Can my doctor be my Facebook friend?

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The doctor-patient relationship can be a close one - but in this week's Scrubbing Up column, Dr Naeem Nazem of the MDDUS asks - can that relationship be extended into social media?

Whether you embrace it or not, the vast majority of people use social media as part of their everyday lives.

Recent figures show there are a staggering 24 million - and counting - active Facebook users in the UK, while one in four people (15 million) have Twitter accounts.

There are undoubted benefits as social media offers a platform for doctors to network effectively, share views and develop their own knowledge and expertise.

For patients engaging with social media, it can educate and raise awareness by giving them greater access to healthcare information.

But if you would trust your doctor with your life, could you be their Facebook friend?

'Blurring boundaries'

On the face of it, it doesn't seem like an unreasonable question - or request.

However, patients interacting with their doctors on social media may inadvertently create an uncomfortable and awkward situation.

It also risks blurring the boundaries in the doctor-patient relationship which could impact on the quality of care they receive.

Patients should consider that doctors are bound by guidance from the General Medical Council which states that you should not mix social and professional relationships and that: "Social media can blur the boundaries between a doctor's personal and professional life and may change the nature of the relationship between a doctor and a patient."

The rise of social media has created some serious ethical challenges for doctors and their relationship with patients.

Even with the proper privacy settings in place, anything posted online may end up being distributed further than intended.

Doctors must keep their relationship with patients professional, or they risk becoming too close which can cloud their judgement and affect their objectivity and clinical decision making.

While Facebook often gives an insight into a person's private life, Twitter is more likely to be used in a professional manner, with many doctors discussing healthcare issues via a tweet of 140 characters or less.

However, when tweeting, doctors should ensure patient confidentiality and only share information on Twitter that cannot be linked to an individual patient.

'Never off duty'

Image caption Consultations should not be taken up by talking about social lives

Doctors and patients should recognise the unique nature of their relationship.

Patients trust their doctors with information they may not have shared with any of their family or friends. Doctors have a duty to respect this information and keep it confidential.

Patients should appreciate the need to keep things professional with their doctor and understand that social media can complicate or alter the nature of that relationship.

During a routine appointment, the amount of time allocated to each patient is fairly limited so the doctor needs to make sure they make best use of that time.

For example, a doctor could make a wrong diagnosis or fail to spot symptoms in a patient (and a Facebook friend) if they are too busy fielding questions about the barbeque they hosted last Saturday - the patient may have seen the photographs posted on their doctor's Facebook page timeline and perhaps noticed a mutual acquaintance.

Such a scenario seems harmless enough, but the doctor is put in an awkward position and the attention is shifted away from addressing the patient's healthcare needs.

We have encountered a range of cases where doctors have sought advice from us regarding social media issues, from critical or abusive posts from patients to hate campaigns.

It is of little surprise to see the number of cases on the subject grow dramatically over the last few years.

Our figures reveal that between 2010 and 2012 there were over four times as many calls from doctors on the subject of social media, with the indications that this figure will continue to rise this year.

Social media is a powerful tool and can offer an insight into a doctor when they are off duty.

Perhaps that is why a patient would want to befriend their doctor in the first place - the intrigue of catching a glimpse of their life without the stethoscope around their neck.

As a doctor, the reality is you are never off duty and their status in the public eye demands a high standard of conduct at all times.

By interacting with patients online they are exposing themselves to be scrutinised from their own homes.

Patients should also respect that and think twice about requesting access to their doctor's private lives for the good of their relationship with their doctor.

Patients should feel comfortable in sharing their personal information and their health with their doctors - but not their Facebook status.

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