As we have mentioned before, patients’ use of social media for health-related purposes continues to rise, with approximately 26 percent of surveyed patients reporting such use.1 Similarly, a survey of more than 4,000 physicians found that more than 90 percent use some form of social media for personal activities and 65 percent use these sites for professional reasons.2,3 Physicians use social media as a means to share information, promote disease education, engage health-care debate and interact with patients and colleagues. 

Previously, we focused on strategies to best employ social media to benefit practice promotion and brand development. However, as more physicians use social media, keep in mind that, for physicians, social media pose potential risks for the distribution of poor-quality information, damage to professional image, violation of personal-professional boundaries, breaches of patient privacy, licensing infringements and legal misgivings.4
Although discussion of all of the latter issues is beyond the scope of this column, we can focus on two overlapping themes: patient-physician boundaries and privacy.


Patient-physician boundaries

Physicians who interact with patients on social media may be violating the patient-physician boundary even if patients initiate the online communication.5 The most effective, and simplest, strategy to mitigate this danger is to keep separate professional and personal profiles and to not accept any online “friend” requests. 

Additionally, post only content of medical value on your professional profile and don’t overlap with any personal posts or comments. You can think of this “division of profiles” analogous to the boundaries in a patient-physician relationship. What you wouldn’t share with a patient in the clinic should be the same standard you apply to online communication. 

Privacy is paramount

We’ve emphasized this point before. Providing specific patient information online would violate patient privacy and has serious legal consequences. Always be cognizant of the Health Insurance Portability and Accountability Act (HIPAA). If you’re posting any patient clinical information or images, it has to have all identifying information removed. You can go one step further and have patients consent to you posting anonymized clinical details for educational purposes on your professional profile to safeguard potential HIPAA privacy breaches.

And don’t use an online platform to communicate directly with a patient about a specific medical problem. If a patient posts or comments with a question that’s directly related to a specific medical condition or procedure, have the office contact her or him to discuss further or to schedule an office visit. 

By following these guidelines, you can prudently grow your online presence without the risk of violating elements of the physician-patient relationship, which can have serious ramifications. RS



1. Greenspun H, Keckley P, Coughlin S. Deloitte 2012 Survey of U.S. Health Care Consumers INFOBrief: Information, technology, social media and online resources for health care—a slow climb. Deloitte Development LLC; 2012. Accessed 27 November 2019. 

2. Househ M. The use of social media in healthcare: organizational, clinical, and patient perspectives. Stud Health Technol Inform. 2013;183:244–248. 

3. Fogelson NS, Rubin ZA, Ault KA. Beyond likes and tweets: an in-depth look at the physician social media landscape. Clin Obstet Gynecol. 2013;56:495–508.

4. Ventola CL. Social media and health care professionals: benefits, risks, and best practices. P T. 2014 Jul;39:491-520. 

5. Farnan JM, Snyder SL, Worster BK, et al. Online medical professionalism: patient and public relationships: policy statement from the American College of Physicians and the Federation of State Medical Boards. Ann Intern Med. 2013;158:620–627.