■ Safety of care:

Improving patient safety and reducing risks

Social media: The opportunities, the realities

Guidance for physicians who use social media in their personal or professional lives

A young doctor on her smartphone

8 minutes

Published: October 2014 /
Revised: May 2022

The information in this article was correct at the time of publishing

For the medical professional, social media platforms offer innovative opportunities for sharing information. Along with the innovation, however, come risks such as online content that can violate privacy, spread misinformation, blur professional and personal activities, or hurt reputations. Physicians should recognize the impact of social media, and consider how to mitigate any potential risks.

Learning and sharing

Medical trainees, faculties, and associations leverage several social media sites to enrich trainees' medical education. Students are looking for opportunities to exchange and learn beyond the formal education setting, often using social media to capture and share clinical learnings.

Students and faculty have an obligation to protect the privacy of patients and must refrain from sharing identifiable patient cases through social media, unless the patient has consented. This principle applies regardless of whether the platform's privacy setting is public or private. Physicians should be mindful that confidentiality may be breached if patients, while not expressly named, can still be identified in an online case example.1 It is recognized that generic case examples or other learning materials that do not contain identifiable patient information can help students learn.

Patient engagement with social media

Increasingly, patients are participating actively in physician education. Patients can serve as teachers by sharing their own insights with physicians through social media. Safeguarding privacy is important in this type of interaction with patients.2

Patients are also participating in social media to keep current on health matters. Some join online patient groups to exchange information with others experiencing similar health conditions. Hungry for information, treatment options, and hope, patients may be acquiring knowledge that is inaccurate or inappropriate for their medical condition.

As patients seek to share their experience with others through social media, they may wish to photograph or record the physician-patient encounter or procedure. Physicians will want to consider how to manage these situations, recognizing the broad reach of social media and the impact this may have. Physicians may wish to ask patients their rationale for wanting to share their medical experiences on social media, and consider discussing whether better alternatives exist. Physicians who agree to participate should document clearly their discussion with the patient in the medical record. If possible, a copy of the photograph or recording should be maintained in the medical record. Physicians who decline to participate should explain the reasons for the decision. If the patient insists on recording the encounter for sharing on social media (or otherwise), physicians will have to use their discretion on whether or not to continue the appointment.

Most hospitals and facilities have policies governing the use of photographs or videos during doctor-patient exchanges.

Professional social media engagement

Physicians have long recognized and applied professional behaviour in all facets of care and private life. This behaviour extends to social media, where society's expectations of doctors remain the same as in "real life."

The consequences of unprofessional behaviour over social media are often more significant because of its reach and permanency. Once posted or recorded, the ability to retract a post or comment is very limited.

At times, social media content gives a false sense of detachment. Because of this, users may post responses or interact in ways that would be considered inappropriate in face-to-face encounters. Physicians should always ask themselves:

  • Is this how I would frame my response, if the individual or group was in my office, or if I was in direct contact?
  • Is this response typical of how I interact?
  • Will I feel the same way tomorrow, or 2 months from now, or 1 year from now?
  • Will my response respect my professional obligations?

Physicians should be aware that a number of regulatory Colleges across Canada have established expectations for respectful professional communications by physicians engaged in social media. Defamation — that is making false statements that can harm the reputation of an individual or an organization — carries the same consequences whether it appears online or in traditional media. The CMPA will generally assist members with College matters relating to the professional practice of medicine; however, CMPA assistance will not generally be available for matters primarily arising from business or personal issues.

Know the obligations

Physicians have a duty to protect the personal health information of their patients, including on social media. When using social media, physicians must always consider what security measures and procedures should be adopted to avoid privacy breaches. This includes using appropriate protection and privacy settings to avoid communicating patient health information.

False or incorrect information can spread quickly and broadly through social media. This introduces a risk for both patients and their doctors. Imagine having a discussion with a patient about a recommended treatment that has been portrayed as dangerous on social media. Patients may be conflicted and may decline the treatment, based on false information.

Physicians are well-positioned to correct misinformation with patients. While physicians don't have an obligation to monitor everything that is stated on social media, they may want to contribute to the exchange with a view of providing factual information that will benefit others. When it comes to a physician's own social media platform, it is important to monitor what is said and be prepared to correct or interject when necessary.

