Facebook and physicians: Not good medicine

Doctors warned to stay off social media to avoid patient privacy conflict

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While he recommends that physicians set their privacy settings to "high" to avoid having patients contact them on public sites, he also said doctors should create separate professional and personal accounts. The professional profiles should contain only contact information and perhaps credentials, Crotty said.

For physicians, however, social networking can be more valuable than learning the latest recipe for chocolate cake in a cup or seeing a friend's vacation photos.

Social networking sites can be places where physicians get advice from colleagues or share ideas on treatments. Crotty said a doctor seeking a second opinion on a social networking site is the equivalent of a "curbside consult," an off-the-cuff act of one physician asking another for an opinion with no formal arrangement. It's a longstanding practice among physicians, but it isn't recommended.

Another ethics conundrum that has come into being with the rise of social networking is whether physicians should peruse their patients' pages on social networking sites.

For example, a doctor who gave a patient a prescription for medicine that could have an adverse affect when mixed with alcohol might decide to check out the patient's Facebook page to see if the individual is telling the truth about his drinking habits, Crotty said.

"Is that a breach of privacy? Or is it fair game because it's public information?" he said. "There are so many questions that we don't know the answer to."

In a recent article in the Society for Academic Emergency Medicine titled "How Facebook Saved Our Day!", a physician describes an incident where medical professionals had to weigh the need to respect a patient's privacy against the need to give her the treatment she needed.

It started when a 34-year-old woman was brought into the emergency room displaying "bizarre behavior" and refusing to open her eyes for an examination. The only identification on the well-dressed woman was a business card. Using the information on the card, the physician looked up her Facebook page, and there he found the names of her husband and her primary care physician, both of whom were able to provide information about the patient's medical history, which included bouts of depression.

"Not to say it's wrong, but it's something we really need to think about as a profession," Crotty said. "HIPAA is a bill that carries criminal and civil penalties for breaches in confidentiality. So it's something we need to be careful of when you think about how you live with the information you have as a doctor."

Private physician social networks

Like many hospitals, Beth Israel Deaconess has set up its own messaging site for patients and physicians, called PatientSite. Patients can include up to two pharmacies in their profiles and add as many of their physicians as they like. The site requires users to log in, and thus enables patients and physicians to communicate securely.

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