Even before Facebook said it would add Skype video and group chats, it was challenging enough for doctors to navigate the brave new world of social networking.
Two years ago, Dr. Gabriel Bosslet received two friend requests from patients on his Facebook page. "I was kind of taken aback by it. I wasn't sure how to respond to it," he says.
The requests were a first for the doctor, who is on the faculty at Indiana University's School of Medicine. Bosslet's wife, a pediatrician, and his colleagues were also receiving friend requests from their patients or their parents on Facebook.
"I thought to myself, there's got to be something out there where people would have at least documented their experiences with this or how often it happens," he says. But to Bosslet's surprise there wasn't much information available.
So last year, he and colleagues mailed surveys to more than 3,000 doctors, residents and med students around the country to gauge their attitudes toward online social networks.
Some 455 people responded, and the results revealed that a majority of them found it "ethically unacceptable to visit the profiles of patients" or interact with patients on social networks for either social or professional reasons.
The findings were published recently in the Journal for General Internal Medicine.
"We really tried to stress in the discussion that these results have to be tempered by the fact that the response rates were so low, but still the results were so compelling — that's why the journal actually did decide to publish it," he told Shots. "Generally response rates this low don't get an editor to raise an eyebrow."
Data from the collected surveys showed the majority of respondents was pessimistic about the potential for online social networks to make patient-doctor communication better. There was also a major concern among doctors over patient confidentiality. A report earlier this year on problems with some doctors' tweets shows the concerns
One doctor who does see potential is internist Kevin Pho, who practices in Nashua, New Hampshire. He also hosts a lively blog and Twitter feed. Pho says there is a fear among physicians when it comes to social networks, but for assistance he pointed them to guidelines from the American Medical Association.
Most doctors don't see more risks than benefits from social networking, he says. He agreed with the findings from Bosslet's study — that doctors and patients should not be interacting on a personal level through social networks — but says communication through such a network can contribute to the doctor-patient relationship.
Pho's policy: never "friend" patients on Facebook. But he would reply to a patient on Twitter asking about a good website for breast cancer screening guidelines. "There has to be some nuance here, and I think that this is so early in the social media game, that a lot of doctors don't fully appreciate that," he says.
Bosslet says there have been some controversies involving social media and his students. Earlier this year, a medical student was reprimanded after a nurse saw his Facebook post regarding a patient.
Bosslet says that the information didn't violate federal privacy rules, but there were still consequences for discussing the patient in a public forum. "All of a sudden we have a forum that blurs the line between public and private," he says.