Leverage social media

Social media can play a role in public health by allowing physicians to:

  • reach large numbers of professionals for public health and policy exchanges
  • connect with professionals at the national and international level to advance research, treatment, and care options
  • disseminate timely health information to trigger action
  • alert their community of outbreaks, vaccination centres, and measures that can be taken to mitigate exposure to contagious diseases

Physicians who use blogs or other social media sites to discuss health-related issues may want to include a reference to the Canadian context in which the information is provided. This will help mitigate the risks of non-Canadians heeding advice that may not be appropriate or relevant.

Publishing information on blogs or other social media platforms could result in legal actions being brought outside of Canada. The CMPA will not generally provide assistance to members who encounter medico-legal difficulty arising from the publication of information to a non-medical audience, when the matter is brought outside of Canada.

Consider the level of engagement

Whether doctors choose to engage in social media or not, they cannot ignore the implications.

Engaging on social media — on a personal basis

  • Recognize that delineating your personal and professional life on social media is often difficult, but that you will want to separate the two as much as possible.
  • Act on social media as you would in your personal and professional life. Compassion, respect, and integrity all belong on social media.
  • Do not "friend" patients on social media sites, as it becomes difficult to separate professional activities from personal ones. Just as with in-person consultations, remember that professional boundaries also apply to social media.
  • Recognize that irrespective of privacy settings, most of what is shared on social media is accessible broadly.
  • Recognize the permanency of what is shared on social media and the difficulty in retracting or removing content.
  • Review and comply with your College guidance on the use of social media.

Engaging on social media — on a professional basis

  • Assess and determine which social media sites align with your objectives.
  • Establish guidelines on the use of social media, including the expectations for your staff. Make your guidelines known to patients, colleagues, and other healthcare providers.
  • Determine if you are the only contributor or if others will support your social media activities. Establish protocols for passwords and renew them often, to avoid misappropriation of your social media identity.
  • Recognize that your activities on social media are an extension of your professional activities.
  • Establish measures to ensure that patients' personal health information remains private and confidential, unless patients have provided consent.
  • Maintain appropriate professional boundaries and ensure that medical information posted is not seen as establishing a therapeutic relationship with online users. Information should remain general and geared to broad-based issues (e.g. vaccination).
  • Media are often leveraging social media to identify opinion leaders or experts on specific topics — determining ahead of time your interest, preparedness, and availability for media interviews will be helpful.
  • Recognize the permanency of what is shared on social media and the difficulty in retracting or removing content.
  • Monitor what is said on your social media site and be prepared to correct or interject when and if appropriate.
  • Review and comply with your College's policies or guidelines on the use of social media.

If you are not active on social media, you should consider:

  • Learning enough about it to understand the implications for your patients, colleagues, and other members of the healthcare team.
  • Recognizing that even if you're not participating, what you say or do can still be shared online.
  • Developing a social media policy for your practice and sharing it with your staff and patients. Stating that you're not engaging may help manage the expectations of staff and patients.
  • Determining if it is worthwhile to monitor what is said online about you and your practice.

The bottom line

  • Review and comply with your College guidance on the use of social media. Be aware that libel, slander, and defamation carry the same consequences whether online or in traditional media.
  • Privacy and security of personal health information is paramount. Always adopt appropriate security measures and procedures to avoid privacy breaches.
  • Maintain appropriate professional boundaries. Remember that when engaging in social media, you are held to the same expectations of behaviours as you would be in your physical or virtual practice setting.


  1. College of Physicians and Surgeons of British Columbia, Privacy Toolkit, 2022. Accessed on February 25, 2022 from: https://www.cpsbc.ca/registrants/standards-guidelines/privacy-toolkit
  2. Giroux CM and Moreau KA, “Leveraging social media for medical education: Learning from patients in online spaces,” Medical Teach, June 18 2020. Accessed on February 25, 2022 from: https://pubmed.ncbi.nlm.nih.gov/32552288/

DISCLAIMER: The information contained in this learning material is for general educational purposes only and is not intended to provide specific professional medical or legal advice, nor to constitute a "standard of care" for Canadian healthcare professionals. The use of CMPA learning resources is subject to the foregoing as well as the CMPA's Terms of Use.