Commentary: Friending patients on Facebook

Can we be friends? Seems innocent enough, no? Yet "friending" on Facebook is fraught with ethical and professional challenges for physicians.

What should you do if a patient wants to friend you on Facebook? Here’s what some doctors have done. According to 2011 survey in the Journal of General Internal Medicine, 58% of practicing physicians reported that they always replied "no" to friend requests from patients, while 42% said that they accepted them on a case-by-case basis (J. Gen. Intern. Med. 2011;26:1168-74).

Physicians who choose to not friend patients online are often concerned about issues including HIPAA (Health Insurance Portability and Accountability Act) violations, maintaining a separation between their personal and professional lives, and offending patients when they decline requests.

What should you do? What is the best practice for physicians friending patients online? The American Medical Association doesn’t prohibit the practice, but it urges physicians to "maintain appropriate boundaries of the patient-physician relationship in accordance with professional ethical guidelines," just as they would in any other context.

By contrast, in 2011, the British Medical Association issued a new guideline advising physicians not to accept friend requests from former and current patients because of how doctors’ personal information could be perceived and shared.

Here’s a simple solution that works well for many physicians: Create a professional Facebook page for your practice and redirect patients there. It’s easy to do: Once you log in to Facebook, go to "create a page," then choose "local business or place," fill in the information, and you’re ready to go. This strategy allows you to keep your personal Facebook account private.

Your personal account should be relegated to family and real-life personal friends. This is where you share photos of your child’s birthday party or updates on your recent kitchen remodel.

Your business page should be devoted to your professional life. This is where you share pertinent information about your practice, links to blog posts you’ve written, and other educational or useful information for your followers. You can write updates with a personal tone, but the content should remain professional and HIPAA compliant.

This two-tiered solution to Facebook friending has many benefits. When you say no to a patient friend request on your personal page, you can redirect him or her to your public page. You’re still keeping the lines of communication open. A public or business page allows anyone to like it, which benefits you and your practice; importantly, it disallows friending. This means you can share information and connect with others (including current, past, and future patients) online, without blurring the line between your professional and personal life.

Even if you do have separate Facebook pages, remember that anything you post online can be discovered. That means a picture of you and your buddies drinking beer at a bar or attending a political rally can be found by people who you might not want to find them. But you know that already.

Just as you work to protect your face-to-face reputation, you should work to protect your reputation online. After all, if your online reputation gets muddied, so will your offline one. It’s about setting boundaries, which physicians have been doing for centuries.

If we’ve met in person, and you really do like me, feel free to friend me on Facebook. If you want to take things more slowly, then follow me on Twitter, where I’m @Dermdoc. And let me know your thoughts about physicians and patients friending online.

Dr. Benabio is in private practice in San Diego. Visit his consumer health blog at http://thedermblog.com or connect with him on Twitter @Dermdoc and on Facebook (DermDoc). 

Can we be friends? Seems innocent enough, no? Yet "friending" on Facebook is fraught with ethical and professional challenges for physicians.

What should you do if a patient wants to friend you on Facebook? Here’s what some doctors have done. According to 2011 survey in the Journal of General Internal Medicine, 58% of practicing physicians reported that they always replied "no" to friend requests from patients, while 42% said that they accepted them on a case-by-case basis (J. Gen. Intern. Med. 2011;26:1168-74).

Physicians who choose to not friend patients online are often concerned about issues including HIPAA (Health Insurance Portability and Accountability Act) violations, maintaining a separation between their personal and professional lives, and offending patients when they decline requests.

What should you do? What is the best practice for physicians friending patients online? The American Medical Association doesn’t prohibit the practice, but it urges physicians to "maintain appropriate boundaries of the patient-physician relationship in accordance with professional ethical guidelines," just as they would in any other context.

By contrast, in 2011, the British Medical Association issued a new guideline advising physicians not to accept friend requests from former and current patients because of how doctors’ personal information could be perceived and shared.

Here’s a simple solution that works well for many physicians: Create a professional Facebook page for your practice and redirect patients there. It’s easy to do: Once you log in to Facebook, go to "create a page," then choose "local business or place," fill in the information, and you’re ready to go. This strategy allows you to keep your personal Facebook account private.

