Social media for doctors – keeping it professional

• Professional and legal obligations apply on social media.
• Always consider how your social media presence may reflect on you as a doctor – regardless of the platform, purpose or intended audience.
• Obtain and document patient consent to use any patient information, even if it appears to be de-identified.
• A social media post is in existence forever. If in doubt, don’t post.

Social media consists of hundreds of platforms, ranging from professional networking sites, social networking platforms, blogs, microblogs and content-sharing platforms. Referral tools, discussion forums, message boards and messaging platforms all fall within the broad category of social media.

It can be beneficial for establishing a professional presence and sharing information, within the boundaries of your professional and legal obligations.

Professional behaviour

Social media is designed to connect people. It often uses other platforms and internet capabilities to identify existing links between people. While you may think personal and professional personas are different, your social media profile will often connect the two. Be careful posting any personal information or opinions on social media. Your private actions may reflect on your public persona.

Be mindful that medical regulators may consider your social media use in the context of a complaint, or in extreme situations if there is a concern about your fitness to hold registration.

Upholding the code of conduct

As a doctor, you are required to adhere to standards of professional behaviour primarily contained in the Medical Board of Australia’s Good Medical Practice: a code of conduct for doctors in Australia.

While you have a right to hold personal views, the code of conduct confirms that you must consider the impact of any social media comment on your role as a doctor, patient access to care, and on the reputation of the medical profession.

The code of conduct also confirms that you have a professional responsibility to promote the health of the community through health education, disease prevention and health promotion.

You may wish to use your social media presence to raise awareness and share information about a public health campaign. However, posting images or comments that could be seen to endorse anti-social behaviours or expressing personal views that might be regarded as contentious could not only damage your professional reputation but also could be in breach of your professional obligations. 

Try to control when photos of you are posted. Ensure you also seek consent from anyone who is in a photo you post.

Maintaining professional boundaries

Consider who you connect or share information with on social media, and how a platform’s settings might make or suggest links to you. Always be sure of the identity of people whose requests you accept and avoid accepting requests from patients. On some platforms, it may be appropriate to be followed by or connected with patients and the general public: ensure you maintain professional boundaries in those situations.

You may be contacted by people seeking information or advice from you in response to your social media presence. Develop a strategy to respond to this. For example, refer them to their own treating doctor for any clinical advice in the first instance. If they ask to see you as their treating doctor and this is appropriate, ensure that a formal doctor/patient relationship is established before you provide any treatment.

Always assume that a patient or colleague will see your social media posts, and ensure you are comfortable with that before posting. Also assume that information shared in closed groups may be shared outside those groups, including with the organisation where you work.

Carefully consider the content of any post – doctors may be more accustomed to certain images or topics that may be distressing to the general public.

Privacy and confidentiality

Privacy legislation and your legal and ethical duty of confidentiality apply to any information about your patients. You need to be particularly cautious when sharing patient information on social media.

If you want to post patient information or an image on social media obtain consent from the patient for the specific purpose and document this in the patient’s clinical records.

Even in a closed group or private message function, the risk of breaching patient confidentiality is high with potentially serious ramifications. Members of a closed group may not be only doctors. 

Images and information can become stored on several people’s devices and can be shared widely without your knowledge. Given the connectivity between apps and platforms on devices, there is also the risk of an image or information being transferred inadvertently to a different app or social media platform.

Sharing information, particularly with international colleagues, can provide a virtual corridor consultation with an expert or to aid in diagnosis. Consider carefully whether social media is the appropriate forum for sharing information for this purpose. 

Always seek and document the patient's consent to share their information and images. When sharing a patient's information or images with colleagues for their clinical opinion, carefully record what images or information you shared, to document the basis for your recommendations for the patient's treatment.

Many doctors have found value in sharing information online for education and training, and benefit from the breadth of knowledge accessible via social media. It is always good practice to get patient consent before sharing images or information even if you believe it to be de-identified. 

A patient may be identifiable from the information or image even if identifiers such as name or date of birth have been removed, for example because of their condition. The metadata of an image may also contain identifying information. There have been occasions where patients have identified themselves, or been identified by friends and family, from information or images posted about them.

Be aware of inadvertent breaches of privacy and confidentiality. For example, there may be identifying information relating to patients or staff in the background of a photograph.

Be aware of the privacy and security settings of your device and of the platforms you are using and review these regularly. 

Understand any default settings, such as granting permission to access contacts, as this may allow access to confidential patient details. Check the terms and conditions of websites before signing up, including whether the site will access information on your device. 

Some platforms are completely public so should be used cautiously. Even on platforms with privacy settings, certain parts of your profile may be publicly available and not protected.

Even if you remove content from some social platforms, copies of that information may still be viewed elsewhere if it has been shared with others. Assume that if you post something online it will become public and you may not be able to delete it. It may be in existence forever – if in doubt, don’t post.

Be aware of your organisation’s social media policies and follow them. Policies will generally prohibit using social media in a way that would breach any law or that would bring your employer into disrepute. It may also prevent comment on workplace matters or on issues not aligned with the organisation’s values. 

The organisation’s policy may prohibit you posting any clinical information on social media, even with patient consent. Unauthorised posting could contravene your employment obligations. It is prudent to check with the appropriate person at your organisation in advance.

• Medical Board of Australia Code of Conduct
• ‘A Guide to Social Media and Medical Professionalism’ AMA, 2020
• Avant factsheet: Clinical images - a snapshot of the issues
• Avant factsheet Messaging Apps: communicating safely in clinical practice

For medico-legal advice, please contact us here, or call 1800 128 268, 24/7 in emergencies.