Physicians must tread lightly on social media, as it is a fast and dangerous way to expose their vulnerabilities and put their careers at risk. Everything from disseminating perfectly accurate medical information to upholding patient privacy must be considered before posting any content. One critical error that can quickly break a physician’s career is not acknowledging the viral nature of social media. Once something is posted, it has the potential to reach tens of thousands of people in a matter of seconds. What may be an innocent comment can be taken out of context and turned into an unerasable mistake. By the time a physician realizes their mistake and removes the post, it may be too late, resulting in a violation of the Health Insurance Portability and Accountability Act (HIPAA), state medical-board action, and potential job loss.

There is an inherent risk of violating privacy when referring to a particular patient on social media in situations like crowdsourcing a diagnosis with colleagues, commenting on a particular patient’s procedure, or posting photos where a patient’s visage inadvertently appears in the background. Should physicians deem such situations necessary, they would benefit from eliminating as many identifiable specifics as possible, such as patient age, physical descriptions, or circumstances of an accident. If after eliminating any identifiers a physician feels that revelation of the patient’s identity is still a risk, the physician should not continue publicizing this patient on social media. According to a study of 271 medical blogs published in the Journal of General Internal Medicine, 16.6% of doctors and nurses divulged information critical to identifying patients, and 3 of the blogs displayed clear images of the patients. Identifying patients on social media requires written consent and is best approved by an attorney before posting.

While physicians may enjoy having a social media account for personal purposes, they are best served not accepting friend requests from patients. What might begin as a casual online exchange could potentially lead to a paper trail of questions regarding medical advice, which may in turn lead to a HIPAA violation. In an effort to limit casual online interactions with patients, physicians should set up two social media accounts—one private personal account and one professional account.

Professional accounts should be strictly that—professional. A study of young urologists in the British Journal of Urology International found that 40% had potentially objectionable content on their Facebook pages, including posts with profanity, drunkenness, and sexual suggestiveness. It’s no surprise that in a survey of job recruiters, 55% second-guessed candidates due to their unprofessional social media profiles. In keeping with professionalism, physicians should refrain from making inappropriate and potentially offensive statements on social media. While it may be tempting to express, for instance,  political views or frustration with patients, doing so puts a physician’s career at risk.

In order to avoid repercussions with the Federation of State Medical Boards, physicians posting about a product or procedure must be sure to reveal any conflicts of interest in their posts. Furthermore, the Federal Trade Commission (FTC) requires that physicians disclose any payments or free products received by advertisers and endorsers.

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