Social Media and Medicine: A Case of #Medicalmadness?

But at what point does it blur the boundaries of the practitioner-patient relationship, and is it acceptable for a practitioner and patient to be virtual “friends”?

When private information becomes public property

The practitioner-patient relationship prides itself on privacy and confidentiality. In contrast, social media craves broadcast and is generally far from secure – once you hit “send”, the content becomes free for all. An anonymous post or blog by a practitioner simply venting with colleagues about their day could contain sufficient information to identify a patient – breaching both privacy and confidentiality – and the potential for that information to be misused or corrupted. Given the ease with which comments on social media can become a viral sensation, there is also the risk of defamation rearing its ugly head.

And what of the medical practitioner who develops a Facebook page to promote their practice, inviting “friends” to like and share their page? While these pages may start off filled with good health advice, healthy alternatives or survival tips for new mothers, they can quickly plummet to an exposé of the practitioner’s weekend habits and recreational activities, doing little to promote their reputation or protect their privacy. Beware also the potential that this form of self-promotion (or simply comments from the public about the content of a practitioner’s page) can easily fall foul of the law governing the advertising of regulated health services.^1-2 For example, it is an offence to publish testimonials on a website or Facebook page that is under your control.

Blurring of practitioner-patient boundaries

In the context of disciplinary proceedings, there is often a necessity for the courts to consider at which point the boundary of practitioner-patient relationship became blurred, when determining whether a practitioner has engaged in professional misconduct, particularly in cases involving an alleged sexual relationship between the practitioner and patient.

Recent case law suggests that the courts will not shy away from scrutinising a practitioner’s virtual persona if the practitioner has engaged in social media with the patient – not only to ascertain whether the conduct complained of occurred, but to also gauge the practitioner’s credibility. The use of computer experts to assist a court with evidence is not a new concept; however, computer experts are now also being asked for their input on aspects of social media, including whether messages were sent and received and whether they have been manipulated.

This also leads to the potential impact that social media might have on the standard of care owed by a practitioner to their patient. Given the potential for information to go astray on social media or for messages to be misconstrued, if a practitioner gives medical advice or results via this forum, the courts could be inclined to impose a higher standard of care if a case of medical malpractice arises.

It will also need to be considered whether a practitioner’s professional indemnity insurance policy extends to any cyber dalliances between a practitioner and their patient, if the conduct complained of or the claim made does not call into question the medical judgement of a practitioner.

It’s not all bad news

The use of social media in the medical arena is certainly not all bad. It is not surprising that a medium which allows its users to create and share content and disseminate that content exponentially has its benefits professionally. In a medical context, it allows spreading the word to the public at large on good health tips, recommendations and breakthroughs. It also provides an avenue to connect patients who suffer the same illnesses so they can lend each other support.

Medical practitioners can now join groups with their international peers who have similar interests or specialties and “chat” about various cases or treatments without having to attend conferences. It provides a useful resource whereby ideas can be bounced off other practitioners anywhere in the world when presented with an unusual case.

There has also been the advent of the “digital practitioner”, a forum in which patients can attend a consultation online, affording the ease of a medical consultation without having to leave your home and expose yourself to, or aid in, the spread of infectious diseases.

While most current social media sites are not set up for the practitioner-patient relationship, it is only a matter of time until the right “apps” are developed which will undoubtedly ease the load of the practitioner’s burden, particularly so on the administrative front. And behold the potential benefits of an app that could compile a patient’s complete electronic clinical records from all over the world at the click of a button! Adapting social media for use in a therapeutic context is likely to bring with it considerable savings in terms of time and cost, which could either be passed on to the patient or aimed at diverting funds to areas of greater need like education, prevention and research.

Proceed with care and caution

Recent warnings are ringing from the legal system that practitioners who seek to engage in social media to provide medical advice and test results should ensure that clear policies have been developed on the subject of a patient’s informed consent. Many peak bodies have developed social media policies to remind them of their professional duties when utilising social media. ^3-4

If you are inclined to engage in social media as part of your practice, use it cautiously and keep it professional in order to minimise your risk of exposure to litigation or disciplinary proceedings. If the boundaries between professional and social are on the verge of being blurred, it may simply be better to just “delete” or hit “ignore” to avoid a case of #medicalmadness.

Diane Usback, Senior Associate, Health
and Kerrie Chambers, Partner, Health
HWL Ebsworth Lawyers

1. Australian Health Practitioner Regulation Agency. Social Media Policy. 2014. Available at: medicalboard.gov.au/Codes-Guidelines-Policies/Social-media-policy.aspx.
2. Australian Health Practitioner Regulation Agency. Guidelines for Advertising Regulated Health Services. 2014. Available at: medicalboard.gov.au/Codes-Guidelines-Policies/Guidelines-for-advertising-regulated-health-services.aspx.
3. Royal Australian College of General Practitioners. Social Media.
4. Australian Medical Association. Social Media and the Medical Profession: A Guide to Online Professionalism for Medical Practitioners and Medical Students. Kingston, ACT: AMA, [2011]. Available at: amawa.com.au/wp-content/uploads/2013/03/Social-Media-and-the-Medical-Profession_FINAL-with-links.pdf.