Maurice Cauchi

A recent article in Ann Intern Med1 highlights issues relating to the possible dangers of doctor-patient interaction through emails, Facebook and other electronic means. Some of the advice given is worth highlighting.

This advice is particularly apt for the younger generations of doctors, who, like others of their age group seem to enjoy a particular facility, fascination and fondness for pocket-sized electronic gadgets which make communications and interactions so easy and so painless.

The State Medical Boards in the US have recently reported several instances of violation of professionalism that led to a major action, including revocation of the licence to practice.

“There are legitimate ways that physicians can engage in social media with patients” Dr Chaudhry, one of the authors of the report commented. As long as there is a pre-established physicianpatient relationship, contact with an email, for instance, to make an appointment or send an urgent report is not considered to have untoward consequences.

Social media have their uses, particularly from an educational point of view, directed to an anonymous audience, relating to topics such as health information, vaccines, etc. The report, however warns that what you say and how that is interpreted could be two completely different things. Dr Chaudhy advises: “Pause before posting.”

Other issues that physicians should be warned about relate to ensuring confidentiality when information of any kind is posted on Facebook, Twitter, etc, which are widely dispersed among the community. Any information posted there may be read by a large number of persons. There is the possibility of it going viral and confidentiality cannot be assured.

These are some of the ‘dont’s’ stressed in this report:

• Do not start a professional relationship with a person who you know only from an email;

• Do not contact patients through social media; ]

• Do not befriend patients through social media;

• Use emails or other electronic communications only with established patients and with patient consent;

•When you receive an email from a person who is not your patient, insist that the patient organises a visit with yourself or with another doctor;

• Never text messages relating to medical issues, “not even with established patients, except with extreme caution and consent from the patient.”

There is no doubt that advances in social medial have been enormous in recent years, and have caught on like wildfire particularly among the younger generation. Those of us who have reached a certain age might be considered to be living in the age of the dinosaurs if we do not participate in these advances and make use of such gadgets. However, it is well to bear in mind that we must not allow professionalism to suffer in an effort to appear “with it” and connected.

Reference

1 Farnan JM, Snyder Sulmasy L, Worster BK, Chaudhry HJ, Rhyne JA, Arora VM et al. Online medical professionalism: patient and public relationships: policy statement from the American College of Physicians and the Federation of State Medical Boards. Ann Intern Med 2013; 158(8):620-7.