Doctors using Facebook for Medical Prescription and online Patient Treatment

New Technology ! New Culture.....

When it comes to Facebook, I will offer full disclosure, a policy I’ve advocated in my medical ethics postings; I am neither a friend nor a fan of this godfather of social media. In my 7 member nuclear family, 6 of us use Facebook as a portal into their personal worlds. Once again, I am the outlier. I just don’t have the time to create and maintain another universe in my life. It would eliminate the scant discretionary time that is still available to me.

Bloggers at the American College of Physicians and KevinMD and have mused about physicians using Facebook to communicate with patients. Earlier this year, Sachin Jain, M.D. wrote a commentary in The New England Journal of Medicine discussing his ambivalance to ‘friend’ a prior patient. While the public might be receptive to ‘friending’ doctors, most physicians won’t be in a hurry to use social media with their patients. Physician Facebookers would not want patients to have access to their vacation photos and personal vignettes, many of which are private for a reason. Reading comments on a doctor's Facebook wall might show how that the physician is really ‘off the wall’. Conversely, do we physicians really want to enter our patients’ Facebook worlds? I think that this would corrode the patient-physician relationship. There should a line between patients and their physicians. While this barrier is not inviolable, I don’t see how blurring or eliminating this separation enhances their health care, which is our designated role. We are their physicians, not their pals. In fact, it is challenging when folks choose physicians who are within their social circle. While some doctors I know welcome this, I try to avoid having friends as patients. My objectivity would be diminished. In addition, depending upon the medical circumstances and outcome, the friendship may be at risk, which could have consequences that extend far beyond the exam room.

Physicians have always been strict guardians of confidentiality and patients’ privacy. Indeed, when I have performed a colonoscopy on a real friend (not a cyber pseudofriend), not even my wife knows that this occurred, unless the patient himself relates it to her. Could physicians who become a patient’s Facebook ‘friend’ maintain confidentiality? The doctor, of course, could make no Facebook reference to the professional relationship. Other ‘friends’, however, might recognize the medical identity of the doctor, which might lead to a line of questioning or speculation that could be problematic.

“Hey, I see that MDWhistleblower is your ‘friend’ now. Isn’t he a gastroenterologist? Are your hemorrhoids acting up again?”

I know that Facebook is a social media empire. It’s being used by tens of millions of individuals, marketing organizations, politicians, government agencies and corporations across the country. It is a powerful tool for personal and business networking. But, it lacks the intimacy of human contact, the mother’s milk of the doctor-patient relationship. Physicians and patients don’t need Facebook time; we need more face time. Is anyone else a ‘fan’ of this?

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