Your personal account should be relegated to family and real-life personal friends. This is where you share photos of your child’s birthday party or updates on your recent kitchen remodel.

Your business page should be devoted to your professional life. This is where you share pertinent information about your practice, links to blog posts you’ve written, and other educational or useful information for your followers. You can write updates with a personal tone, but the content should remain professional and HIPAA compliant.

This two-tiered solution to Facebook friending has many benefits. When you say no to a patient friend request on your personal page, you can redirect him or her to your public page. You’re still keeping the lines of communication open. A public or business page allows anyone to like it, which benefits you and your practice; importantly, it disallows friending. This means you can share information and connect with others (including current, past, and future patients) online, without blurring the line between your professional and personal life.

Even if you do have separate Facebook pages, remember that anything you post online can be discovered. That means a picture of you and your buddies drinking beer at a bar or attending a political rally can be found by people who you might not want to find them. But you know that already.

Just as you work to protect your face-to-face reputation, you should work to protect your reputation online. After all, if your online reputation gets muddied, so will your offline one. It’s about setting boundaries, which physicians have been doing for centuries.

If we’ve met in person, and you really do like me, feel free to friend me on Facebook. If you want to take things more slowly, then follow me on Twitter, where I’m @Dermdoc. And let me know your thoughts about physicians and patients friending online.

Dr. Benabio is in private practice in San Diego. Visit his consumer health blog at http://thedermblog.com or connect with him on Twitter @Dermdoc and on Facebook (DermDoc). 

Can we be friends? Seems innocent enough, no? Yet "friending" on Facebook is fraught with ethical and professional challenges for physicians.

What should you do if a patient wants to friend you on Facebook? Here’s what some doctors have done. According to 2011 survey in the Journal of General Internal Medicine, 58% of practicing physicians reported that they always replied "no" to friend requests from patients, while 42% said that they accepted them on a case-by-case basis (J. Gen. Intern. Med. 2011;26:1168-74).

Physicians who choose to not friend patients online are often concerned about issues including HIPAA (Health Insurance Portability and Accountability Act) violations, maintaining a separation between their personal and professional lives, and offending patients when they decline requests.

What should you do? What is the best practice for physicians friending patients online? The American Medical Association doesn’t prohibit the practice, but it urges physicians to "maintain appropriate boundaries of the patient-physician relationship in accordance with professional ethical guidelines," just as they would in any other context.

By contrast, in 2011, the British Medical Association issued a new guideline advising physicians not to accept friend requests from former and current patients because of how doctors’ personal information could be perceived and shared.

Here’s a simple solution that works well for many physicians: Create a professional Facebook page for your practice and redirect patients there. It’s easy to do: Once you log in to Facebook, go to "create a page," then choose "local business or place," fill in the information, and you’re ready to go. This strategy allows you to keep your personal Facebook account private.

Your personal account should be relegated to family and real-life personal friends. This is where you share photos of your child’s birthday party or updates on your recent kitchen remodel.

Your business page should be devoted to your professional life. This is where you share pertinent information about your practice, links to blog posts you’ve written, and other educational or useful information for your followers. You can write updates with a personal tone, but the content should remain professional and HIPAA compliant.

This two-tiered solution to Facebook friending has many benefits. When you say no to a patient friend request on your personal page, you can redirect him or her to your public page. You’re still keeping the lines of communication open. A public or business page allows anyone to like it, which benefits you and your practice; importantly, it disallows friending. This means you can share information and connect with others (including current, past, and future patients) online, without blurring the line between your professional and personal life.

Even if you do have separate Facebook pages, remember that anything you post online can be discovered. That means a picture of you and your buddies drinking beer at a bar or attending a political rally can be found by people who you might not want to find them. But you know that already.

Just as you work to protect your face-to-face reputation, you should work to protect your reputation online. After all, if your online reputation gets muddied, so will your offline one. It’s about setting boundaries, which physicians have been doing for centuries.

If we’ve met in person, and you really do like me, feel free to friend me on Facebook. If you want to take things more slowly, then follow me on Twitter, where I’m @Dermdoc. And let me know your thoughts about physicians and patients friending online.

Dr. Benabio is in private practice in San Diego. Visit his consumer health blog at http://thedermblog.com or connect with him on Twitter @Dermdoc and on Facebook (DermDoc).