Unwanted Facebook ‘friend’ requests - what you need to know

07 March 2016 | Avant Media

What should you do when a patient sends you a Facebook ‘friend’ request? Dr Jason Laurens, a Doctor in Training, shares his perspective on doctors’ use of social media profiles based on his personal experience.

Medical professionals everywhere work hard and pour their souls into patient care. Although immeasurably rewarding, it can also be mentally and emotionally challenging. This aspect of our profession is partially alleviated by the fact that when our day is over we can melt into society and enjoy the social freedoms of any other member of the community, or so we hope.

Sadly this isn’t always the case. As professionals, we are held to high ethical standards and these can place restrictions on doctors’ social lives. To navigate this, many doctors use pseudonyms for Facebook accounts, while others shun social media altogether to avoid photos or posts being published on the internet that may hurt them professionally. Some doctors also do this to avoid patients trying to ‘friend’ or message them. However, the use of pseudonyms can impinge on their social lives. While I understand that some patients just wish to thank us, others seem to have ulterior motives.

Most of us have attended a seminar or two where the dangers of social media have been discussed and doctors’ lives laid bare for all to see as examples of wrongdoing. Despite widely available education on the pitfalls of social media, unprofessional posts and unethical relationships with patients still occur.  

Many doctors in training use first names only when introducing themselves to patients to make them more approachable and to eliminate any officialdom which can create barriers. This also allows us to keep our surname – our most identifiable feature – private. However, our full names are clearly printed on all manner of medical records and documents including scripts, medical certificates,  and discharge summaries leaving us exposed to unwanted friend requests, follows and messages from patients.

During my recent emergency department term I felt my social anonymity was eroded when two patients tried to ‘friend’ me on Facebook. As someone who has strict personal and professional barriers it was a no brainer to decline the request from a patient whose name I recognised. However, the second friend request wasn’t from a name I recognised. I inadvertently accepted the friend request. Shortly afterwards, I received a friendly message to which I replied, but it quickly became clear that the message was from a patient. It turned out that I had treated the patient in the emergency department and he/she had found my surname on the discharge summary, enabling the patient to search for me on Facebook. I wished the patient well and proceeded to ‘unfriend’ and ‘block’ them.

I discussed the incident with a friend and fellow doctor about whether my friendly bedside manner could be misunderstood by patients. I told her that I assess every patient with the same professional routine; I use drapes, have a chaperone present where appropriate and never mention a patient’s appearance. And surely suggesting to an elderly patient that they don’t look a day over 60 could hardly be considered flirting?

However, based on the unequal power dynamic of the doctor/patient relationship, I can understand why some patients can become attached to their doctor. Although, I do not believe this should restrict my use of social media or anonymity away from work. I continue to use my real name on social media for both personal and professional reasons. If I was to use a pseudonym while posting on a work group about mental health and welfare, would people know who I am and whom to contact for advice? Would they take me seriously when leading discussions regarding working conditions? Possibly not. To negate inappropriate attention, should I have to use a pseudonym or further restrict my public profile making it virtually impossible for friends and family to find me? I don’t believe so. As doctors, we just need to be aware of the issues, how to maintain professional boundaries and where to seek advice if unsure.

I recommend doing what you feel allows you that little piece of anonymity we all crave from time to time, without limiting your ability to share your life with friends and family. I won’t be changing the way I use social media profiles just yet – only time will tell whether this is a sustainable ideology.

Avant’s key tips

  • Politely decline invitations from patients to be Facebook ‘friends’
  • Be aware that making friends with patients can lead to unreasonable patient demands
  • Avoid having conversations with patients of a personal nature which could be misconstrued.

Avant also encourages doctors to know their responsibilities when using social media under the Australian Medical Association (WA’s) Social Media and the Medical Profession; a guide to online professionalism for medical practitioners and medical students and the Medical Board of Australia’s Social media: How to meet your obligations under the National Law and Good Medical Practice: a Code of Conduct for Doctors in Australia.

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