White Coat Notes

“Pause before posting,” and other tips for doctors online

Use secure e-mail systems. “Pause before posting” items to a personal or professional blog, to consider the implications for patient protection. And above all, a new policy paper issued Thursday by the American College of Physicians and the Federation of State Medical Boards suggests, doctors should remember that the boundaries of the physician-patient relationship apply online as much as they do in an exam room.

A large majority of state medical and osteopathic licensing boards have disciplined doctors for communicating inappropriately with patients through blogs or social media platforms or for other unethical behavior online, a study published last year in the Journal of the American Medical Association found.

Certainly, Facebook, Twitter, e-mail, and other online forums can be useful tools, said Dr. Humayun J. Chaudhry, president of the medical board group, during a media call introducing the policy. “There are, at the same time, some real challenges and cautions that physicians need to be aware of.”

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Chaudhry and Dr. David Fleming, chairman of the ethics committee of the American College of Physicians, said that doctors should avoid friending their patients on Facebook and establish guidelines for how to handle e-mail or other communications seeking advice from people who are not established patients, including family members or friends.

The policy also touches on how doctors should handle information that may be posted online about them, recommending periodic “self-auditing” of rating sites and other forums.

Physicians should consider writing profiles for themselves “that would be able to come up in a reasonably discoverable fashion, so that the information that present and future patients could find about us is accurate and fair,” Fleming said.

The policy paper is not the first such position statement issued by medical groups about online communication. A commentary published in November in the Journal of General Internal Medicine, for example, reflected on the tricky issue of disclosing conflicts of interest online.

Chaudhry and Fleming said their groups pursued the topic after realizing that problems with inappropriate online communications were not limited to the youngest doctors, who grew up using social media, but were popping up for physicians of all ages.

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