Doctors' Online Behavior

SAN FRANCISCO—If your doctor doesn’t "friend" you on Facebook, don’t be offended.

A position paper by the American College of Physicians (ACP) and the Federation of State Medical Boards published in the Annals of Internal Medicine lays out very specific guidelines for doctors who use social media.

The main thrust of the paper, according to Dr. Humayun Chaudhry, president and CEO of the Federation of State Medical Boards, is to separate doctors’ personal and professional lives and to help them maintain a professional distance from their patients. 

“We’re not telling people what to say, we’re just asking people to think before they hit ‘send,’” he said during a press conference Thursday morning at the American College of Physicians' Internal Medicine conference in San Francisco.

The paper offers doctors a best practices approach to handling social media and will help them determine how it fits into the patient-doctor relationship.

The report reinforces commonsense rules for doctors—and everyone else—online: Pause and think before you post.

What Doctors Should Be Doing Online

A study published last year in the Journal of the American Medical Association found that 92 percent of state medical boards had at least one instance in which a doctor’s online activity warranted a professional reprimand.

The new paper recommends using only digital forms of communication, such as e-mail, for patients with whom doctors have a preexisting relationship and to avoid any kind of communication that could violate patient confidentiality laws.

As far as commenting and liking on Facebook, the conference panel warned doctors about how quickly and permanently a simple post can go awry.

“A comment you make can take on a life of its own,” Chaudhry said. “It can go viral and be taken out of context.” 

The paper draws the following guidelines for doctors’ behavior online:

  • Keep your professional and personal lives separate online.
  • Do not use text messaging for medical interactions except with extreme caution.
  • Do not give clinical advice online without a prior professional relationship.
  • Establish a professional online profile that will appear prominently in a Google search, instead of relying on online ranking sites.

The Changing Face of Online Care

Doctors' offices often have a Facebook page to share health information with patients, but confidentiality and professional standards dictate that communication of personal information be kept to a bare minimum.

Dr. David Fleming, chair of the ACP’s Professionalism and Human Rights Committee, said the goal of online patient interaction is to move away from less-secure social media—Facebook, Twitter, etc.—and toward more secure online formats. This includes using teleconferencing to talk to patients.

However, the panel that created the paper is wary about overusing online media not only because of confidentiality concerns, but also because it cannot replace face-to-face or phone interaction with patients.

As far as responding to personal friend requests from patients, Fleming recommends being forthright and encouraging them to come into the office.

“The point is to be clear about what your limitations are,” he said, “and not to be disrespectful.”

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