Health With a Capital H

Health Care Providers Online: How Far Is Too Far?

June 9, 2011

By Sarah Byrnes, Health Communications Associate II

Blog Entry Photo

A recent study by the George Washington School of Medicine and Health Sciences found that 3 percent of tweets posted on Twitter by doctors were unprofessional. This included use of profanity, potential privacy violations, sexually explicit material, and discriminatory statements.  The increasing prevalence and usage of social media for professional and personal reasons has created an ethical minefield for health care providers because the medico-legal implications have not been fully explored. Recent social media missteps by physicians have led to intense online debate in the blogosphere.

Some of the more egregious cases have made headlines:

  • An emergency room physician was reprimanded by the Rhode Island Medical Board in April 2011, fined $500, and fired from her job for posting information about a patient on Facebook.
  • In June 2010, five nurses were fired from a California medical center for discussing patients on Facebook.
  • Four emergency room staff members were fired, and three were disciplined, for posting pictures on Facebook in April 2010 of a man stabbed and dying.
  • Two nurses from Wisconsin were fired in 2009 for posting a patient’s X-ray on Facebook. The case was referred to the FBI for possible HIPAA violations.

A 2009 Manhattan Research survey reported that 60 percent of U.S. physicians are either actively using social media networks or are interested in doing so. That number has likely increased over the past 2 years as use continues to grow.  While physicians can, and should, positively leverage social media to improve their practices, social media blunders can lead to serious HIPAA violations, concerns about professionalism, and damage to reputations.

Social Media Guidelines for Health Care Providers

To help doctors, nurses, and other health care providers navigate the murky waters of “sharing” on social media, several professional medical organizations have developed guidelines for using social media responsibly (see below). These documents emphasize the importance of knowing patient confidentiality rules, avoiding defamatory or offensive statements, using secure privacy settings, developing a social media policy for the workplace, and establishing appropriate boundaries for doctor-patient interactions on social media sites.

American Medical Association

In late 2010, the American Medical Association issued a policy for physicians meant to help “maintain a positive online presence and preserve the integrity of the patient-physician relationship.” In 2011, the Massachusetts Medical Society added to the AMA’s guidelines by addressing online reviews and discussions, and the public trust.

Ohio State Medical Association

The Ohio State Medical Association issued Social Networking and the Medical Practice: Guidelines for physicians, office staff, and patients in 2010 to help health care providers navigate the “increase in legal and ethical concerns surrounding social media.”

Indiana University School of Medicine

The Indiana University School of Medicine developed the Guidelines for Use of Online Social Networks for Medical Students and Physicians-in-Training to instruct students how to “safely and responsibly” use social media.

The Australian Medical Association and the New Zealand Medical Association

The Australian Medical Association and the New Zealand Medical Association collaborated on Social Media and the Medical Profession: A guide to online professionalism for medical practitioners and medical students, available on Google Docs, to “assist doctors and medical students to continue to enjoy the online world, while maintaining professional standards.”

A Gray Line

Do you have any social media guidelines you would add to protect health care providers from exposing patient information? Should a patient’s health information be off limits completely? Add your comments and let us know what you think.