I use Facebook. I’ll just start right out by saying it. But sometimes I wish I could stop. While I do share meaningful conversation and get caught up on how my friends and their families are doing, I also spend a great deal of my time trying not to see things. While others might be able to scroll right past that friend’s post about vaccines causing autism, or about treating their child with unsafe homeopathic treatments, or about how flu shots cause the flu and kill more people than they save, doctors cannot. We read, then re-read their posts, our blood begins to boil, and we can never really look at that person the same way again. Then we ask ourselves, do I really want to start this conversation? Sometimes I do, and sometimes I don’t.

I know that I have spent time on Facebook trying to explain that the article someone posted is actually not scientifically even plausible, or that the study linking autism to vaccines was debunked years ago, or that giving your infant homeopathic silver is not, in fact, safer than giving them Tylenol. Other times, I have laid awake at night worrying that maybe I should have said something when I didn’t to an equally disturbing post.

As a physician, it is difficult to draw the line on Facebook between providing advice based on years of education and training, and just letting people remain ignorant, especially when you see that others are agreeing, sharing, and spreading harmful or even dangerous information. When is it our responsibility to speak up? When can we just let things slide? Is there such a thing as being a bystander physician in social media?

These are questions I continue to struggle with. I have found myself regretting decisions both to speak up and to not speak up in these types of situations, especially when health-related decisions about children are involved. What I do know is that it causes me some undue stress, and I’m sure it must do so for other physicians as well. People feel comfortable posting things and saying things online that would generally be thought of as socially unacceptable in person. Since people are going to continue to be relatively uninhibited in posting about their political, social, and medical views on Facebook, is there a role for physician activism in this media?

Andrea Paul is chief medical officer, Boardvitals.com.