In order to protect themselves from unintended consequences and to maintain public trust, physicians who use social media should protect the privacy and confidentiality of their patients; avoid requests for online medical advice; and act with professionalism, according to model policy guidelines for the appropriate use of social media (PDF) adopted by the Federation of State Medical Boards.

The guidelines also recommend that physicians be forthcoming about their employment credentials and conflicts of interest, and be aware that information they post may be available to everyone, may be misconstrued, “may be taken out of context or remain publicly available online in perpetuity.”

“Digital media has enormous potential for doctors and patients, allowing us more opportunities to share information and establish meaningful professional relationships,” Dr. Humayun Chaudhry, FSMB president and CEO (PDF), said in a news release. “However, physicians also need to be aware of how to maintain the same professional and ethical standards in their online activity as they do in the rest of their practice. Failing to do so can hurt patients and physicians' careers.”

In a research letter published this past March in the Journal of the American Medical Association, it was reported that, of the 48 medical boards responding to a survey, 69% reported instances of physicians engaging in inappropriate online communication with patients or sexual misconduct. Also, 63% of responding medical board reported cases of physicians prescribing medications online for patients with whom they did not have an established clinical relationship with and 60% reported cases of physicians misrepresenting their credentials online.

The new guidelines provide some examples of questionable online behavior and included a complaint registered by a patient after she saw her physician's Facebook page that reportedly showed pictures of the doctor intoxicated and noted that “the patient begins to question whether her physician is sober and prepared to treat her when she has early morning doctor's appointments.”

The guidelines also note that “physicians should not use their professional position, whether online or in person, to develop personal relationships with patients,” and “the appearance of unprofessionalism may lead patients to question a physician's competency.”

While peer-to-peer education and online dialogue is encouraged, the guidelines state that physicians should never mention patients' room numbers, refer to them by code names or provide any other identifying information.