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
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
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.