practice partner
Dr. Karen Devon
sphere.
Maintaining patient privacy and confi-
dentiality isn’t the only legal and profes-
sional consideration, but it is a primary one.
Among the other obligations that the Col-
lege notes regarding social media use:
maintain professional boundaries with
patients and those close to them;
keep professional and respectful
relationships (with patients, colleagues,
other members of the health-care team);
44
Dialogue Issue 2, 2017
avoid conflicts of interest.
They’re all important, but how to take care
around privacy and confidentiality? Start
with the assumption that all content on the
Internet is public and accessible to all.
When posting information online that
relates to an actual patient, the College urges
caution. An unnamed patient may still be
identified through a range of other informa-
tion, such as a description of their condi-
tion, their area of residence, other details of
the clinical encounter or a photo (even if
blurred).
Moreover, there’s an issue even if the only
person who can identify the patient based on
the information provided is the patient. That
can still be a breach.
On private forums, like online physician
support groups, the same rules apply. Don’t
count on the fact that these forums remain
private. Any users might disseminate infor-
mation beyond the group, where it can take
on a life of its own. Or the forum’s security
could be compromised. If you haven’t taken
care to ensure the confidentiality of your
new but the need to maintain patient pri-
vacy and confidentiality is not.
That demands a focus in the age of Face-
book, Twitter, Instagram, YouTube, blogs
and the like. The media itself amplify the
risks and concerns.
Dr. Karen Devon, a surgeon at Women’s
College Hospital in Toronto, has written
about social media use and doctors, includ-
ing an essay for JAMA. She points out that
the relative informality of social media, and
the fact you can’t see your audience, can at
times make you let down your guard.
Any violation of privacy and confidential-
ity is problematic. With social media,
“there’s an exponential spread and a perma-
nence,” says Dr. Devon.
Every piece of material posted, every ex-
change, raises the stakes. A breach of patient
rights, whether intentional or inadvertent,
can have a reach and a life forever. “Think
before you post,” she says.
To provide guidance to physicians, the
College has published a document – Social
Media: Appropriate use by Physicians –
that clarifies how doctors can meet existing
professional expectations in the social media
comply with relevant legislation with
respect to physician advertising;
uphold the law related to defamation,
copyright and plagiarism when posting
content online; and