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Internet liability for gastroenterologists


 

In this month’s "Roadmap," Andrew Feld – M.D. and J.D., discusses the intriguing intersection of social media, the Internet, and medicine. He analyzes opportunities and dangers of connectivity. Physicians who utilize social media in their medical practices or private communications must be aware of the power and permanence of electronic "footprints." During this year’s Digestive Disease Week® AGA Spring Postgraduate Course, I moderated a session about new and previously unimagined resources that are being developed to monitor patients remotely, enhance our communication, and allow us to "hover" over patients in need of intense physician management. This is a new world that carries awesome power and responsibility but one worth exploring.

John I. Allen, M.D., MBA, AGAF, Special Section Editor

The Internet continues to change the physician-patient relationship. Not only do people perform Internet searches to determine the disease causing their symptoms before they visit the doctor, but 47% of people now perform Internet searches on their own physicians, and 37% of people consult physician rating sites.1 The information that patients find online can impact their perceptions of physicians as well as the physician’s reputation and practice. Therefore, physicians should be aware of what patients may find online and how they can use online resources to protect their reputation. This article outlines what patients may discover about physicians online, the impact of the Internet on a physician’s reputation, and best practices for when patients post negative comments online.

Information about physicians available online

Kayla A. Feld

When a patient performs a simple Internet search of a physician’s name, the results may include personal and professional contact information; publicly available social media accounts; disciplinary data, if any, reported on a state government website; articles written by the physician; and reviews of the physician by patients, insurance companies, and/or the physician’s staff. These results are part of the physician’s digital footprint. Information contained in the digital footprint may have either a positive or negative impact on a physician’s reputation and the public’s trust in the medical community. Physicians can partially control what information is listed first in response to an Internet search of the physician’s name and attempt to mitigate any negative results that are returned. This is accomplished by asking for patient testimonials, ensuring top search results provide the name of the physician and information about his or her practice, performing periodic Internet searches, and maintaining a public and a private profile.

Social networking

Physicians should be aware of the most widely used social media modalities. Thus, important types of social media are Facebook, Twitter, and LinkedIn. Facebook allows a user to create a profile page with a "wall" on which others can write, link the profile to another user’s profile by "friending," and restrict or share access to their information with all of the user’s "friends" or even the public at large. Similarly, Twitter is an online social networking site that emphasizes microblogging by allowing a user to post, send, and receive short text messages, up to 140 characters long, that are known as "tweets." Finally, LinkedIn is an online professional network that allows a user to create a profile that lists the user’s educational and work background. Users can connect with business acquaintances, network, and privately or publicly search for a job.

Jessica M. Belle

There are numerous legal issues that may be implicated when physicians write about their professional work on their social media accounts. These include compliance with Health Insurance Portability and Accountability Act (HIPAA), Title VII of the Civil Rights Act, Americans with Disability Act, and general common law tort principles. Posting identifiable photos of patients, placing information about patients in a non-HIPAA-protected manner, and responding to nonpatient inquiries in a manner that may create a duty to that patient are examples of actions that violate HIPAA and are illegal.

The American Medical Association (AMA) cautions physicians that anything written online may exist permanently, even if a user attempts to delete or remove the items from the user’s personal page.2 The AMA expects physicians to self-monitor by alerting each other to unprofessional comments made by or about a fellow physician. When a physician knowingly refuses to remove unprofessional online comments, the AMA expects physicians to inform the appropriate authorities. Social media modalities can be important tools, but physicians must be cognizant of their legal and ethical obligations when using such tools.

Review sites

In addition to being aware of social media modalities, physicians should be aware of how patients can rate them online. Websites such as Healthgrades, Angie’s List, and RateMDs generally allow patients to rate physicians in several areas and leave a general comment about their experience. Most sites permit physicians to update their profiles to include basic contact information as well as the physician’s qualifications and certifications.

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