Behave yourself online; that's the message state medical boards are sending. Find out what could get you in hot water, and how the boards are cracking down on violators.

Your behavior online can devastate your career and your practice.

That’s the lesson learned from a study of reports to state medical boards that punished physicians for inappropriate online communication with patients, prescribing without a previous relationship, and misrepresenting their credentials, according to an article published in the March 21 issue of Journal of the American Medical Association.

In the study, based on a survey of the 68 executive directors of medical and osteopathic boards in the United States and its territories, researchers found that reported violations included:

inappropriate contact with patients online (69%),

inappropriate prescribing (63%), and

misrepresentation of credentials or clinical outcomes (60%).

In response to these violations, 71% of state medical boards held formal disciplinary proceedings, and 40% issued warnings resulting in serious actions such as license limitation (44%), suspension (29%), or revocation (21%).

“I was definitely surprised,” lead author Ryan Greysen, MD, MHS, MA, and assistant professor of hospital medicine at the University of California, San Francisco, wrote to Medical Economics eConsult in an email. “This was higher than we anticipated, and I think it underscores that boards do see this issue as within their responsibilities to regulate.”

Greysen cited research that shows that nearly 90% of physicians use a social media Web site for personal use, and 67% use social media professionally.

“Let me just say that I am not against physicians using social media; on the contrary, I think it is a highly valuable technology that has great potential to help our patients,” Greysen says. “But with any new technology, there are risks and complications that need to be understood and minimized first.”

Greysen says physicians should be aware of the AMA’s policy on social media use and of their own organization’s rules, which may include other restrictions.

In April, the Federation of State Medical Boards will consider adopting ethical and professional guidelines for electronic and digital media use by physicians, including email, texts, blogs, and social networks. The guidelines will address the following areas:

protecting the privacy and confidentiality of patients,

avoiding requests for online medical advice,

acting with professionalism and being aware of potential conflicts of interest, and

being aware that information posted online may be available to anyone and could be misconstrued.

“I think the larger issue going forward is less about how to more effectively monitor or report and more about how to educate and prevent,” Greysen says.

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