Dialogue Volume 13 Issue 2 2017 - Page 45

practice partner patient, their story could wind up anywhere. Dr. Devon is active on a couple of Face- book groups, one led by physicians and another by patients. If referencing a patient, she goes beyond de-identifying; she also gen- erally gets express written permission from the patient to share information, and states that she has that permission. It’s an extra layer of precaution. Social media offers opportunities and demands responsibility For guidance on responsible social media use, it’s helpful to review the College docu- ment on the topic, as well as other relevant College policies including Confidentiality of Personal Health Information; Main- taining Appropriate Boundaries and Preventing Sexual Abuse; and Physician Behaviour in the Professional Environ- ment. The College has also developed an educational module about social media and it is posted on the website. Other bodies for doctors, like the Cana- dian Medical Association and the Canadian Medical Protective Association, have pub- lished material on their websites about the opportunities and responsibilities around using social media. To be sure, there are a range of other issues around social media use by doctors. Like friending patients, posting content (even personal) that might be viewed as unprofes- sional, and providing clinical advice to spe- cific patients (as opposed to generic health information for educational or information sharing purposes). Sometimes the obligations around privacy and confidentiality get extra scrutiny be- cause social media breaches grab headlines. Several cases in other jurisdictions show how a doctor or other health-care professional has gone way over the line. In one incident, a model/actress was admitted to emergency for excessive alcohol consumption. Without her consent, a doc- tor allegedly took and posted embarrassing photos on Instagram of the woman crying, dishevelled and hooked up to an IV. An Edmonton pharmacist once landed in hot water after she got into a dispute with a group of women at her church about the romantic activities of a man in the congre- gation. The pharmacist posted disparaging comments about one female congregant on Facebook. When the woman complained, the pharmacist then accessed her health records and posted information about her prescription medication use online. Other times, health-care professionals have found negative reviews of themselves on rating sites, and actually scolded the patients online and revealed details about their health. Cases don’t have to be so egregious to be serious. On social media, as elsewhere, it’s paramount to always respect patient privacy and confidentiality, no matter the forum. If patient privacy and confidentiality is breached, it may not matter if it was because of carelessness rather than intent. The words and images posted online can undermine patient trust and harm the reputation of the physician, their institutions and the profes- sion. For doctors, social media does have a lot to offer. It can be valuable to connect with other medical professionals on Twitter, share health-care information with the public, or comment online about difficult or interest- ing cases. As Dr. Devon observes, “The world is changing how we learn and teach, and social media is a great tool.” Just remember, she says, whether patients are Googling doc- tors or doctors are posting about patients, “people are listening – and evaluating.” MD Issue 2, 2017 Dialogue 45