In a small number of cases, doctors and medical students have been criticised for posting derogatory comments about patients and colleagues on social media and for breaching patient confidentiality. Here we outline a few basic factors that you need to take into account in relation to your use of social media.
Why you need to be aware online
Social media is an established part of contemporary life and you may, quite rightly, expect to make full use of its social, educational and professional potential.
While the majority of students and health professionals use social media without encountering problems, its informal nature, and the ease with which information can be exchanged, have created some difficulties.
Social media and patient confidentiality
You have a legal and ethical duty to protect confidential patient information. Disclosing identifiable information about patients without their consent is unlawful and unethical and is likely to be in breach of General Medical Council guidance. Although taken in isolation, individual pieces of information may not identify patients, taken in sum they may be identifiable, either to the individual or to relatives and friends.
Social media can blur the boundary between private and public domains, and information that you believe to be shared with a limited number of people can in some circumstances be easily broadcast, significantly increasing the likelihood that individuals can be identified. You must therefore exercise care in your use of social media.
The scale of the problem
US research into medical students’ use of new media, as reported by deans of medical schools, found the following (which, in some cases, resulted in official warnings from medical schools and dismissal):
- patient confidentiality violations
- use of discriminatory and profane language
- depictions of intoxication and illicit substance use
Chretien KC et al. (2009) Online Posting of Unprofessional Content by Medical Students. JAMA 302(12):1309-15.
Maintaining boundaries – privacy and personal information
Trust in the doctor-patient relationship is predicated on an exchange of information that is relevant to the provision of appropriate care. The objectivity that good clinical care requires, usually involves maintaining boundaries between a doctor’s private and professional lives. Although doctors may choose to divulge personal information during consultations, they are able to control the extent and type of the disclosure.
Where you post significant amounts of personal information on social media, patients may gain unrestricted access and you need to consider carefully what impact this might have on your professional relationships. In our view, you should consider adopting conservative privacy settings on social media where they are available and appropriate. Not all content on the internet can be protected in this way and you need to be aware of the possible risks of posting content that is in the public domain.
Social networking sites, such as Facebook, also facilitate the development of online friendship networks. Doctors and medical students have reported, for example, that patients and former patients have sent them friend requests on Facebook. We recommend that, in these circumstances, if you receive friend requests you should politely decline.
Professionalism and new media
As outlined previously, the General Medical Council imposes certain obligations on you in relation to behaviour both in your personal and professional life. Although any breach of binding professional duties, such as the obligation to respect patient confidentiality, represents a clear case of misconduct that may call into question fitness to practice, medical professionalism encompasses a broader, less well-defined set of standards.
Developed over time, they represent the conduct broadly expected of health professionals by medical peers and society. Although the way you use social media in your life is a matter for personal judgment, you should consider whether the content you upload onto the internet could compromise public confidence in the medical profession.
You are entitled to engage fully in debates about issues that affect your personal and student life and, increasingly, these debates take place on the internet. Although people often feel less inhibited when posting comments online, it is important to remember that our freedom to express our opinions is not absolute. In law it can be restricted by the need to prevent harm to the rights and reputation of others.
Defamation is the act of making unjustified statements about people or organisations that damage their reputation and can result in legal action. You need to be aware that any material posted online, even pseudonymously can be traced to the original author. You should therefore exercise sound judgment when posting online and avoid making gratuitous or unsubstantiated negative comments about individuals or organisations.