Originally published October 2014; reviewed March 2020
1. Have an objective and select the right platform
Physicians should have clear objectives for their professional social media presence so they can select the most appropriate social media site. If your goal is engagement, then platforms such as Facebook and Twitter may be appropriate. If the aim is teaching and learning, then private physician networks may be the best choice. To disseminate health information to benefit the public, blogs may be considered. If the goal is advocacy or a call to action, media interviews with potential social media exposure may generate the desired outcome.
2. Avoid social media for one-on-one discussions
Doctors must remember that social media can be used to engage in public communication, but it is not appropriate for private conversations. Social media may be ideal to connect with patients collectively on issues such as general health promotion or office administration, but you must not communicate specific patient health information to an individual over social media. While some sites appear to facilitate private conversations through direct messages, content communicated via social media is unprotected and publicly accessible. Confidentiality of patient information can be placed at risk.
3. Establish clear boundaries
Whatever platform you use, you need to keep clear boundaries between your professional and personal social media use. For example, if using Facebook both professionally and personally, it's best to have a separate account for each. And, the high standard of behaviour that physicians are held to (by statute and professional necessity) also extends to your social media use.
4. Recognize that the reach is wide and the audience unknown
Because social media has a broad reach, it can be difficult for physicians to know their audience and tailor their messages. As a result, your information should be general in nature and directed at a non-scientific audience. With no physical barriers to the Internet, the information may be used by Canadians or people in other countries.
5. Consider the impact of your communication style and reach
Communication principles that apply when speaking to patients, stakeholders, or the media also apply when using social media. You should use clear language, have supporting examples that respect privacy and confidentiality when giving an opinion, provide credible sources and research, address all sides of an issue, and present information professionally. Remember that information shared via social media can have a significant and lasting impact. When contributing to social media, keep in mind that the information reaches far and wide, and is permanent.
6. Generate interest, participation
The very nature of social media is to invite people to review, share, respond, and contribute to information. Comments, reactions, support, and contrary views are all part of the landscape and should be delivered respectfully. Each participant brings their unique perspective to the discussion. In other words, social media is a two-way street and you should be prepared to be part of a dialogue, when appropriate.
7. Be aware that libel, slander, and defamation apply
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. When defamatory statements are published or spoken online or otherwise, you may face allegations of libel or slander. As well, you should be aware of the potential for cyber libel — when something posted on the Internet is both untrue and damaging.
You must also realize that plagiarism and copyright infringement can lead to legal action.
8. Develop a social media policy
Physicians should determine how they will use social media — to engage patients or disseminate information, or both. When it's appropriate, physicians may choose to answer certain questions or respond to comments in a discussion, however they should be mindful of the content and the audience.
When you state in a policy or guideline how you intend to use social media, it sends a clear message to patients and others on what to expect. Guidelines should be communicated and apply to staff, patients, colleagues, and other healthcare providers working within your office.
9. Manage privacy and minimize breaches
Some social media platforms allow physician-only groups to participate and share expertise in a way that mimics grand rounds in hospitals where doctors gather to discuss cases. Physicians must recognize these online practitioner communities are still virtual spaces and can be subject to security breaches.
When using social media, you 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.
10. Follow College guidelines
Medical regulatory authorities (Colleges) recognize that physicians are using social media in their practice and have created material to guide physicians on how to engage online while meeting legal and professional obligations. The material includes information on how to respect professional boundaries and the importance of exercising caution when posting information that could identify a patient.