In the BMA’s social media guide they state that “because of the power imbalance that can exist in any doctor-patient relationship,” it’s important to establish a professional boundary. They state that it can be difficult to maintain those boundaries with all the personal information available on Facebook.
The BMA suggests physicians politely decline friend requests. They write:
“Given the greater accessibility of personal information, entering into informal relationships with patients on sites like Facebook can increase the likelihood of inappropriate boundary transgressions, particularly where previously there existed only a professional relationship between a doctor and patient.
“Difficult ethical issues can arise if, for example, doctors become party to information about their patients that is not disclosed as part of a clinical consultation. The BMA recommends that doctors and medical students who receive friend requests from current or former patients should politely refuse and explain to the patient the reasons why it would be inappropriate for them to accept the request.”
For instance, what if you were to see a picture posted of your patient in a bar drinking a beer. You know that with his medical condition he should strictly avoid alcohol. Do you bring this up at his next visit, or let it go because he did not share this with you himself?
The BMA guidance 1) suggests that physicians adopt conservative privacy settings on their online profiles, 2) warns doctors to respect patient confidentiality, and 3) advises they declare conflict of interest.
The social media policy of the American Medical Association does not come right out and say physicians should not “friend” patients, but says they should “maintain appropriate boundaries of the patient-physician relationship in accordance with professional ethical guidelines just, as they would in any other context.” It also suggests doctors “should consider separating personal and professional content online.”