Doctors shouldn't buddy up with patients on Facebook or Twitter, hospitals warn

Filed Under: Facebook, Featured, Privacy, Social networks, Twitter

Friendly doctorHospitals, worried about lack of professionalism and inadvertent leaking of confidential data, are warning doctors not to set up relationships with patients on Facebook and Twitter.

A recent article in Network World pointed to a typical scenario in the case of Stanford University School of Medicine student Matt Goldstein, who graduates in June.

Goldstein, who has accepted a position at Brigham & Women's Hospital in Boston, said that the hospital told him in a letter that it would prefer that he refrain from using social media with patients.

The hospital also recommended that if he uses Facebook, Goldstein should change his settings to optimize privacy.

In addition, the hospital suggested that Goldstein review photos of himself posted online, to ensure he can establish a professional online identity.

Goldstein said he was a bit disappointed to have his social media interactions with patients curtailed, but he's well aware of the sensitivity of the patient-doctor relationship - never mind the legal quagmire that social interactions might lead to vis-a-vis patient privacy.

How much of a problem is social media interactions in the medical profession?

PDF paperA study (PDF) done in August 2011 by an online physicians' community site called QuantiaMD found that out of 4,033 surveyed clinicians, over 65% of physicians are using social media for professional purposes.

That includes not just social networking sites such as Facebook or Twitter, but also online communities specific to the profession, blogs, and YouTube.

Very little of that use, though, is for communicating with patients.

Rather, the vast majority of doctors go online to seek out education or consultation, whether it's about new developments in medicine or consultation with peers about (anonymous) patients' issues.

As a matter of fact, as QuantiaMD's study noted, the American Medical Association (AMA) - the largest physicians' and medical students' association in the US - recently issued guidelines warning physicians about the pitfalls of letting the patient-doctor relationship bleed into online forums.

AMA Guidelines for social media

The AMA suggests that doctors "consider separating personal and professional content online" so as to "maintain appropriate professional boundaries."

The concerns are manifold, and the AMA is smart to caution doctors and medical students to watch their backs online.

The AMA worries about doctors maintaining their reputations and public trust, for one thing. Nothing like seeing Facebook photos of your doctor sucking off a beer bong to undermine their air of authority, I always say.

But one of the most serious dangers, of course, is the possibility that doctors may blow patient confidentiality online.

The AMA's first suggestion goes right to the heart of this concern, which is completely understandable, given that disclosing confidential patient information can mean running afoul of the Health Insurance Portability and Accountability Act (HIPAA), a US regulation that addresses the security and privacy of health data.

The AMA recommendation:

Physicians should be cognizant of standards of patient privacy and confidentiality that must be maintained in all environments, including online, and must refrain from posting identifiable patient information online.

Oddly enough, the evening I sat down to look into this issue, I was interrupted by a medical emergency that involved a friend with a frightening rash.

We called on the expertise of another friend, who happens to be a doctor. I'm writing this in an emergency room now.

Before I left to drive my friend to the hospital, I asked my physician friend if her hospital has a policy against social media interaction with patients.

She told me that social media use by hospital staff isn't codified and is instead left up to individual clinicians.

"But you personally don't choose to interact with patients, say, on Facebook, do you?" I asked her.

She blushed, "I don't have a Facebook."

I find myself relieved at the lack of relevance of social media in this one doctor's life, given the risks of jeopardized privacy and confidentiality. How does her social media abstinence compare to the population overall, though?

Medical mouseA December 2011 comScore survey found that 98% of online US citizens use social media.

QuantiaMD's findings that 65% of doctors use social media—a substantially smaller percentage than the 98% of the general population who do - suggests that we're looking at a population of professionals who have more important things to do than "Friend" their patients.

The Facebook generation who've grown up enmeshed in the social interaction of online communities are aging up and out into professions that include medicine.

Let's hope their interest in their chosen field, and their sense of professionalism, continues to keep up the wall between patients and doctors, particularly in the world of online social media, where privacy often appears to be in need of mouth-to-mouth resuscitation.

Friendly doctor image courtesy of ShutterStock

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7 Responses to Doctors shouldn't buddy up with patients on Facebook or Twitter, hospitals warn

  1. cf. · 1235 days ago

    I would not want and would not accept my Drs friendship request . He is my doc not my friend

  2. This is the kind of stupid crap that perpetuates lack of communication between doctors and their patients. Back in the old days (oh boy here we go) when doctors knew their patients and Dr. offices weren't set-up like like an assembly line there was more open communication and a heck of a lot less malpractice lawsuits.

  3. Tony · 1235 days ago

    Doctors,should try all they can to keep the privacy of their patients.Its one of the ethics of their profession between the doctor and the patient.Using social network should have a limit for security reasons.

  4. Nigel · 1235 days ago

    "Nothing like seeing Facebook photos of your doctor sucking off a beer bong to undermine their air of authority, I always say."

    Indeed...that's one of my favorite ancient maxims.

    I've been searching for a suitable adjective apropos to the very concept of my doctor appearing on Facebook. For the time being, I've settled on "icky".

    • Dan · 1234 days ago

      Doctors are people too, you know. I think it is a little unfair to them to consider it "icky" if they have a Facebook profile. Do they not have the same rights as everyone else?

      • Lisa Vaas · 1223 days ago

        Personally, I would be thrilled to make fun of my dentist on Facebook. As it is, I've already written a Yelp review that mentioned this interesting cheek-jiggling thing he does to distract patients when sticking a needle full of painkiller into our gums and talking about the gambling ring he ran when he was in the Marines. As for my nephrologist, I would enjoy posting photos of the plastic model of a kidney that sits on his desk, adorned with googley eyes. Or maybe of some of his neck ties. They're flabbergastingly bad, and he's famous for them.

        Would this add or detract from their professional personae? Who cares? People who respect hierarchy more than me, I suppose.

        If I were them, though, I wouldn't FFFFFFFFFFFriend me with a 10-foot FFFFhole. I like them so much, I'd be sure to cyberstalk them.

  5. Sizzle · 1234 days ago

    Wow! Just imagine..... It would be like an continuous episode of Embarrassing Bodies shot through into social networking.

    Facebook patient: "Doctor, I have ear ache"
    Facebook doctor: "Can you publicly post me a picture of your ass?"
    Facebook patient: "Erm, I said ear ache?"
    Facebook doctor: "Exactly, but it's not that really that entertaining is it?"

    And so on......

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About the author

I've been writing about technology, careers, science and health since 1995. I rose to the lofty heights of Executive Editor for eWEEK, popped out with the 2008 crash, joined the freelancer economy, and am still writing for my beloved peeps at places like Sophos's Naked Security, CIO Mag, ComputerWorld, PC Mag, IT Expert Voice, Software Quality Connection, Time, and the US and British editions of HP's Input/Output. I respond to cash and spicy sites, so don't be shy.