Groups Issue New Social Media Guidelines for Physicians

Most physicians routinely reject online friend requests from patients, wary of blurring the lines between personal and professional relationships. But do the same rules apply if the request comes from a former patient? And even if you reject both types of requests, how much personal information can you share via Facebook, Twitter, or other social media sites without appearing unprofessional?

To help with such ethical quandaries, the American College of Physicians (ACP) and the Federation of State Medical Boards (FSMB) have issued new guidelines for maintaining professionalism and patient confidentiality online. The guidelines, published in the Annals of Internal Medicine, examine the influence of social media on the patient-physician relationship and make recommendations for how physicians should conduct themselves online.

“It is important for physicians to be aware of the implications for confidentiality and how the use of online media for nonclinical purposes impacts trust in the medical profession,” said Humayun Chaudhry, DO, president and CEO of FSMB, in a recent ACP news release.

While information obtained online can be helpful in the care of a patient, it can also damage patients’ trust in their physicians, according to the paper. For example, the practice known as patient-targeted googling might be considered beneficial if used to identify an unconscious patient in the emergency room, but might be resented by patients if used by a physician to digitally track their unhealthy behaviors, like smoking or overeating.

The paper also advises physicians to be wary of text and email communications with patients that can be taken out of context or misinterpreted, as evidenced by the rising number of complaints to state medical boards of online professionalism violations. The most common violations reported, according to a 2012 study in Journal of the American Medical Association, were inappropriate patient communication, such as sexual misconduct; use of the Internet for inappropriate practice, such as prescribing without an established clinical relationship; and online misrepresentation of credentials.

“The ease of use and immediacy of social media tools-especially if users do not engage in ‘pausing before posting’-can lead to unintended outcomes or messages,” according to the new guidelines.

Other recommendations from the ACP and FSMB include:

• Keep professional and personal online personas separate.

• Reserve digital communication only for patients who maintain face-to-face follow-up.

• Implement health information technology solutions for secure messaging and information sharing.

• Help ensure that patients get accurate information about your credentials by establishing a professional profile that will appear first in Internet searches, instead of a physician ranking site.

• Refrain from venting frustrations or posting critical comments about patient behaviors in online forums.