In a small number of cases, doctors and medical students have been criticised for their use of social media. Concerns have been raised over derogatory comments about patients and colleagues posted online.

There have also been reports of accidental breaches of patient confidentiality. Here we outline a few basic factors that you need to bear in mind when using social media.

Why you need to be aware online

Social media is a part of modern life. Professional uses of social media can include sharing ideas and information, campaigning, and debating health issues.

The majority of students and doctors use social media in either their professional or personal lives without a problem. But its informal nature, and the ease with which information can be exchanged, can create difficulties if used unwisely.

Social media and patient confidentiality

You have a legal and ethical duty to protect confidential patient information. Disclosing identifiable information about patients without their consent is unlawful and unethical. It is also likely to be in breach of GMC guidance.

When taken in isolation, individual pieces of information may not identify patients, taken in sum they may be identifiable. This could be either to the individual or to relatives and friends.

Social media can blur the boundary between private and public domains. Information that you intend to share with a limited number of people can be easily broadcast more widely. This increases the likelihood that individuals can be identified. You must therefore exercise caution when posting online.

The scale of the problem

US research into medical students’ use of new media, as reported by deans of medical schools, found the following:

• patient confidentiality violations;
• use of discriminatory and profane language; and
• images of intoxication and illicit substance use.

In some cases, this resulted in official warnings from medical schools and dismissal.

Maintaining boundaries – privacy and personal information

Trust in the doctor-patient relationship is based on exchanging information that is relevant to providing appropriate care. The objectivity that good clinical care requires usually involves boundaries between a doctor’s private and professional lives.

Although doctors may choose to divulge personal information during consultations, they are able to control the extent and type of the disclosure.

Patients can have unrestricted access to material you post online. If you post significant amounts of highly personal information on social media, you need to consider carefully what impact this might have on your professional relationships.

Different social media platforms have adjustable privacy settings. How secure or private you want to make your social media activity is up to you. Whatever options you choose, your privacy (and confidentiality) can never be guaranteed - even in closed groups or forums.

Doctors and medical students have reported that patients and former patients have sent them friend requests on Facebook. If you use Facebook as a personal space online, in general, it may not be wise to accept friendship requests from patients.

However, there may be times during your career when you will need to use your judgement. For example, doctors working in small communities are likely to have friends who are patients or former patients so it may be unavoidable in some cases.

Professionalism and social media

As outlined previously, the GMC imposes certain obligations on you in relation to behaviour both in your personal and professional life.

Any breach of binding professional duties, such as the obligation to respect patient confidentiality, represents a clear case of misconduct that may call into question fitness to practise. However medical professionalism spans a broader, less well-defined set of standards.

Developed over time, it represents the conduct broadly expected of health professionals by medical peers and society.

Although the way you use social media in your life is a matter for personal judgement, you should consider whether the content you upload could compromise public confidence in the medical profession.

Defamation

You are entitled to engage fully in debates about issues that affect your personal and student life.

Although people often feel less reserved when posting comments online, it is important to remember that our freedom to express our opinions is not absolute. In law, it can be restricted by the need to prevent harm to the rights and reputation of others.

Defamation is the act of making unjustified statements about people or organisations that damage their reputation. It can result in legal action. You need to be aware that even anonymous posts can be traced to the original author.

You should therefore exercise sound judgment when posting online and avoid making unsubstantiated negative comments about individuals or organisations.