Social Media and Healthcare

In the age of Social Media, the relationships between physicians and patients are changing. While there are no guidelines or laws on how to communicate with your patients online, the American College of Physicians (ACP) and Federation of State Medical Boards (FSMB) have recently come up with a framework. Their policy paper “Online Medical Professionalism: Patient and Public Relationships.” was released this week and delivers recommendations on when to observe social media profiles and when it’s better to pause before posting.

The guidelines point out that “it is paramount to maintain the privacy and confidentiality of patient information, demonstrate respect for patients, ensure trust in physicians and in the medical profession, and establish appropriate boundaries.” Online communications may come with risks, but there are also a lot of good use cases for using those new outlets. Here are some detailed recommendations the ACP and FSMB give in their new publication:

• 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.
• 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.
• Many trainees may 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.

While digital communication is encouraged, the study suggests to always do face-to-face follow-ups after you have checked in with your patient via email. Studies have shown that online conversations are often initiated by the patients sending friend requests to their doctors. The FSMB advises to refrain from adding patients on Facebook or other private networks. In terms of Googling patients, the report emphasizes that online research might bring up helpful insight about an individual, but the physician should always keep the intent of their Google search in mind.

With the rise of blogs and forums, doctors further have the opportunity on contributing to public health. Regarding physician-produced blogs, the framework suggests to avoid ranting and venting about the industry. Authors are advised to “pause before posting” controversial or negative content.

The full position paper has been published online by Annals of Internal Medicine.