Why Your Doctor Can't Be Your Online Friend

The boundaries between the physician – patient relationship have always been difficult as the relationship is based on trust, intimacy and the ability to share information from both sides of the desk.  This relationship has grown more complex due to the rise of social media engagement.  Physicians are being friend-ed, followed and reviewed across the digital channel like crazy, placing the doctors that care for them in difficult positions regarding the confidentiality of their patients who often don’t think about the impact of their digital-buddy request.Similarly, due to the ease of digital communications, the commonly time-stretched doctor also faces temptation to use quick communication methods to reach their audience, in lieu of a more professional path.  No-one really wants their test results Tweeted to them! These examples of digital doctoring to be avoided are covered in the guidance.  Protecting patient privacy and confidentiality is stressed as the main area for focus when using social media.In order to help doctors better understand digital communication best practices and to fill a gap than many medical practice management efforts have neglected, about a week ago, the American College of Physicians (ACP) and Federation of State Medical Boards (FSMB) published a policy paper entitled“Online Medical Professionalism: Patient and Public Relationships.” Some of the highlights from this publication can be found in this helpful table (click to enlarge):

The article itself is interesting to read and a good idea for both doctor and patient alike to understand the digital expectations.  Here, I have called out some of the guidance details: 

On boundaries: “Professional distance and privacy are appropriate for both physician and patient. Physicians should not “friend” or contact patients through personal social media. Physicians should familiarize themselves with the privacy settings and terms of agreements for social media platforms to which they subscribe, and they should maintain strict privacy settings on personal accounts. Professional profiles should be constructed with an explicit purpose (such as networking and community outreach).”

On self auditing: “Physicians should consider periodically “self-auditing” to assess the accuracy of information available about them on physician-ranking Web sites and other sources online.

Ranking, feedback, and other Web sites may offer patients insight into physician training and office practices… Physicians should consider doing routine surveillance  of their online presence by searching for their names, and they should correct inaccurate information.”

On Googling patients: “Digitally tracking the personal behaviors of patients, such as determining whether they have indeed quit smoking or are maintaining a healthy diet, may threaten the trust needed for a strong patient–physician relationship. Commentators encourage physicians to consider the intent of the search, whether it affects continuing therapy for the patient, and how to appropriately document findings with implications for ongoing care.”

And it cautions doctors to pause before they post controversial or negative content. Certainly good advice for everyone!