; however, its declining share price seems to be pushing Facebook to more agressively monetise the relationships of its nominally captive audience, pushing more ads and sponsored stories, asking users to pay for their messages to be seen by their friends (whose feeds can only contain so many updates, after all, and there are commercial sponsors to compete with), and, the implication goes, throttling back how much unsponsored chatter a user sees. As this ratchets up, eventually people will notice that their friends' announcements and photos aren't making it to them but instead the fact that their friend ostensibly likes Toyota or Red Bull is and start tuning out. Then Facebook will decline, as MySpace and Friendster did before it, and something else will take its place.
Perhaps the best thing to hope for is that whatever fills the niche occupied by Facebook will be not so much a service but a decentralised system of independent services, each free to set its own terms and policies. They could be based on a protocol such as Tent or Diaspora*, and, as the servers interact, allow for great diversity; some servers will be free to use but spam your eyeballs with ads until they bleed, others will charge, say, $25 a year and offer ad-free unlimited hosting; some will have Zuckerbergian wallet-name policies, others will allow users to choose the pseudonyms of their choice (as, say, LiveJournal did back in the day, and community-oriented web forums often do), with some uptight silos only federating with others with wallet-name policies, and being seen by those outside of those as terminally square. And, of course, unlike on Facebook, there will be nothing stopping someone from having multiple accounts. Of course, there will be nothing preventing people from running their own silos, though any system which depends on people doing this will become a ghetto of deep geeks with UNIX beards who enjoy setting up such systems, to the exclusion of everyone else.
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