This simple question makes many physicians uncomfortable. This unease could be for several reasons, but two of the main ones are patient/doctor relation boundaries and legal concerns.
Many practitioners feel that social media blur the fundamental line between personal and professional communications with their patients. A 2011 survey, conducted by the Canadian Medical Association (CMA) revealed that physicians are uneasy about this. When doctors were asked whether they had received patient requests to “friend” them on Facebook, 15% answered yes, but many also noted that they routinely ignore these requests.
The ethical and legal risks of online medical conversation are another apprehension. In the same CMA survey, 80% of surveyed physicians said they believed that the use of social media could pose professional and legal risks to them. This is mostly because of confidentiality concerns. Confidentiality has been at the heart of medical practice since Hippocrates and is still a key ethical principle. There are also concerns about the protection of patient online data, which have been addressed by laws such as the Personal Health Information Protection Act (PHIPA). The later requires health care providers to keep all personal health information confidential and to maintain its security. In addition, doctors are legally liable for any and all advice given to a patient. One can imagine the concerns involved in having a conversation with a patient on Facebook. Not only is there no guarantee of the conversation being private (i.e., Facebook has been hacked a few times, most recently in February of 2013), but there are also concerns about the servers storing the data, which are located in the U.S. and are therefore subject to U.S. laws, which are different from Canadian ones, such as the USA Patriot Act.
Although social media tools, such as Facebook and Twitter, present challenges and concerns that may cause apprehension, they also offer opportunities. Online education is a reality, and many patients turn to the Internet to learn more about their symptoms or their conditions. How can patients distinguish between valid medical information and misinformation circulating on the web? Physicians have a great opportunity to contribute to health education and help patients filter online information better, by informing them of local or national resources and of organization that already exist on health matters. If no such online information exists, doctors may wish to create an informative public Facebook page for their patients’ education. In this way they are not befriending their patient, but using Facebook to share general valuable information with them and others. By empowering and educating patients through social media, doctors would be helping our health care system while playing a health care advocacy role and demonstrating their social accountability in an additional way.
What’s your take on the patient/doctor relation in the age of technology?