What Doctors Can Do When Patients “Friend” Them on Facebook

In a previous post, I talked about whether doctors can be “friends” with patients on Facebook. I had said then that No, that would be inappropriate. But what can be done then? Should we just ignore friend requests from patients?

Shortly after I posted a link to my previous post about this topic on yes, a Facebook page, the group page of the Philippine Medical Informatics Society, Dr. Paul Fontelo of the National Library of Medicine kindly posted links to three articles that provided some information about this topic. The first was the American Medical Association social media policy that I had mentioned in that post, but the second and third links were documents that I’d not seen before.

1. Leiker M. When to ‘friend’ a patient: Social media tips for healthcare professionals. WMJ Feb 2011;42-43. She is the Associate General Counsel for the Wisconsin Medical Society.
2. Memorandum from the Ohio State Medical Association, 2010. Social Networking and the Medical Practice: Guidelines for Physicians, Office Staff and Patients.

Using these two articles, I’ll attempt to answer what we can do when patients attempt to “friend” us doctors on Facebook.

If you wish to take advantage of the benefits of social media, create a personal page and a secondary page that represents your practice, allowing patients to become fans only of the latter (Berkman, Massachusetts Medical Law Report, Social Networking for Physicians, 2009). Keep your personal social networking pages personal.

This is in consonance with what the AMA policy also suggests. This implies that the doctor maintains an awareness of what she can post on her personal page vs the professional page. Leiker also gives the same advice. Furthermore, she says:

If you accept patients as friends on your personal Facebook page you should take extra precautions such as: (1) not posting anything too intimate, contentious, or that could be viewed as disrespectful of patients; (2) advising patients that the confidentiality of the existence of a patient-physician relationship between them may be compromised once they are identified as a “friend,” and (3) limit the ability of “friends” to post to your wall or account.

Finally, Leiker asks that doctors be very cautious in their interactions with patients on social networks.

A physician’s “friend” on Facebook asks a health-related question, and the physician responds with a form of advisory answer.

Caution: This seems like just a physician being helpful. He is offering the same type of response one might offer a family friend one runs into at the grocery store. It might be the same question and the same response.

Warning: The physician most likely has created an electronic record of an exchange that could be construed as a physician-patient relationship.

What does this mean: All the risks associated with physician-patient relationships might apply, such as malpractice, patient abandonment and HIPAA.

I still think that simply not accepting patients as “friends” on Facebook is better and easier. I’d rather not put up a Facebook fan page at this point – but then I don’t get that many patient friend requests anyway. And while I do care deeply for my patients, to keep my life-work balance, I try to leave patient concerns at the door when I leave the clinic. Since I only go online after work, putting up a fan page will be like bringing work home. 🙁

Photo credit: http://www.flickr.com/photos/birgerking/5600215736/