Friend request or patient at best?

Friend request or patient at best?

Privacy, confidentiality and trust are at the core of every doctor/patient relationship. With social media providing potential for others to connect and engage with us, how can doctors ensure they maintain professional boundaries with patients when online?

At the same time, the constant pressure to be “on” means social media friend requests and follows happen at all hours of the day. Maintaining professional boundaries has never been more important.

The Medical Board of Australia’s Code of Conduct (section 3.4.5) states that good medical practice involves “ensuring that your use of social media is consistent with your ethical and legal obligations to protect patient confidentiality and privacy.”

Due to the power imbalance inherent in a doctor-patient relationship, the preservation of professional boundaries is key to preventing abuse of the relationship. This means that accepting a “friend request” or allowing unfiltered access to your personal life, beyond what would normally be part of the doctor-patient relationship is crossing professional boundaries.

Tips for maintaining boundaries on social media:

  • Don’t connect with patients, their friends or family online. If you receive a friend request, a polite message informing them that it is your policy not to establish online friendships sets the tone.
  • Consider separating personal and professional profiles on all social media platforms.
  • Adjust privacy settings so that only family and friends can see updates and images.
  • Update your privacy settings to prevent others from being able to “tag” you in photos, memes and other content you might not welcome. Social media is often used as a screener by potential employers and others. Photos or information that you would not be comfortable talking about in a professional setting can be a risk to your professional reputation years later.
  • Remember what you say online is permanent. Avoid making comments about colleagues, patients, workplaces or work-related incidents. Whether you are commenting in a personal or professional capacity, it’s a good idea to keep your social media presence as professional as possible.
  • Maintain patient privacy at all costs.

In extreme circumstances, if professional boundaries have been disregarded by a patient, you may decide to end a professional doctor/patient relationship. “Good medical practice involves ensuring that the patient is adequately informed of your decision and facilitating arrangements for the continuing care of the patient, including passing on relevant clinical information” (Good medical practice: a code of conduct for doctors in Australia (section 3.13)).

More information:

Medical Board of Australia: Good Practice Guide
AHPRA: Social Media Policy
AMA: Social Media and the Medical Profession
Medical Council of NSW: Ending a therapeutic relationship… is it the answer?