MedCity Influencers, Hospitals

When physicians use social media: Facebook or facepalm?

Physicians must weigh possible patient care benefits against the need to protect patient privacy and preserve professionalism in the online world.

Ever hear the one about the physician in an impaired provider program who appears in a Flickr photo with a martini in hand?  How about the one about the physician’s office manager who makes a comment on a patient’s Facebook photo, congratulating the patient on her weight loss and asking if her diabetes has improved?  If only these were jokes.  Unfortunately, these situations actually occurred.

The creation, dissemination, and use of information online offers new opportunities for patient care.  However, physicians must weigh possible patient care benefits against the need to protect patient privacy and preserve professionalism in the online world. The American College of Physicians (ACP) and Federation of State Medical Boards (FSMB) released a paper in 2013 called, “Online Medical Professionalism:  Patient and Public Relationships.”  That paper highlights some guidelines that physicians should consider as they venture into the great wilderness of the World Wide Web.

Some highlights:

  • Physicians should keep their professional and personal personas separate. Physicians should not “friend” or contact patients through personal social media.
  • Physicians should not use text messaging for medical interactions, even with an established patient except with extreme caution and consent by the patient.  (One note of caution here, however, is that even where a patient has consented, HIPAA concerns arise due to the lack of security associated with text messages versus, for instance, encrypted e-mail.  Thus, hospitals and medical practices should be wary of their  patients’ protected health information being transmitted via text message, possibly on smart phones that are personally owned and operated by the individual practitioners, which are entirely outside the control of the hospital or practice).
  • E-mail or other electronic communications should only be used by physicians within an established patient-physician relationship and with patient consent.
  • Situations in which a physician is approached through electronic means for clinical advice in the absence of a patient-physician relationship should be handled with judgment and usually should be addressed with encouragement that the individual schedule an office visit or, in the case of an urgent matter, go to the nearest emergency department.
  • Establishing a professional profile so that it “appears” first during a search, instead of a physician ranking site, can provide some measure of control that the information read by patients prior to the initial encounter or thereafter is accurate.

Trainees could inadvertently harm their future careers by not responsibly posting material or actively policing their online content. Educational programs stressing a pro-active approach to digital image (online reputation) are good forums to introduce these potential repercussions.

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