Physicians and other healthcare professionals engage in social media for many reasons, including sharing medical information, debating healthcare reform and policy, educating and interacting with the general public, engaging in health advocacy, and developing a professional network.
While there are many benefits of having a public social media profile as a physician, it is not without risk, and it can affect your relationship with your patients and your credibility as a physician. Here are some things to keep in mind when you go online.
Prevalence of social media use among physicians
Social media conduct is a thorny issue within the physician community—between convoluted HIPAA rules and patient confidentiality, blurring the lines of your private and professional life can cost you your job.
A large portion of the general public uses social media, and the physician population is not too far behind: “A survey of more than 4,000 physicians conducted by the social media site QuantiaMD found that more than 90% of physicians use some form of social media for personal activities, whereas only 65% use these sites for professional reasons,” note the authors of an article in Pharmacy and Therapeutics.
An example of poor judgment
Here’s a personal anecdote that speaks to potential issues of social media use among physicians:
During my intern year of residency, a young attending was seeing a patient in the continuity obstetrical clinic who had a herpes outbreak on vaginal examination. My attending took a photo of the patient’s outbreak without asking her permission and posted it on her social media for teaching purposes. Although it was an interesting clinical case from a medical standpoint, the patient found out what happened and was extremely upset with the attending and the residency practice.
The patient’s identifiers and face were left out, so (technically) HIPPA was not violated, but the patient never gave my attending permission to take a photo or share the image on the internet.
As a physician, I understand that sharing interesting medical cases on social media is a common avenue for educational purposes for the medical community and a general audience.
The question becomes, then, where do we draw the line with using social media for medical education purposes? On the one hand, it can be a platform to help educate the general community, but it can also be a way to negatively affect physicians when they expose too much of their (or another person’s) personal life.
When credibility becomes questionable
Medical information on social media sites is often uncited, incomplete, or informal, making it difficult to decipher what is evidence-based and accurate vs what is opinion, even if it comes from a physician. If you are using social media for career purposes, maintaining your credibility as a doctor is of the utmost importance.
When posting a clinical case, it is imperative to leave out all patient identifiers and follow up with an evidence-based link to a journal that parallels the case.
An example would be describing a patient with an interesting dermatological condition and linking a journal article to that specific condition. It is also wise to change the time of day, year, and patient details so that nobody associated with the patient can identify the case.
Separating your personal and professional life
Another common slip-up among physicians on social media is posting personal information that blurs the line between appropriate and inappropriate behavior. This can include political viewpoints, use of profanity or discriminatory language, images of sexual suggestiveness or intoxication, and negative comments about patients, the workplace, an employer, a colleague, or a school. The authors writing in Pharmacy and Therapeutics note guidance from the AMA and the Federation of State Medical Boards to maintain separate personal and professional social media accounts for this purpose.
This is also useful when it comes to receiving a friend request from a patient. A general rule of thumb is not to “friend” patients online; however, this is often a gray area, as some patients can also be friends.
There is no strict rule of recommendation by governing bodies regarding this issue, but many physicians have a professional-only social media account for this exact reason. It may be plausible (and much easier) to add a “friend request” from a patient to your professional social media page rather than your personal.
Whether you have one or two accounts, the AMA strongly advises physicians to use strict privacy settings. However, keep in mind that privacy settings do not always give complete protection, and anything posted online permanently lives on the internet.
Consider the consequences
Poor behavior on social media, whether it is violating HIPAA, giving out medical advice, talking about a lawsuit, overstepping physician-patient boundaries, venting about a patient, providing disinformation, poor conduct, or any other behavior that is deemed inappropriate, can not only cost you your job, but it can also put you in hot water with the state licensing board.
You can also expose yourself to lawsuits by giving medical advice through social media. When applying for a job or residency program, employers can find your online profiles (sometimes, even the one that is private) and potentially not hire you if they find something inappropriate or in poor taste.
When applying for a job, some physicians disable or delete their social media account until they have accepted the job and started working.
Social media can be an incredible tool for physicians when used carefully. To sum it up, here are my top tips for maintaining your social media integrity as a physician:
Never post anything while angry
Keep separate professional and personal accounts
Never use patient identifiers
Always ask permission from a patient if posting about their case
Refrain from giving medical advice
Do not be anonymous; give your real name and your credentials
Stay professional, even when talking about hot topics such as politics and controversial medical issues
Be respectful: Don’t say anything online that you would not say to your patient or colleague in person
Finally, remember that all unsolicited advice is self-serving; step off your pedestal
Each week in our "Real Talk" series, mental health advocate Kristen Fuller, MD, shares straight talk about situations that affect the mental and emotional health of today's healthcare providers. Each column offers key insights to help you navigate these challenging experiences. We invite you to submit a topic you'd like to see covered.