Doctors shouldn’t buddy up with patients on Facebook or Twitter, hospitals warn

Hospitals, worried about lack of professionalism and inadvertent leaking of confidential data, are warning doctors not to set up relationships with patients on Facebook and Twitter.

The AMA recommendation: “Physicians should be cognizant of standards of patient privacy and confidentiality that must be maintained in all environments, including online, and must refrain from posting identifiable patient information online.”(1)

 Should Physicians Interact with Patients on Social Media?

As I read the article, Doctors warned not to use social media with patients  I reflected on how far I had strayed from the so-called professionalism in medicine. Five years ago, I empathetically agreed, maintaining a professional “wall” between physician and patients. Fast forward to today and I am ambivalent about the AMA recommendations.

It is certainly a safe recommendation and a traditional stance, but what of the rapidly changing interconnected globalized world of medicine? Are physicians being left behind the digital age of interconnectivity? Or are physicians using technology to further insulate themselves from patients?

Few newly trained physicians know how to do physical exams and instead rely solely on technology. Most lack the ability to take good histories. Time but also inability to communicate have made complete histories obsolete. Obolete histories mean patient’s voices are not necessary, and their stories are becoming the fictional subjective interpretations of medical providers rather than the voice or words of patients.

Another thing, if X-rays and labs are normal—and they usually are—highly trained physicians– not having done histories or physicals– concoct histories and physicals to suit desired diagnoses, without regard to patients’ history or findings on physical exam. Incentives are strong motivators for certain diagnoses where patients are given diagnosis for the purposes of experimentation or starting new drugs.

Finally, Some providers go as far as to dismiss patient complaints when patients disagree. These providers refer “uncooperative” patients to psychiatry, from which there is no sane return. I am especially disappointed with Emergency Departments where patients are bullied and defamed by both first responders and ED staff, setting the tone for further abuse of staff and misdiagnoses.

It is disappointing to hear the AMA take the same old stance that is not working.

Let’s be creative! Simply state that online conversations are not private, and physicians will not discuss personal medical information on social media–patients will understand.

Social media offers opportunities for Physicians to educate, interact, and get to know the communities they serve. Many physicians already see a role for social media in chronic illnesses, cancer, depression and rare diseases.

Patient online communities are rapidly growing meantime physicians are discouraged from joining these communities. Most physicians join online physician communities where knowledge is exchanged about diseases, but not about how to deliver compassionate or quality care or how best to cool the flaring embers of an irate patient or how to avoid conflicts of interest.

Currently, the wall between patients and physicians is thick and filled with mistrust. Social media offers opportunities for physicians to build trust with patients, to remove the god-like facade, and tear down unnecessary barriers that lead to poor patient-physician relationships, medical errors, and discriminatory care–all contributing to the astronomical costs of health care. Finally, social media offers the opportunity for physicians to understand the multi-cultural nature of their patients, such an understanding could be key to reducing unnecessary tests, medical errors and misdiagnosis.

The AMA should have programs that teach physicians how to interact safely online rather than a stance that ignores progress in the surrounding world. Providers need tools to improve embattled and severed patient-physician relationships.

What a wonderful surprise had the old ways of the AMA embraced the future, by showing the adaptability of medicine. However, the AMA responded cautiously and missed scalable and repeatable opportunities to engage patients, repair broken relationships with patients and improve health literacy within communities by tapping myriad of resources offered through social media.

Interesting, AMAs concern around confidentiality, given patient data is widely available to government agencies, research institutions and third parties who not bounded by HIPAA.

Many physician already interact with patients online. I find it convenient to email my physician. What are your thoughts?

Related Articles:

1. Doctors warned not to use social media with patients

2. Doctors, Patients & Social Media