HEALTHY LIVING
07/14/2011 03:21 pm ET Updated Sep 13, 2011

UK To Doctors: Don't Be Facebook Friends With Your Patients

Don't be offended if your doctor doesn't accept your friend request on Facebook.

The British Medical Association recently issued a new guidance advising doctors not to accept friend requests from former and current patients because of how doctors' personal information could be perceived and shared.

"The accessibility of content on social media however raises the possibility that patients may have unrestricted access to their doctor’s personal information and this can cause problems within the doctor-patient relationship," doctors wrote in the BMA guidance.

And it goes the other way, too, the BMA says: By being Facebook friends with their patients, doctors are able to see glimpses into their personal lives that may not otherwise come up at a doctor office visit.

"Social media presents doctors and medical students with opportunities, as well as challenges," BMA medical ethics committee member Dr. Tony Calland told The Guardian. "The BMA guidance is important as it provides doctors with the tools to prevent potential social media pitfalls."

The guidance comes after several doctors and nurses were suspended in 2009 for posting pictures on Facebook of them lying down in random places -- including a hospital helipad, the BBC reported.

According to one small French study published in the Journal of Medical Ethics last year, 73 percent of 202 surveyed doctors said they had a Facebook profile, with 99 percent saying they listed their real name on their profile pages. Eighty-five percent of the doctors in the study said they would decline a patient's friend request, while 15 percent would decline or accept on an individual basis, the study said.

The American Medical Association doesn't ban doctors from being Facebook friends with patients, but it still urges caution. According to its Professionalism in the Use of Social Media policy, doctors should factor in confidentiality and privacy issues when creating an online presence, and should self-monitor what they put on the Internet because information on the web lasts into perpetuity.

And "if they interact with patients on the Internet, physicians must maintain appropriate boundaries of the patient-physician relationship in accordance with professional ethical guidelines just, as they would in any other context," according to the AMA ethics policy.

Dr. Neil Baum, M.D., a urologist at Touro Infirmary, wrote on MedPage Today's KevinMD.com that a doctor's most precious possession is his or her reputation, but social media and the Internet have the power to "wreak havoc on your reputation and on your practice."

He wrote:

In this era of online communications and social media, our reputations can be attacked in a nanosecond. Using that building metaphor, it is like imploding a building with a stick of dynamite and leveling it to the ground in a pile of rubble in seconds.

Dr. Arthur Derse, director of the Center for Bioethics and Medical Humanities at the Medical College of Wisconsin, said last month on WUWM Milwaukee Public Radio that confidentiality can be easily put at risk when the doctor-patient relationship moves online.

"When online, you forget you have this relationship and this responsibility, and you think you're chatting with friends, and you're disclosing to the world something about the doctor-patient relationship," Derse told WUWM.

And some doctors like to use the Facebook blog tool to write entries about past or current patients, while of course keeping the patient names and identifying information private because of federal privacy laws, Derse said.

But the trouble can come when patients see that blog entry -- even if their information has been changed or made generic enough to be unidentifiable to the outside world, or if the doctor had asked their permission to write about them -- they can still recognize themselves and may feel uncomfortable being written about, he told WUWM.

Facebook isn't the only social media site used by doctors -- many have also created Twitter pages to talk shop. In a letter published in the Journal of the American Medical Association earlier this year, an analysis of 260 self-identified doctors with at least 500 followers showed that half of their tweets were about health or medicine, while 12 percent of their tweets promoted themselves.

But 3 percent of the tweets in the analysis were considered "unprofessional" because they violated the privacy of a patient or contained profanity or a discriminatory statement.