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Our interactions and presence on social media have continued to increase, especially during the pandemic when the need and desire to stay connected with one another has been heightened. Many professionals, including physicians, use social media in their practice as an effective tool to communicate and interact with colleagues and patients, market their practice and their business, and to share content and information with a broad audience. Along with the opportunities for networking, business development and socializing that social media presents, there are also risks associated with its use by physicians and other professionals. It is important for physicians and other professionals to understand the risks associated with their online presence and ensure that their behaviour and actions on social media are in line with the professional, legal and ethical obligations of their profession.

Guidance from the CPSO: Should physicians be active on social media?

The College of Physicians and Surgeons of Ontario (CPSO) recognizes the benefits and opportunities that the participation in social media provides to physicians, including the enhancement of patient care, medical education and the fostering of collegiality among fellow physicians and health professionals. However, physicians continue to be expected to comply with all professional obligations, including legal obligations, ethical obligations, and CPSO policies, when creating an online presence and engaging in the use of social media. These professional, legal, and ethical obligations must be upheld at all times.

The CPSO has published guidelines to assist physicians with ensuring that their presence online and their use of social media complies with their professional obligations. A selection of these guidelines are as follows:

  • Assume all content on the internet is public
  • Ensure compliance with legal and professional obligations to maintain patient privacy and confidentiality
  • Refrain from providing clinical advice to patients through social media
  • Protect your reputation, the reputation of the profession and public trust
  • Refrain from establishing personal connections with patients or people who are closely associated with patients

The CPSO has published several other guidelines with respect to the use of social media which can be found here.

Best practices for physicians when engaging on social media

Considering the guidelines of the CPSO outlined above, it may be helpful for physicians to consider the following best practices when using social media and creating their online presence:

Uphold Moral Principals and Integrity

As a professional, it is very important to ensure that integrity, morals and ethics are upheld at all times, including online. As the CPSO indicates in its guidelines for the use of social media, it is strongly advised that physicians refrain from providing clinical advice to specific patients through social media. 

Social media is a great tool to use for the dissemination of general medical or health information for educational or informational sharing purposes. When sharing information on social media, it is important to ensure that physicians are very clear that their posts are not intended as medical advice and that they are not providing a medical opinion. It may also be helpful to indicate the basis of the information that is being shared, whether based on scientific studies, professional experience or personal opinion.

Ensure Patient Privacy is Protected

Trust is essential to a sound patient-physician relationship. Physicians have a statutory obligation to protect and maintain patient privacy and confidentiality. The Personal Health Information Protection Act (PHIPA) places unique responsibilities on individuals that control and collect health information, and requires health information custodians, including physicians, to take steps that are reasonable in the circumstances to ensure that personal health information in the custodian’s custody or control is protected against theft, loss and unauthorized use or disclosure. When posting to social media, the duty of privacy and confidentiality must be maintained at all times, by ensuring that any posts that are made have been clearly removed of any identifying information. Physicians must not post identifiable patient information or images to social media. It is possible for an unnamed patient to be identifiable through minimal information such as the area of residence or a description of the patient’s condition. Failure to protect patient health information and comply with the requirements under PHIPA may result in a host of liability issues, including significant fines and disciplinary action by the College.

Maintain Professionalism

Physicians have an obligation to maintain professionalism and act in a manner that upholds the professional standards and ethics of the medical profession. Whether the physician is interacting in person or online, such professionalism expectations remain the same in all scenarios. Inappropriate behaviour on social media, including the publishing of offensive or damaging statements, may have the effect of bringing the professionalism of the physician into question. This in turn could serve to weaken the public’s opinion of the physician and of the profession itself. Physicians who engage in the use of social media should ensure that all communications are professional and are in line with the expectations and obligations of the profession.

Additionally, as the CPSO suggests in its guidelines, physicians should refrain from establishing personal connections with patients online. If the physician receives a request on his or her personal social media page, the physician may consider guiding the patient to connect on their professional social media page, or to contact the office. Forming personal connections with patients may blur professional boundaries and compromise the physician’s ability to remain objective.

Social media platforms have created opportunities for physicians to increase professional and patient engagement, to advocate for the profession and to build and maintain connections with colleagues, peers and the public. It is important for physicians to understand the risks associated with the improper use of social media and to always be mindful that their legal, professional and ethical obligations also extend to their online presence.

Katherine Serniwka practices with Siskinds’ Professionals Practice Group. If you have questions about the information contained within this article or any other questions related to professional corporations, please write to [email protected].

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