Physicians on Facebook may risk compromising doctor-patient relationship

Moubarak G. J Med Ethics. 2010.doi:10.1136/jme.2010.036293.

Physicians who have a profile on the social networking site Facebook may be compromising the doctor-patient relationship, according to research published online in the Journal of Medical Ethics.

Failure to deploy sufficient privacy settings is at the root of the problem, the research indicated.

“Doctors must be aware that comments and pictures posted online may be misinterpreted outside of their original context and may not accurately reflect their opinions and real-life behavior,” the researchers wrote. “This information could also become accessible to people [for whom] it was not intended.”

A survey of postgraduates

The researchers based their findings on a survey of the Facebook activities of 405 postgraduate trainee physicians at Rouen University Hospital in France. According to a press release, 202 physicians returned the survey.

Of the 202 respondents, 73% said they had a Facebook profile. Eighty percent said they had a presence on the site for at least a year.

With regards to use, 24% stated that they logged on to the site several times a day — but 49% said that they logged on once a day or several times a week.

Forty-eight percent believed the doctor-patient relationship would be “altered” if patients discovered their physician had a Facebook account, but 76% considered that it would change only if the patient had open access to their physician’s profile independent of its content.

Still, 99% of those physicians surveyed displayed sufficient personal information for them to be identified — including their real name, their birthdates (97%), a personal photograph (59%), their current university (59%) or their current position (55%).

Privacy and ‘friend requests’

More than half of the participants claimed to have changed at least one of the default privacy settings, but 17% could not remember if they had done this. Those who had been on the site for less than a year were less likely to limit access to the content of their profile.

The researchers found that 85% of respondents said that they would automatically refuse a friend request from a patient. One in seven said they would decide on a case-by-case basis. Only 6% of those who used Facebook had received a friend request from a patient, with four respondents saying they had accepted the request. Reasons given for accepting a patient as a friend included feeling an affinity for the patient or fear of embarrassing or losing the patient if the request was declined.

Primary reasons given for rejecting the requests were the need to keep a professional distance or the suspicion that the patient was interested in a romantic relationship.

“This new interaction (whether it is romantic or not) results in an ethically problematic situation because it is unrelated to direct patient care,” the researchers wrote. “Moreover, public availability of information on a doctor’s private life may threaten the mutual confidence between doctor and patient if the patient accesses information not intended for them.”

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