QMC 4 Should doctors accept social media “requests” from patients?

I had a feeling I was going to get this question sometime. So I wasn’t surprised when Dr. AV asked me if it’s okay to accept Facebook “friend requests” from patients.


The answer is NO.

Let’s look at all the guidelines & statistics first.

The BMJ research showed 73% of doctors surveyed had a Facebook profile, with 24% logging on several times a day. The survey also showed that 6% of doctors had received a friend request from a patient. Most respondents said they’d refuse the request – and rightly so – but 15% said they’d decide on a case by case basis. [1]

The British Medical Association said medical staff and students should reject any approaches by current and former patients to avoid the risk of blurring the boundaries of the doctor-patient relationship. A number of medical staff have been investigated and struck off for “improper use” of Facebook. [2]

The American Medical Association published a policy on professionalism in the use of social media, which addresses the importance of maintaining appropriate boundaries in the patient-physician relationship, refraining from posting protected health information online, and separating personal and professional content online.[3]The Journal of Medical Ethics has published more specific guidelines urging physicians never to invite a patient to become an online friend, or to accept a friend request from a patient. [4]

So, the rules say no. And you can lose your license in the UK, if you do happen to make an off the cuff comment or share a good old story online.

A Facebook relationship is not the same as a professional relationship, if you’re on the other side of this discussion. It is true that patients are starved for more personal relationships with their physicians. But that’s no reason pictures about me and my family on Facebook would be of any benefit to them. On the flip side, I already know all I need to know from my patients from my excellent history taking skills, thank you very much. I have no intention of gathering any more data from anywhere else.

Why not, you ask? A number of reasons:

  1. You could accidentally reveal sensitive information. (HIPPAA violation everyone?)
  2. The lines do get blurred. This is not a friendship. The doctor patient relationship remains objective when there’s that distance. You lose that objectivity when you get into a personal relationship and it clouds your judgment. It’s the same reason we remained detached in the ER.
  3. Especially if you’re in mental health, you know it affects the physician-patient dynamic.
  4. You could lose your license.
  5. There is no advantage to this, that cannot be achieved through a website or an email.

Yes, I know doctors have lives and yes, those lives should be outside of their patients. But my advice would be:

  1. Keep your professional and private life separate.
  2. Privacy is a decision you have to make.
  3. Always remember that whatever you post online, will be used to judge you, by your employers, colleagues and patients.

I’m extremely private. I don’t share images or details of my private life online. My writing struggles yes, but not my life. I have to admit I don’t like Facebook, but have to, for my publishers sake. My fans reach me everywhere else.

If you’re on the fence, I’d still say you can open a separate account, but be wary. Be very wary of what you post. Read Dr. Kevin Pho’s book,Establishing, Managing and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices” for clarity on this subject.

Ask yourself, can I provide better medical care with Facebook?

What do you think? Are the rules wrong?





3. American Medical Association. 2010 Interim Meeting of the House of Delegates. AMA policy: professionalism in the use of social media. http://www.ama-assn.org/ama/pub/meeting/professionalism-sociamedia.shtml. Accessed June 10, 2011.

4. Guseh JS II, Brendel RW, Brendel DH. Medical professionalism in the age of online social networking. J Med Ethics. 2009;35(9):584–586.


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