Digital Marketing

Medical Communications: Considerations for Using Text Messages and Social Media

For starters, physicians should know that, in 2011, the American Medical Association issued guidelines in its Code of Ethics for physicians using social media:

• Physicians must safeguard patient privacy and confidentiality online and via text message, and must refrain from posting identifiable patient information;

• Clinicians should realize that privacy settings are not absolute and that once on the Internet, the content is likely to be there permanently.

• If interacting with patients on the Internet, physicians must maintain the same professional and ethical boundaries as they would in any other context.

• Doctors are strongly encouraged to separate personal and professional content online.

• Doctors must defend the profession and must act if their colleagues post unprofessional or unethical content.

• Physicians must recognize that online actions and posted content can negatively affect their reputations with patients and colleagues, can have consequences for their medical careers, and can undermine public trust in the medical profession.

Interactions with other doctors

Connecting with other doctors through social media is a great way to share information and improve the profession. However, most of the time texting and using social media to work with other doctors is not appropriate.

Messages between physicians for the purpose of treating a person must be documented in a timely and appropriate manner in the patient’s medical record. Right now, that is excruciatingly difficult to achieve consistently and successfully.

There are at least some popular social media platforms that are exclusive to doctors only. Some of them say they allow anonymous posts and interactions. However, clinicians must realize that almost nothing on the Internet is actually anonymous. Doctors must ensure that they respect the ethics and obligations of the practice of medicine when posting something on any site, whether their names are available or not. HIPAA does not subsidize just because a doctor’s name is not directly related to a publication. It also does not subsidize because a patient’s name is not mentioned in a publication.

Good practice is for a physician to steer clear of the post or text message before sending it, consider what it will be for, and consider whether to preserve the confidentiality and ethical obligations that are necessary for the situation.

Additionally, physician interactions with other physicians on purely social media, especially with superiors at work, can blur the lines between professional and personal life. Supervising physicians (employers, assistants, teachers, etc.) should not attempt to connect with their subordinates through social media and subordinate physicians should think twice about asking to communicate with supervising physicians.

Interactions with patients

First, before any interaction with a patient through social media, text messages, video conferencing, or similar transmission, physicians must comply with each and every telemedicine statute applicable in the states where they practice. Telemedicine laws are constantly evolving to keep up with changes in the area of ​​communications, and physicians are well served to familiarize themselves with the laws.

The WADA Code of Medical Ethics contains an opinion on the use of email to communicate with a patient. Perhaps most importantly, the Code states that email correspondence should complement a doctor’s personal encounters with a patient. Additionally, a physician is held to the same professional and ethical standards by email as he or she is in person. Medical advice or patient-specific information should not be transmitted over an insecure connection and without prior authorization from the patient.

Although the WADA has not published guidance regarding text message communications with patients, clinicians are encouraged to consider using the same guidelines. For example, text messages containing specific patient data should not be delivered over a public or insecure connection. Copies of the text message should be kept in the patient’s file to ensure continuity of care. And physicians must realize that they are subject to the same level of attention over text messages as in their office encounters. A single text message delivered without a complete picture could subject the physician to as much responsibility as an incorrect in-office evaluation. Appropriateness of care cannot be sacrificed for ease of communication.

Messages sent to patients via social media are even more troublesome. Patient privacy laws generally preclude providing specific patient information in this way. Furthermore, even if patient-specific information is not transmitted via social media, failure of a physician to maintain proper professional boundaries with his patients can tarnish the reputation of the profession and subject the physician to disciplinary action.