The American College of Physicians and the Federation of State Medical Boards have released a policy paper to help physicians protect patient interests and be professional in online settings.

The American College of Physicians (ACP) and the Federation of State Medical Boards (FSMB) have released a policy paper, “Online Medical Professionalism: Patient and Public Relationships,” in an effort to help physicians protect patient interests and be professional in online settings.

“Digital communications and social media use continue to increase in popularity among the public and the medical profession,” says Phyllis Guze, MD, FACP, chairwoman of the ACP Board of Regents. “This policy paper provides needed guidance on best practices to inform standards for the professional conduct of physicians online.”

Published online and in the April 16 issue of Annals of Internal Medicine, the paper examines and provides recommendations regarding the influence of social media on the patient-physician relationship. It also addresses the role of online media and public perception of physician behaviors and strategies for patient-physician communications that preserve confidentiality while best using new technologies.

“It is important for physicians to be aware of the implications for confidentiality and how the use of online media for non-clinical purposes impacts trust in the medical profession,” says Humayun Chaudhry, DO, MS, FACP, president and chief executive officer of the FSMB.

Notable recommendations from ACP and FSMB:

Keep your professional and personal personas separate. Do not “friend” or contact patients through personal social media.

Do not use text messaging for medical interactions, even with an established patient, except with extreme caution and consent by the patient.

Only use e-mail or other electronic communications within an established patient-physician relationship and with patient consent.

If you are approached through electronic means for clinical advice in the absence of a patient-physician relationship, handle the exchange with judgment. It usually is appropriate to address such requests by encouraging the individual to schedule an office visit or, in the case of an urgent matter, to go to the nearest emergency department.
Establish a professional profile so that it appears first during a search by a patient instead of having a physician ranking site come up first. Doing so can help you control the information read by patients before their initial encounters or thereafter and ensure that it is accurate.
Be mindful of what you post, and activiely police your online content (including posts others make in response to yours) so you do not inadvertently harm your career.

The paper includes a chart of online activities, potential benefits and dangers, and recommended safeguards for physician behavior. For example, communicating with patients using e-mail offers the potential benefits of great accessibility and immediacy of answers to non-urgent issues. The potential dangers are confidentiality concerns, replacement of face-to-face or phone interaction, and ambiguity or misinterpretation of digital interactions. The safeguards include reserving digital communications for patients that maintain face-to-face follow-up only.

The paper was authored by ACP’s Ethics, Professionalism and Human Rights Committee; ACP’s Council of Associates; and FSMB’s Committee on Ethics and Professionalism.