How is Facebook Affecting Medical Ethics and Malpractice Liability?

nejmlogoShould doctors on Facebook be wary of sharing too much information with patients, colleagues, or representatives of insurance companies?

An article in the latest issue of the New England Journal of Medicine by Dr. Sachin H. Jain explores how Facebook is changing the nature of the doctor-patient relationship and the difficulties of balancing a personal and professional persona in social networking.

Facebook is quickly evolving into much more than a “social networking” site, with more and more people using the site to cultivate a variety of professional connections. But conflicts can arise when your professional and personal worlds intersect, especially when dealing with health and medicine.

When a former patient sent Dr. Jain a Facebook friend request, he accepted it with some hesitation. He was unsure of the patient’s motives, but felt Facebook offered a way to learn a little more about the woman’s daughter, whom Dr. Jain had delivered. However, Jain says he had reservations about inviting a patient into his personal life, as there were some potential ethical and legal repercussions to the online interaction.

“In confirming this patient as my ‘friend’ on Facebook, I was merging my professional and personal lives. From my Facebook page, Ms. Baxter could identify and reach anyone in my network of friends, view an extensive collection of personal photographs, read my personal blog, and review notations that others had left on my ‘wall,’” Jain says. “The anxiety I felt about crossing boundaries is an old problem in clinical medicine, but it has taken a different shape as it has migrated to this new medium.”

It turned out that the patient was seeking some advice, as she was considering entering medical school. Dr. Jain was relieved that the interaction was indeed somewhat professional, but the entire situation showed him how Facebook can break down the barriers put in place to help keep doctors at a safe distance from their patients so as to remain impartial.

For doctors, are also the issues that apply to every professional with a public Facebook profile, including a patient/client having access to photos or posts that could be detrimental to the professional’s image. While it’s always wise to police what you share on Facebook, it can be especially damaging for medical professionals to post questionable material. Should a patient with access to a doctor’s or nurse’s Facebook profile find something that breaches doctor-patient confidentiality, there could be potential legal issues. We might even theoretically see insurance companies trolling doctors’ personal pages for incriminating evidence, and the wrong content could affect the already high price of malpractice insurance.

Dr. Jain was fortunate that his former patient was only seeking advice, but he was cautious and advices others to be careful.

“The issues raised by access to online media are in many ways similar to issues that physicians and medical institutions have dealt with for generations. Physicians, after all, are members of real-life communities and might be observed in public behaving in ways that are discordant with their professional personas,” Jain says. “What is different about the online arena is the potential size of the community and the still-evolving rules of etiquette.”

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7 Responses to “How is Facebook Affecting Medical Ethics and Malpractice Liability?”

  1. How is Facebook Affecting Medical Ethics and Malpractice Liability? | Medical Colleges , News, Journals, Jobs ,education informations says:

    [...] was indeed somewhat professional, but the entire situation showed him how Facebook can …Read Full about this medical News / resources Related Medical informationsShould ER doctors be immune from medical malpractice? | [...]

  2. Violet says:

    What are the chances of them winning this case? It seems like I am hearing more and more about this.

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  4. Solo Lawyer Picks Up Over 600 Fans For His Practice’s Facebook Page says:

    [...] and professional relationships becoming intertwined, much like the concerns recently raised over Facebook pages for those in the medical field. Add Comment [...]

  5. Michael Kirsch, M.D says:

    There are many reasons why Facebook sharing between patients and physicians is a bad idea. The malpractice risk is just one of them. See

  6. Monique Terrell says:

    I’m sure there is some level of risk involved with a physician who makes an online connection with their patient or past patient.

    The risk I see is actually getting to know your patient and having more of a relationship thereby creating a longer-lasting experience.

    Additionally, when it comes to patient, Doctor confidentiality don’t behave on Facebook any different than you would if you ran into a patient at a local event. If you wouldn’t say it in person then why say it online.

    I think this is more of an issue of common since than anything. FB and other social media sites are nothing more than communication tools, behavior and etiquette still matters.

    Monique Terrell, CEO
    Sparkle Internet Image Solutions

  7. Scott Albin says:

    I believe the hippocratic oath speaks to the modern day issues if compare the ideas and translate the concepts into social media term:

    The physician should not comment-on, share, or post protected patient care related information on Facebook.

    Protected patient-care related information disclosure should occur solely through secure and protected systems (i.e. not Facebook), designed and maintained for the intended purpose of documenting and communicating protected patient care related information.

    Recognizing that the Hippocratic Oath states,

    “All that may come to my knowledge in the exercise of my profession or in daily commerce with men, which ought not to be spread abroad, I will keep secret and will never reveal.”

    “What I may see or hear in the course of treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep myself holding such things shameful to be spoken about.”

    The physician should not “friend” patients on Facebook.

    Facebook friendships between a physician and a patient lead to sharing of personal information that may negatively impact appropriate professional relationships.

    Recognizing that the Hippocratic Oath states,

    “In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing and all seduction.”

    “Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons.”

    The physician should not get involved with moral turpitude on Facebook.

    Recognizing that the Hippocratic Oath states,

    “I will preserve the purity of my life and my arts.”

    “In purity and according to divine law will I carry out my life and my art.”

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