Tribune: ‘Social media – helpful or harmful?’

MPS article in September’s Medical Tribune: ‘Social media – helpful or harmful?’

17 Sep 2013

Marika Davis

In the September 2013 edition of the Medical Tribune HK, MPS medicolegal advisor Dr Marika Davies explores how to stay safe when using social media.

Social media – helpful or harmful?

Dr. C picks up a pen and writes on a piece of paper: “Stupid patient doesn’t understand she has to LOSE WEIGHT before we can operate on her.” He pins it to the noticeboard in the doctors’ office. His colleagues see this and add to it, writing their own derogatory comments about overweight patients. Although this may seem like a very unlikely way for doctors to behave, if we transfer the setting to a doctors’ internet forum it suddenly becomes a realistic scenario, yet is no more excusable.

Doctors are increasingly using social media to communicate with each other and with their patients. While this has clear advantages in being quick, easy and accessible, there is also the potential for problems, not least of all because of the blurring of professional boundaries in the virtual world of the internet. Careful use of social media in order to avoid the pitfalls that exist within it is essential.

How to stay safe when using social media

Be secure

Your duty of confidentiality applies online as well as offline

Use the most secure privacy settings on social networking sites, such as, but remember this is not failsafe and not all information can be protected on the web. Also remember that there is no such thing as being truly anonymous when posting online. Identities can be traced and doctors should bear this in mind when posting comments. Even ‘doctors only’ forums have risks as they may be accessed by members of the public or employers, or friends of friends may pass on information attributable to you.

Respect confidentiality

Your duty of confidentiality applies online as well as offline. Even if you do not mention a patient’s name, they may be identifiable from information written about them. One ER doctor posted information online about a patient involved in a car accident, not realising that the case would be publicised in the local press, making the patient instantly identifiable. The matter was brought to the attention of her employer and she was disciplined.

Act professionally

You have a responsibility to act professionally at all times and not bring the profession into disrepute. Consider who may be able to access embarrassing photographs of you and whether there is information you would not want your employer to see. Derogatory or flippant comments about patients can be damaging to the public perception of doctors and their trust in the profession.

Maintain boundaries

Avoid giving a knee-jerk reaction when responding to critical comments patients have made about your care online, no matter how upsetting or potentially damaging the comments may be

It may be flattering to receive contact online from a patient with whom you have a good rapport, but conversing with patients online is inadvisable. Relationships should be kept strictly professional and the doctor-patient boundary should not be blurred. Be cautious about online contact with colleagues too so as to maintain the distinction between your personal and professional lives.

Think before you type

Once you post a comment or photograph online you relinquish control of that information, so think carefully before hitting ‘send’. Avoid giving a knee-jerk reaction when responding to critical comments patients have made about your care online, no matter how upsetting or potentially damaging the comments may be. Consider whether to treat the comment as a complaint through the usual channels, which will allow you the opportunity to explore and investigate their concerns and provide an explanation and apology where appropriate.
Taking care to avoid these potential pitfalls will help you make the most of social media, which offers exciting new ways to communicate in the ever-changing world of medicine, and has become an integral part of our lives.

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