Do patients respect the line? Transgression of boundaries reported by Swiss general practitioners

OBJECTIVE: Transgression of boundaries in the relationship between physician and patient is commonly studied with patient as victim and physician as transgressor. A recent survey in the U.S. reported that almost 90% of physicians face transgression by patients over one year. Incidents happened mainly through verbal abuse, disregarding privacy, and overly affectionate behavior. Since this incidence seems to be alarmingly high, we were interested to analyze how often general practitioners in Switzerland experience transgression by patients. METHODS: 24% of the members of the Swiss Society of Internal Medicine (SGIM) and of the Swiss Society of General Medicine (SGAM) (n=675/2781) responded to an internet-based survey which asked for experiences of transgression by patients and for physicians' responses to transgression in the last 12 months. RESULTS: 81% of responding physicians experienced transgression over the period of one year. Analyzing the frequency of incidents per physician per year, the most common forms of transgression were 'use of physician's first name' (7.7/y), 'asking personal questions' (1.8/y), 'being verbally abusive' (1.5/y), and 'being overly affectionate' (1.4/y). Calculated incidence of transgression was 3 per 1000 patient contacts. 39% of physicians decided to ignore the incident, 37% discussed the event openly. Transgression led to dismissal of patients in 13% of events. CONCLUSION: Transgression even in mild and modest form is a rare phenomenon in Swiss practices. PRACTICE IMPLICATION: The Swiss data do not suggest that there is a specific risk for Swiss practitioners to be exposed to major transgression for which they should specifically be prepared for example in communication skills trainings.

Privacy Panel: Usable and Quantifiable Mobile Privacy

The ever increasing popularity of apps stems from their ability to provide highly customized services to the user. The flip side is that in order to provide such services, apps need access to very sensitive private information about the user. This leads to malicious apps that collect personal user information in the background and exploit it in various ways. Studies have shown that current app vetting processes which are mainly restricted to install time verification mechanisms are incapable of detecting and preventing such attacks. We argue that the missing fundamental aspect here is a comprehensive and usable mobile privacy solution, one that not only protects the user's location information, but also other equally sensitive user data such as the user's contacts and documents. A solution that is usable by the average user who does not understand or care about the low level technical details. To bridge this gap, we propose privacy metrics that quantify low-level app accesses in terms of privacy impact and transforms them to high-level user understandable ratings. We also provide the design and architecture of our Privacy Panel app that represents the computed ratings in a graphical user-friendly format and allows the user to define policies based on them. Finally, experimental results are given to validate the scalability of the proposed solution.

Fuzzy Web Knowledge Aggregation, Representation, and Reasoning for Online Privacy and Reputation Management

A social Semantic Web empowers its users to have access to collective Web knowledge in a simple manner, and for that reason, controlling online privacy and reputation becomes increasingly important, and must be taken seriously. This chapter presents Fuzzy Cognitive Maps (FCM) as a vehicle for Web knowledge aggregation, representation, and reasoning. With this in mind, a conceptual framework for Web knowledge aggregation, representation, and reasoning is introduced along with a use case, in which the importance of investigative searching for online privacy and reputation is highlighted. Thereby it is demonstrated how a user can establish a positive online presence.

Self-disclosure and privacy calculus on social networking sites: the role of culture

Social Networking Sites (SNSs) have become extremely popular around the world. They rely on user-generated content to offer engaging experience to its members. Cultural differences may influence the motivation of users to create and share content on SNS. This study adopts the privacy calculus perspective to examine the role of culture in individual self-disclosure decisions. The authors use structural equation modeling and multi-group analysis to investigate this dynamics. The findings reveal the importance of cultural dimensions of individualism and uncertainty avoidance in the cognitive processes of SNS users.

Privacy concerns and identity in online social networks

Driven by privacy-related fears, users of Online Social Networks may start to reduce their network activities. This trend can have a negative impact on network sustainability and its business value. Nevertheless, very little is understood about the privacy-related concerns of users and the impact of those concerns on identity performance. To close this gap, we take a systematic view of user privacy concerns on such platforms. Based on insights from focus groups and an empirical study with 210 subjects, we find that (i) Organizational Threats and (ii) Social Threats stemming from the user environment constitute two underlying dimensions of the construct “Privacy Concerns in Online Social Networks”. Using a Structural Equation Model, we examine the impact of the identified dimensions of concern on the Amount, Honesty, and Conscious Control of individual self-disclosure on these sites. We find that users tend to reduce the Amount of information disclosed as a response to their concerns regarding Organizational Threats. Additionally, users become more conscious about the information they reveal as a result of Social Threats. Network providers may want to develop specific mechanisms to alleviate identified user concerns and thereby ensure network sustainability.