Healthcare News & Insights

‘My therapist just friended me!’ Awkward ethics of the digital age

The traditional boundaries between patients and physicians are blurring as social networking grows. Can clinicians accept a patient’s “friend” request? Should your therapist read your blog? What are the new boundaries?

At this point, most professionals have at least dipped a toe into the social networking waters. But even those who are the most casual of Internet users may find themselves facing new ethical dilemmas as new tools allow patients and practitioners to learn more about each other than might be ideal.

Researching patient history vs. old-fashioned snooping

For many doctors, especially therapists, there’s no question that a peek at a patient’s Facebook profile or similar site might provide useful information to aid treatment. For example, if a recovering alcoholic won’t admit to a doctor that he or she has fallen off the wagon, photos from last weekends’ bender could help start the needed conversation.

Another example: One therapist saw a new patient who appeared to have mania and possibly delusions. Among other things, he claimed to be closely connected with several powerful politicians. A quick Google search showed his political claims were actually true — his mental illness wasn’t as severe as that first meeting indicated.

While there are no standard ethical guidelines for how and when doctors should use the Web to check on patients’ info, the consensus among ethicists is that searching for info relevant to treatment is fair game — if it’s just out of curiosity, it’s not.

But even when doctors are sure they’re meeting the first criteria, there’s no consensus on how to handle the process: Should you warn patients in advance? Only check their profiles out if they’ve given permission? How should information gleaned from the Internet be used in treatment?

When patients find you online

Of course, the Internet cuts both ways — health care providers who use Facebook, LinkedIn and other networking tools may be surprised to find a patient wants to connect socially.

Most ethics experts see this as more dangerous ground. Sharing some personal information can be helpful: An oncologist who fought and survived breast cancer herself is going to have an easier time earning the trust of a newly diagnosed patient. Knowing that the orthopedist is performing your knee surgery first thing after returning from a week at Sandals may have the opposite effect.

For therapists, the situation can be even more fraught. Vulnerable patients are more likely to be emotionally affected by even innocuous personal information about a therapist, causing rifts that may permanently damage the relationship.

No one suggests health care professionals can’t make use of social networking sites like everyone else. But it’s probably wise to follow a few basic guidelines:

  • Use security settings to keep your personal profile as private as possible. If you want to use Facebook and the like to promote yourself or your business, make a second profile for just that purpose — and make sure it’s 100% professional.
  • Consider creating a set policy for connecting with patients and others online — and make it known to new patients. Better to explain upfront that you can’t accept friend requests and LinkedIn connections, rather than risk upsetting a patient who feels personally rejected.

Is social networking a way for doctors to get more relevant information on patients? Or is it just a Pandora’s box of awkwardness waiting to explode? Share your thoughts and experiences in the comments.

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