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Ever visited a patient's Facebook page? Had a patient visit yours?

The other day Eric Widera and I were teaching a course to the medical students about writing for social media outlets like Twitter and GeriPal.  One of the students asked us if a patient had ever contacted us online - my answer was no, I think Eric said he discovered a caregiver's blog.  We've mostly been able to duck this issue so far, but it's only a matter of time.

A new study in the Journal of General Internal Medicine adds some empirical data to this issue.  In a survey of medical students, residents, and practicing physicians:

  • 15% of practicing physicians had visited the online profile of a patient or family member
  • 28% of practicing physicians were aware of a patient or family member visiting their personal site
  • 35% of practicing physicians had received a "friend" request from a patient or family member
  • 5% of practicing physicians had requested to be a "friend" with a patient or family member
  • 22% of all respondents felt it was ethically acceptable for physicians to visit the online profiles of patients within personal online social networking sites.
Now the response rate to this survey was low, so these numbers should be taken with a grain of salt.  It may be that those with experience using social media to interact with patients were most interested in completing the survey.  Nonetheless, this is an issue that is not going away.

Where should the boundaries be between professional and private lives of clinicians and their patients?  What are your experiences?  What are our obligations for professionalism in online social networks?

by: Alex Smith

Comments

Amy Corcoran said…
Alex - this is very interesting. Maybe it is a good thing that I still do not have a Facebook page. GeriPal has been my first on-line endeavor and I had trouble putting my name out there...

I am sure many remember when you had to be concerned that your patient and/or their family would some how reach you on your house phone or come up to you at a public outing to ask about their health problems. Or on the flip side, imagine being at a house party and running into a patient who does not want anyone to realize that you are their physician. These boundaries have always been a bit blurry but social networks make it easier to peak into each others lives since almost everyone has a Facebook page and a smart phone.

Recently I was asked to play 'words with friends' with a group of medical students that I teach. What do I do?

Hummm...boundaries are difficult. For me it will be avoiding Facebook and other social networks that highlight my personal life. Although, I am told I can limit who and how much is available for all to see...I am still not sure it is for me.
Anonymous said…
I could see the "need" (i.e., curiosity) of the patient to seek out the doctor's social networking profile online, but I don't why a doctor would want to search for his/her patient's Facebook/MySpace/Twitter/other online social networking account. Doesn't the doctor get everything he/shee needs from the patient's medical records, social history included? What could be useful in viewing a patient's social networking profile online then? In the old days, it used to be natural and common for doctors and patients to know about each other's personal lives, as they resided in small, tight knit communities. Your doctor could be the person who grew up in the house next door and you would know all the scandalous bits of news that travel so well in small communities.

Now, the world has changed vastly and the whole Facebook/social networking scene is useful in maintaining social ties and whatnot, but to search for a patient's/doctor's profile is a bit creepy and unnatural. If that person wanted to share aspects of their personal life with you, they would. Oh, right, but there's not time during an office visit to talk much about anything aside from the "chief complaint." So, you can't really ask your doctor how his/her family is doing without them rushing you out of the office, and they only ask you about yours in the context of SOAP notes.

I think it's kind of strange that people invite themselves in other people's lives via online social networking sites in the first place. The patient-doctor relationship is unique and meaningful (the doctor knows so much about the intimate and private details of the patient's life and is under Hippocratic oath to use this information to improve the patient's health), so I can understand why the patient would want to know just as much about the physician so they can feel comfortable. But, it's becomes an issue of boundaries at a certain point.

But, my overall take on things is, share responsibly. There are account settings that allow one to make their profile more or less private; if you have something to hide (or someone to hide from), then use this to your advantage. However, if you're willing to share and risk over-exposing yourself, then it is your perogative, as either the patient or the doctor.

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