Social Media & Medicine — Tips for Avoiding Trouble

The ever-increasing popularity of social media sites like Twitter, Facebook and others, can create issues for doctors and other health care providers. A few weeks ago, I posted about the Rhode Island physician who lost her job and was reprimanded by the Medical Board for inadvertently  identifying a patient on Facebook. Other than the HIPAA and physician-patient privilege issues, social media can present other issues for doctors. For example, last year, ran a story about physicians on a humanitarian mission to Haiti posting photos on Facebook. The article, which can be read here, indicates that the Puerto Rican Medical Board investigated the posting of photos of doctors drinking, posing with guns and partying. Ultimately, Medical Board exonerated the physicians, but the incident itself highlights the risks of social media for doctors.

A major concern for health care providers with an online presence is maintaining professional and personal boundaries. The AMA has issued a policy on professionalism in the use of social media for physicians that should be required reading for all healthcare professionals. The AMA Policy can be viewed here.

Doctors and other healthcare providers who choose to have a social media presence should keep a couple of things in mind:

  • Nothing about the Internet is Private. The physician-patient privilege and HIPAA prohibit disclosure of any information that would identify a patient. The more unique a case is, the more likely a description would identify the patient. Don’t discuss patients or cases, no matter how interesting. Here’s what can happen.
  • Boundaries become Blurred Online. As with the physicians in Haiti discussed above, the lines between private and professional life can be difficult to discern. An April 2007 article in the AMA Journal Of Ethics, cautions against physician’s disclosure of personal issues to patients, such as similar medical conditions, in an attempt to empathize with the patient. Allowing patients “behind the curtain” into a physician’s personal life is a situation ripe for problems. Although patients may feel a greater connection to the physician, they can also start to view the relationship as something more. Most commenters recommend avoiding “friending” patients on Facebook. See”A Doctor’s Request: Please Don’t Friend Me” from USA Today; and “Practicing Medicine in the Age of Facebook” from the New England Journal of Medicine. Because of the unique nature of the physician-patient relationship, keep your personal and professional life separate.
  • The Same Rules Apply Online as Off. If physicians or practices choose to have Facebook or other social media presence, keep in mind that all of the rules that apply in the real world apply online. This means that poor advice, poor decisions, and poor communication online can have the same affect as that given in person.

Social Networkers Beware: Facebook Post Results in Physician Discipline

It was bound to happen eventually. According to an MSNBC.COM Report on Monday, the Rhode Island Medical Board reprimanded a physician for inadvertently identifying a patient in a Facebook post. Not only was the doctor reprimanded, she lost her emergency room privileges and was fired from her hospital . Apparently, the doctor didn’t name the patient or intend to reveal privileged information, “the nature of one person’s injury was such that the patient was identified by unauthorized third parties.”

The article can be read here: Doctor busted for patient info spill on Facebook – Technology & science – Security – The Boston Globe ran a more comprehensive article on the general issue of social media today: For doctors, social media a tricky case – The Boston Globe. The Boston Globe article discusses some of the issues that can come up with social media, including privacy and boundaries issues. Physicians with Facebook accounts should carefully consider what they post and whether to permit patients to “friend” them. Although seemingly innocuous, it could result in medical board issues. Especially where the injury or condition is unique.

I also found the comments to the article telling. At least one of the comments called for the doctor’s license. The incident and the discipline reinforce how seriously medical boards and patients take the physician-patient privilege, and how easy it is to inadvertently breach that privilege. I haven’t heard of any issues like this in Colorado, but it isn’t difficult to see how this could become a big issue in the future. Look for more hospitals and practice groups to enact social media policies governing physician and staff’s use of social media.

Copyright Miller | Kabler, P.C., Attorneys-at-Law