According to a survey published in the Journal of the American Medical Association, common violations have been: inappropriate communication with patients, cyber-prescribing medication without an established patient relationship and misrepresentation of credentials online.
Guidelines that help prevent this type of unethical behavior is certainly important, however with the massive amount of physicians (or so-called “physicians”) exercising their free speech in the vast network of blogs and social media sites, who is responsible for monitoring the healthcare community when their activity extends beyond the hospital walls and into the gargantuan World Wide Web?
As it stands, the responsibility lies in the hands of doctors themselves. As a physician, if you’re not policing your own online behavior, a fellow colleague may report any misconduct to the appropriate authorities and you could face serious consequences for your actions. Take heed and follow the four tips below to avoid the possibility of jeopardizing your medical career.
Keep your patient’s ailment to yourself.
As a common rule, do not discuss a patient’s condition online. Even if you do not disclose the patient’s personal information, you may unintentionally violate your doctor-patient confidentiality privilege. In a recent case, a Rhode Island emergency room physician had detailed her patient’s ailment on Facebook, and although she did not explicitly mention the patient’s name or demographics, the characteristics of the injury were specific enough so that a colleague was able to identify the individual. As of April 16, 2012, the physician’s clinical privileges at the hospital have been terminated. Let this incident serve as a lesson – respect your patient’s privacy and preserve the public’s trust in the medical community.
Keep all comments professional – even your personal posts.
A physician’s reputation is very important and it’s not worth undermining your career by publishing negative or inappropriate comments that you would never utter in the workplace. Even if your social media account or blog is limited to a group of friends and family, it’s risky to have the mentality of thinking that the public can never trace the content back to you. Social media privacy settings are fickle and with the ability to archive public information, the Internet rarely forgets. Even if you realize your mistake and remove the content afterward, there is no telling how many colleagues have already witnessed your inappropriate behavior or how much damage it has already caused to your reputation in the healthcare community.
Do not prescribe medication online.
Social media platforms are no doubt an excellent resource to find information about current health topics and to connect with colleagues in similar specialties, however, it is not a place to practice medicine. Among the most cited infracts reported by medical boards is internet prescribing without having established a face-to-face relationship with the patient. In rare cases, this violation has even led to the death of innocent consumers. Aside from already having a real-life relationship with your patient, other factors that separate misconduct from legitimate online prescriptions differ significantly from state to state. To see a breakdown of regulations by state, click here to read the National Clearinghouse on Internet Prescribing established by The Federation of the State Medical Boards (http://www.fsmb.org/ncip.html). In all cases, a physician should already have a good understanding of the patient's problem, medical history and current health status before issuing a prescription online.
Do not “friend” your patients on Facebook (or other social media venues).
While the AMA does not explicitly prohibit physicians from “friending” patients on social networks, it's safer to keep your profile private in order to maintain a professional doctor-patient relationship. Although family vacation photos and wild snapshots of you at your hospital’s holiday party may be harmless, they may not project the professional image you wish to maintain in front of your patients. By allowing your patients to read silly wall comments left by your friends and family, you may have trouble influencing them with your authority in medicine if their view of your professional ranking has diminished. It’s best to keep clear boundaries between your social and professional life. Don’t worry about offending your patients by declining their friend requests – simply follow-up with a cordial private message that explains your policy of not linking to any patients in order to maintain professionalism in your field. Your patients will appreciate and respect this type of honest and direct communication and they’ll likely feel less awkward during future visits. Nevertheless, while it’s best to play it safe by abiding to the above rule, if you really have the determination to reach out to your patients using a social media platform, be sure to create two separate accounts so that your personal information can remain totally separate from your professional profile.
As a physician, it’s important to remember that you don’t just represent yourself online, but you serve as an example for the medical profession as a whole. Don’t let your online behavior taint the status of your colleagues or hospital. Be respectful of these guidelines and reach out to fellow physicians who may need a little guidance in their own online behavior. Social media has the potential to be a valuable asset to healthcare professionals, but it’s up to you to make sure that this technology is encouraged and not abused.
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A MGMA Report from Matthew O'Donnell
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