Note: This story contains some graphic images.
While you’re on Instagram looking at puppies, artisan desserts and celebrity selfies, some doctors are on a different photo sharing app, looking at gangrene, gallstones and rashes.
First-year emergency medicine resident John Corker has just uploaded a photo. It’s of a fresh red and greenish wound on the top of a right foot.
“What you’re looking at here is a badly infected foot," he says. "It's a commentary on what can happen when patients don’t have good follow up.”
He put this photo on Figure 1 – an app that’s been called the "Instagram for doctors." Sitting on a bench outside of Parkland Hospital in Dallas, Corker scrolls down below the image to reveal it was starred by a number of people, "which means they appreciated the image" he says.
It might seem like a strange thing to appreciate, but hundreds of thousands of people have created an account on Figure 1. Most are doctors, like Corker, who join the service to learn about medical conditions and share the occasionally gruesome photo. The x-rays, lesions, tumors and gunshot wounds are categorized by anatomy and specialty. Corker says in the emergency room, access like this is invaluable.
“If I’m able to log on to Instagram or Figure 1 and see a picture of something that I learned about three years ago in medical school that I may see in the future, that’s really helpful for my learning going forward,” Corker says,
Unlike Instagram, Figure 1 requires users to remove all personal details – faces or birthmarks, for example – from the photos they post.
“The best way to keep a secret is not to have it,” says 34-year-old critical care doctor and Figure 1 co-founder Joshua Landy.
“We give them all the tools they need to remove any potentially private details from the photo," Landy says. "There’s an automatic tool to block out faces, tools that let you block out name, date, tattoos, or other identifying marks that might be in the photo.”
Then Landy and a small team review each image before giving the final go-ahead.
Of course, doctors are supposed to ask for consent before snapping a photo of that amputated finger or bumpy rash, but there’s some variation in what counts as consent.
“We encourage all users to get consent. However, they’re not restricted to using our consent form. They’re permitted to using the consent form from their jurisdiction. Some hospitals require it to be done on paper, and some require it to be using voices instead of just paper.”
Now if you’re thinking all this photo snapping and sharing is new, it’s not.
Classic textbooks are teeming with images of guts and brains spliced and splayed in professional lighting. In some specialties, like dermatology, photos are especially useful.
“We diagnose and treat based on seeing, feeling, and examining the skin. Looking for rashes, abnormalities — and so pictures inherently are a daily part of our practice,” says dermatologist Seemal Desai.
As medical file sharing and photo sharing become ubiquitous, Desai has a few words of advice to doctors about to hit upload: “Always keep in the back of your mind, 'Is what I’m doing in the best interest of my patient?' And, 'Is this going to help outcome of my patient?' And if the answer is no, you don’t need to be involved in it,” he says.
If you want to peruse the archives of Figure 1, you don’t have to be a doctor or a nurse. Lurkers are allowed. In fact, nearly 10 percent of Figure 1 users are not in health care. You won’t be allowed to comment, but you can admire close-ups of busted lips and green glistening gallstones to your heart's content.