Members of professions that deal with the public, such as medicine, now often face dilemmas about whether and how it might be permissible to report their professional lives using the Internet-based communication and social networking tools that are now almost ubiquitous. The most popular of these is Facebook, which now has over 500 million active users worldwide.

Oncologists, working in one of the most high profile of all medical disciplines – ecancer recently reported the conclusion of a Cancer Research Campaign sponsored survey that cancer, ahead of Alzheimer's and heart disease was the UK's "greatest fear"¹ – may well find these issues harder to deal with than colleagues in other specialties. It is therefore encouraging that medical associations are discussing these issues and proposing guidelines.

The US-based small business forum Allbusiness.com recently reported the publication of two such sets of guidelines², from the American Medical Association and the Ohio State Medical Association. Both stress the crucial importance of privacy and confidentiality in doctor-patient relationships while recognising the important role that social networking can play in, for example, sharing generic disease-related information or advertising services to potential patients.

The American Medical Association produced its policy guidelines on professionalism in the use of social media³ at the interim meeting of its House of Delegates in 2010. These are wholly concerned with privacy issues and take the form of a short, clearly stated, numbered list. Physicians are reminded that the normal ethical guidelines of their profession should be maintained at all times, including in online interaction, and that they should "consider separating personal and professional content online".

The guidelines produced by the Ohio State Medical Association⁴ are very much longer and more detailed, and include a number of short scenarios to illustrate the points made. In several cases readers are advised that a certain practice is acceptable but only with caution, or if certain precautions are taken; these include giving medical advice to members of online networks and sharing professional experiences on sites like Facebook.

The fact that privacy settings on social networking sites are not necessarily foolproof was using an analogy: discussing some topics on Facebook might be similar to discussing them by an office water-cooler, but only if one assumes that the boss (or a patient) might be filling his or her glass. The guidelines end with a section on tools and resources, and a set of suggestions and sample policies on best practice that will be particularly useful for those doctors who are responsible for setting the rules in, for example, a group practice.

The report on Allbusiness.com also draws attention to a paper recently published in the Journal of the American Medical Association discussing the experience of US medical schools in assessing inappropriate use of social networking sites by medical students⁵. Forty-seven of the 78 medical schools that responded reported some type of inappropriate use, and six (8% of the full sample) reported that this had involved violations of confidentiality. The report recommended that these issues should become an explicit part of the medical school curriculum.

It is interesting that all these recently published examples are from the US, and it will be useful to find out to what extent, if at all, policy and practice differs in Europe. 

References

1. http://www.ecancermedicalscience.com/news-insider-news.asp?itemId=1456

2. http://www.allbusiness.com/health-care/health-care-professionals-physicians-surgeons/15318117-1.html

3. http://www.ama-assn.org/ama/pub/meeting/professionalism-social-media.shtml

4. http://www.allbusiness.com/health-care/health-care-professionals-physicians-surgeons/15318117-1.html

5. Chretien, K.C., Goldman, E.F., Beckman, L. and Kind, T (2010) It's your own risk: medical students' perspectives on online professionalism JAMA 85, S68-71