Patient privacy


Do no harm. There are few words that mean more to physicians, which is why many are reluctant to engage with patients online. They see social media as a minefield of potential privacy violations.

Avoiding social media entirely for fear of committing a privacy violation is not the answer in today’s increasingly social world. Instead, you should educate yourself about how to use social media safely and effectively.

Dr. Jeffrey Benabio

Numerous medical centers and governing bodies are trying to establish social media guidelines for physicians and health care workers, but since social media is continually evolving, so will the guidelines for using it. Some existing guidelines include the following:

• American College of Physicians: new recommendations offer guidance for preserving trust when using social media.

The Federation of State Medical Boards Model Policy Guidelines.

Cleveland Clinic Social Media Policy.

Mayo Clinic Social Media Policy for Employees.

Centers for Disease Controls Social Media Guidelines and Best Practices.

It’s true that engaging with patients online poses risks to us as providers. It’s also true that we take on risk every day that we see patients. And just as a physician who violates a patient’s privacy in person could face legal ramifications, so too could he face them from committing a privacy breach online.

I encourage everyone to do their own research before engaging in social media, but here are the guidelines I adhere to for using it safely:

• Include a disclaimer on your social networks that states content is not medical advice, but rather educational information. For example, on my @Dermdoc Twitter account, my bio includes "Views here are my own, and are not medical advice."

• Maintain separate personal and professional online accounts, and direct patients to your professional accounts only.

• E-mail and other electronic modes of communication should be used only within a secure system with an established patient/physician relationship and with patient consent.

• Never respond to specific clinical questions from nonpatients online. Encourage the individual to contact his or her medical provider, or in the case of an emergency, to go to the nearest emergency department.

• Text messaging should be used only with established patients and with their consent.

• Never post information or photos online that could re-identify a patient, unless you have his or her written consent.

• If a patient identifies himself online of his own accord, you are not responsible. However, you should explain to him that you’d rather not discuss his specific case in public and redirect him to a secure means of communication with you.

• Never argue, demean, or accuse patients online. Your online behavior should reflect your professionalism and respect of others.

• Never post content or photos of yourself that are unprofessional or incriminating, such as a photo of you and your buddies partying.

In my next column, I’ll present specific examples of safe and appropriate responses to patients online.

Dr. Benabio is Physician Director of Innovation at Kaiser Permanente in San Diego. Visit his consumer health blog at and his health care blog at Connect with him on Twitter @Dermdoc and on Facebook (DermDoc).

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