Facebook and physician professionalism

by Walter van den Broek, MD, PhD

Do Facebook and other social networking services damage the profession of physicians or the public trust in this profession?

So far, no systematic research into this topic has been published. However several cases were presented in the media resulting in disciplinary measures. On social networking sites patients may learn information about their doctors that compromises the professional relationship. Threats to patient confidentiality is another danger of Facebook and other social networking sites.

How can we deal with this issue?

Don’t forbid the use of these sites or pose heavy restrictions on it’s use, but instead, educate medical students about the dangers. Teach them how to be professional on these sites. It’s the most mature way of dealing with it, and an opportunity to use social networking sites to teach medical students one of the many competences they’ll need: professionalism.

Medical educators can support students as they explore their developing sense of professionalism by designing courses or educational experiences that create communities of reflective practice on social networks such as Facebook. Such programs could challenge students to think critically about their online personae and the potential repercussions of online activity for themselves and for the profession.

Since data on Facebook use by medical graduates are lacking, a New Zealand group did a study with a cross sectional survey. They studied the extent of Facebook use by junior doctors, the use of the privacy options and the nature of the material readily available to the public.

A total of 220 (65%) graduates had Facebook accounts; 138 (63%) of these had activated their privacy options, restricting their information to ‘Friends’. Of the remaining 82 accounts that were more publicly available, 30 (37%) revealed users’ sexual orientation, 13 (16%) revealed their religious views, 35 (43%) indicated their relationship status, 38 (46%) showed photographs of the users drinking alcohol, eight (10%) showed images of the users intoxicated and 37 (45%) showed photographs of the users engaged in healthy behaviours.

So only a quarter of all graduates did not use the privacy options and the information revealed could bring the profession in disrepute, along with breaching the professional boundary between doctor and patient. Teaching medical students professionalism with the use of social networking sites is a unique opportunity for their education as well as for the profession.

Walter van den Broek is a psychiatrist who blogs at
Dr. Shock MD PhD.

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