Social Media - Appropriate Use by Physicians
The term ‘social media’ refers to web and mobile technologies and practices that people use to share content, opinions, insights, experiences, and perspectives online. There are many prominent examples of social media platforms, including Facebook, Twitter, YouTube, LinkedIn, and blogging sites, among many others.
Social media can be used for both personal and professional purposes. Many physicians are now using social media in their practices to interact with colleagues and patients, to seek out medical information online, and to share content with a broad audience.
Whether engaging in social media for personal or professional use, the nature of these platforms, which are highly accessible, informal, and public, raise important questions about the steps physicians should take to uphold their important professional obligations while online.
This document provides guidance to physicians about how to engage in social media while continuing to meet relevant legal and professional obligations.
This document is not a policy, nor does it establish any new expectations for physicians that are unique to social media. Rather, this document clarifies how existing professional expectations can be met in the social media sphere.
College position on social media
The College’s position is that physicians are expected to comply with all of their existing professional expectations, including those set out in relevant legislation, codes of ethics, and College policies, when engaging in the use of social media platforms and technologies.
If physicians do so, the College recognizes that social media platforms may present important opportunities to enhance patient care, medical education, professional competence, and collegiality, among other potential benefits.
Relevant professional expectations
Legal and professional expectations that govern medical practice are set out in the College’s Practice Guide, policies, and relevant legislation. A number of these obligations are relevant to the use of social media by physicians, and are articulated below. These obligations are not unique to social media, but apply to medical practice in general, and must be met by all physicians.
They are as follows:
Comply with all legal and professional obligations to maintain patient privacy and confidentiality.1
Maintain appropriate professional boundaries with patients and those close to them.2
Maintain professional and respectful relationships with patients, colleagues, and other members of the health-care team.3
Comply with relevant legislation with respect to physician advertising.4
Comply with the law related to defamation, copyright, and plagiarism when posting content online.5
Avoid conflicts of interest.6
In order to satisfy the above professional expectations while engaging in social media, it is recommended that physicians:
Assume that all content on the Internet is public and accessible to all.
Exercise caution when posting information online that relates to an actual patient, in order to ensure compliance with legal and professional obligations to maintain privacy and confidentiality. Bear in mind that an unnamed patient may still be identified through a range of other information, such as a description of their clinical condition, or area of residence.7
Refrain from providing clinical advice to specific patients through social media.8 It is acceptable, however, to use social media to disseminate generic medical or health information for educational or information sharing purposes.
Protect their own reputation, the reputation of the profession, and the public trust by not posting content that could be viewed as unprofessional.
Be mindful of their Internet presence, and be proactive in removing content posted by themselves or others which may be viewed as unprofessional.9
Refrain from establishing personal connections with patients or persons closely associated with them online, as this may not allow physicians to maintain appropriate professional boundaries and may compromise physicians’ objectivity.10 It is acceptable to create an online connection with patients for professional purposes only.
Refrain from seeking out patient information that may be available online without prior consent.11
Read, understand, and apply the strictest privacy settings necessary to maintain control over access to their personal information, and social media presence undertaken for personal purposes only.
Remember that social media platforms are constantly evolving, and be proactive in considering how professional expectations apply in any given set of circumstances.
1. Personal Health Information Protection Act, 2004, S.O. 2004, c. 3, Schedule A (hereinafter PHIPA), the CPSO’s Confidentiality of Personal Health Information policy.
2. For more information please see the CPSO’s Maintaining Appropriate Boundaries and Preventing Sexual Abuse and Treating Self and Family Members policies.
3. The duty of physicians to maintain professional and respectful relationships is set out in the CPSO’s Physician Behaviour in the Professional Environment policy, and the Practice Guide.
4. For more information on physician advertising, please see Part II of O.Reg., 114/94, enacted under the Medicine Act, 1991, S.O. 1991, c. 30.
5. For example, Copyright Act, R.S.C. 1985, c. C-42.
6. For more information on conflicts of interest, please see Part IV of the General, O. Reg., 114/94, and the CPSO’s Practice Guide.
7. A breach of confidentiality may be deemed to have occurred if the facts available are sufficient for the patient to be identified, even if only by themselves. This is consistent with the definition of “identifying information” in section (4)2 of PHIPA.
8. Clinical advice is defined as advice of a clinical nature that is directed toward a specific individual to address a medical concern. It is distinct from general health information that is not patient-specific, but disseminated to a general audience for education or information sharing purposes.
9. Be mindful that once information has been posted online, it may be difficult or impossible to remove. Reasonable steps should be taken to remove information that has been posted by one’s self or others.
10. Some physicians may find it preferable to maintain a separate online presence for their personal and professional networks. For more information on maintaining appropriate professional boundaries, please see the CPSO’s Maintaining Professional Boundaries and Preventing Sexual Abuse policy, Treating Self and Family Members policy, and Dialogue article “Maintaining Boundaries.”
11. Patients are entitled to a reasonable expectation of privacy. While physicians are expected to adhere to all of their relevant legal obligations under PHIPA with respect to the collection of personal health information, they should also refrain from seeking out other types of non-protected information online without prior consent.