Professionalism in the time of social media: Do’s and don’ts for DOs

In a fit of frustration earlier this year, an obstetrician-gynecologist from St. Louis ranted about a patient on her Facebook page.

Almari Ginory, DO

Before posting, physicians should ask themselves how their patients would feel if they saw the post, suggests Almari Ginory, DO. (Photo by Patrick Sinco)

“So I have a patient who has chosen to either no-show or be late (sometimes hours) for all of her prenatal visits, ultrasounds, and NSTs,” the post read. “She is now 3 hours late for her induction. May I show up late to her delivery?”

Several news organizations wrote about the posts, spurring an outcry and calls for the physician to lose her job.

“Is this what you want people to see when they’re googling you?” asked Almari Ginory, DO, during an OMED session Tuesday on professionalism and social networking. During her presentation, Dr. Ginory, an assistant professor of psychiatry at the University of Florida in Gainesville, detailed both the appropriate and inappropriate ways physicians can use social media.

The ob-gyn’s angry Facebook post is an example of a common error physicians make when using personal social media sites—venting about patients. These diatribes can damage a physician’s reputation even if no specifics are mentioned, Dr. Ginory said. Before posting, physicians should ask themselves how their patients would feel if they saw the post, she suggested.

“You’re a doctor, first and foremost,” Dr. Ginory said. “Even on your personal page, you’re a doctor. Venting is self-serving. It’s not in the best interest of patients. It serves no educational value and it serves no real benefit except to get it off of your chest.”

Patients, not ‘friends’

Physicians may wonder how to respond when their patients send them friend requests. Dr. Ginory led a survey of 182 psychiatry residents last year that found that more than 95% of them had Facebook profiles and nearly 10% had received a friend request from a patient. Residents expressed concerns about the effects of rejecting such requests.

Dr. Ginory was clear that befriending patients over social media crosses a professional boundary and is discouraged. A patient ‘friend’ may begin asking questions about the physician’s private life based on information gleaned from Facebook.

Dr. Ginory suggested physicians hold off on acting on the request until they meet with the patient again. Then they can explain why they can’t accept it. Former patients are off-limits too, she noted.

“When I left Miami to go to Gainesville, one of the most common statements I heard was, ‘Oh, I’m not your patient anymore—we can be Facebook friends now,’ ” she said. “I told them, ‘Once a patient, always a patient.’ ”

While Dr. Ginory’s advice may sound like common sense, boundaries and appropriate conduct may not be so obvious to physicians who are new to social media. Dr. Ginory recommended that physicians read the social media guidelines published by the American Medical Association and the Federation of State Medical Boards (FSMB). The AOA is currently developing social media guidelines for osteopathic physicians and students.

While physicians must exercise great care, social media can be a way for them to promote their practice and connect with patients, Dr. Ginory noted.

“If you want to use [social networking] for your practice, it’s free advertising,” she said. “You don’t have to pay for a Web page. You can open up a Facebook page and include your office information, office hours and address. And it’s free.”

But physicians must be careful not to give advice on social networking sites. For instance, a patient may post on a physician’s wall, “I might be suffering from ADHD. Does this problem have a treatment or cure?” If the physician responds, “Yes, it can be treated,” the exchange may be interpreted as the beginning of a clinical relationship.

To protect themselves, Dr. Ginory suggested physicians post a disclaimer on their professional social media pages to clarify that information posted is not necessarily the physician’s viewpoint and that no medical advice will be given on the page.

“Another thing experts always say is, put in the disclaimer that you don’t check the page regularly—so the site isn’t a place to be posting about suicidal ideations … or anything of the sort,” she said. “This will help protect you a little bit.”

Attendee Linda F. Delo, DO, already had a disclaimer on the Facebook page for her Port St. Lucie, Fla., practice. But Dr. Ginory’s presentation inspired her to to take another precaution.

“I just sent an email to my office manager to make sure that we have a policy in our employee manual regarding our staff and Facebook and other social media,” she said. “We need to protect ourselves so that we are not liable for something the staff says or does and to be sure that they know they have to continue to protect our patients’ privacy.”

Michael Brown, DO, said he hoped the presentation didn’t scare anyone away from using social media.

“My clinic and my health system have used [social media] very successfully and it has become a great tool,” Dr. Brown, a family physician from Kansas City, Mo., told the audience. “This was excellent information on how to behave appropriately on Facebook. But please don’t walk away scared of using this. Your patients are growing up in this environment and this is how they communicate. This is the future. So learn how to use [social media] appropriately because there are great opportunities for you to connect with patients in very appropriate ways.”

Original article – The DO – October 2, 2013

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