Digital Dilemma: How to Stay Professional Online

Maintaining Medical Professionalism Online
Maintaining Medical Professionalism Online

"Professionalism" is a "core competency" of the practice of medicine and encompasses diverse domains, including compassion, responsiveness to patient needs that supersedes self-interest, and respect for patient privacy.1 New technologies and practices, such as social media, have created new challenges for physicians seeking to avail themselves of an important mode of communication, while retaining medical professionalism.2

POLL: Do You Use Social Media to Reach Patients?

A position paper issued by the American College of Physicians (ACP) and the Federation of State Medical Boards (FSMB) addresses these concerns.3 The authors provide "a framework for analyzing medical ethics and professionalism issues in online postings and interactions."

Communication With Patients via E-mail, Text, and Instant Messaging


The potential benefits of these types of physician-patient communications is facilitating "greater accessibility and more immediate responses to non-urgent issues." Potential pitfalls are that these are not secured methods of communication, so confidentiality might be breached. 

Additionally, it is all too easy for digital communication to replace face-to-face or telephone interactions. Finally, digital communications can "lead to ambiguity and misinterpretation of content."

The authors recommend establishing guidelines regarding issues that are appropriate for digital communication, and reserving digital communication only for patients who maintain face-to-face follow-up.

Use of Social Media Sites to Gather Information About Patients


The authors regard the gathering of patient information from social media sites as potentially beneficial, in that it facilitates "observing and counseling patients on risk-taking or health-averse behaviors," as well as enabling the physician to intervene in an emergency. 

On the negative side, it might threaten trust in the physician-patient relationship. The authors recommend considering "the intent of the search and application of findings, and the implications for ongoing care."

Use of Online Educational Resources and Related Information With Patients



According to the authors, the advantage of this practice is to "encourage patient empowerment through self-education," and to supplement environments that are lacking in resources. However, non-peer-reviewed materials may provide inaccurate information and scam "patient" sites might misrepresent therapies and outcomes.