By Bliss Mishler, Coffee Break Medical Marketing

Doctor typing on laptop

If you are like most physicians today, you probably use social media. Online communication has made the dissemination of health information and the promotion of your practice easier than ever. These formats are fun, informal, and accessible. But for physicians, the consequences of careless use can be dire.

Take heart. You are not alone in the social media jungle; there are guidelines you can follow to keep you out of trouble.

The organizations linked below, for example, offer policies that help you stay on the right side of ethics and the law in social media:

You can also check with your own State Medical Board. If your practice is part of a larger medical facility or university, they probably have existing policies and guidelines you should follow as well.

In the meantime, we have put together a summary of guidelines and considerations to make the best use of this ever expanding medium.

What is Social Media?

Most guidelines consider social media to be any online platform used for communication. This can include email, texting, blogging, and social media channels such as Facebook, Twitter, Instagram, and LinkedIn.

For personal use, these outlets have considerable benefits. According to a Pew internet survey, people who use social networking sites have more close ties and are less socially isolated. Seventy one percent of online adults use Facebook alone.

For businesses, social media outlets are growing in use and the benefits offered to professionals. The marketing potential is substantial. Nearly 90% of all Americans are online and three quarters of them use social networking sites.

A report by the American Academy of Family Physicians states that 70% of primary care physicians use social media. Doctors find these platforms help them connect with patients and colleagues, share research, and disseminate practice and health information.

Unfortunately, some physicians are also getting into trouble on social media.

According to the Federation of State Medical Boards, boards can discipline physicians with a letter of reprimand or revocation of a license for the following social media offenses:

  • Inappropriate communication with patients online
  • Use of the Internet for unprofessional behavior
  • Online misrepresentation of credentials
  • Online violations of patient confidentiality
  • Failure to reveal conflicts of interest online
  • Online derogatory remarks regarding a patient
  • Online depiction of intoxication
  • Discriminatory language or practices online

In addition, violations of the Health Insurance Portability and Accountability Act (HIPAA) can result in civil and criminal penalties of over a million dollars.

Social Media Guidelines

So, what can you do to get the benefits of social media without all the risk?

Terry Kind, MD, MPH, who wrote about social media in the May, 2015 issue of the AMA Journal of Ethics says, “The ‘starting point’ should always be our existing norms of communication, confidentiality, and all relevant tenets of professionalism, applied to new settings.” Unlike in-person communications, he points out, after you hit post, your comments will live on in perpetuity. They may also be subject to misinterpretation when taken out of context.

Be Professional

“Physicians should not use their professional position, whether online or in person, to develop personal relationships with patients. The appearance of unprofessionalism may lead patients to question a physician’s competency.” Multiple groups echo this advice from the Federation of State Medical boards.

To this end, all interactions with patients should be associated with a professional (not personal) social media profile. If a patient “friends” you on Facebook, for example, direct them to follow you on your professional profiles instead.

Personal profiles should not have a professional email or credentials attached to them, either, lest a personal opinion be misconstrued as professional advice.

Oh—and don’t post drunken photos of yourself on Facebook.

Be Careful About Giving Advice

Communication via social media with established patients can be efficient and truly helpful. Just make sure the interaction is included in the patients Electronic Medical Record (EMR) and is HIPAA compliant.

However, the American Congress of OB/GYN guidelines say “It is strongly discouraged for physicians to answer specific medical questions online from those who are not patients.” Though this is similar to an interaction that may occur in an informal setting such as a friend asking advice at a dinner party, the digital record of the interaction is permanent and may create a liability if it is later “construed as establishing a patient-physician relationship.”

Don’t Talk About Work

Using social media to gripe about work is risky behavior. This is true even when the message is intended only for other health team members. Online comments always carry the potential of becoming public. And even the smallest piece of information can be used to link back to a patient’s identity, creating a serious HIPAA violation—not to mention very bad will.

Never use photos of patients, their room numbers, or even code names.

Check Privacy Settings

Any social media communication has some risk of becoming public, so think before you post. To mitigate the risk further, always check privacy settings for personal social media profiles or private group accounts.

For physician-only sites, like Doximity, double check that they are secure and information is only accessible to registered users. Even then, be cautious about what you say.

Be Honest

In the digital world, you don’t necessarily know the person on the other end of the chat is who they say they are. They, in turn, have no way of being certain that you aren’t an impostor.

Always be honest about your credentials, your professional affiliations, and any conflicts of interest.

Remember, these guidelines are a starting point and should not be construed as legal advice. Use your best judgment, and keep an ear to the ground for updates from your State board and professional organizations.