When considering 'Googling' a patient, one must weigh professional boundaries

SAN DIEGO — During an American Psychiatric Association Annual Meeting workshop chaired by Liliya Gershengoren, MD, MPH, experts discussed the risks that may exist when psychiatrists “Google” their patients. All the panelists preached caution to varying degrees and the need for an overarching policy.

Patient-targeted Googling “is an absolutely fascinating topic and it’s one that we all have various quandaries about. I think there are a whole bunch of colleagues who do this but feel very sneaky about it,” said Glen O. Gabbard, MD, clinical professor of psychiatry, Baylor College of Medicine.

Glen O. Gabbard

In this era of cyberspace, “the frame is the frame is the frame,” he said. "There is already a frame within treatment takes place. It’s asymmetrical by design and it’s all about the patient’s issues.”

There is a set of professional boundaries that constitute the architecture of the frame, Gabbard said, including professional role, place and space, business transactions, language, confidentiality, excessive self-disclosure, time, money, gifts, clothing, sexual relations and physical contact.

The APA Ethics Committee released this statement in November 2016: “Psychiatrists must be aware of their responsibility to maintain professional boundaries in their internet activities both in respecting their patients and establishing separation between personal and professional internet and social media presence.”

“So basically, they are saying the boundaries apply in cyberspace as they would elsewhere,” Gabbard said.

There are complications to “Googling” your patient including confidentiality and misinformation, he said.

In terms of confidentiality, Gabbard said that because psychotherapy is not coercive and is confidential, patients have the choice and right to keep something private even if that is on the internet.

“I want to draw an analogy to 30 years ago, before we had the internet,” he said. “What would you think of someone 30 years ago, who got in his or her car and had the patient’s address and drove into the neighborhood of where the patient lived to gain information about the patient?"

Gabbard also said there is a lot of misinformation on the internet and there is a risk of assuming information gained by “Googling.”

“Are we really ‘Googling’ patients just because it is so easy to do so? We have good reasons not to drive around the neighborhoods of people to check them out and see what they are doing,” he said. “I am wondering if the ease of the access is the big problem. And does it make it okay because it is easy to do.”

He concluded by calling for an overarching policy. – by Joan-Marie Stiglich, ELS

Reference:

Gabbard GO. Patient-targeted Googling: Oh! What a tangled web we weave, when first we practice to deceive. Presented at: American Psychiatric Association Annual Meeting; May 20-24, 2017; San Diego.

Disclosure: Gabbard reports no relevant financial disclosures.