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Physician Facebook Phobia

By Pamela Wible, MD | January 18, 2013

Dr Wible is a family physician born into a family of physicians. She has developed a model for change in healthcare delivery that first asks a community what it wants and needs from the healthcare experience. Her model for the “ideal clinic” is taught in graduate medical curricula.

Physician Facebook fears Change your name. Don't friend patients. Delete your Facebook account. This is official social media advice for today's medical students and physicians.

What fuels physician Facebook phobia?

Patients may make romantic advances or request appointments on Facebook. Patients might view a physician's personal posts or vacation photos. One silly picture can forever tarnish a doctor's reputation. And physicians who post political and religious comments may harm patient relationships. Really?

Physicians must first do no harm. Any patient can post their medical records online, but a doctor should never reveal anything about a patient without consent. Physicians who break confidentiality risk fines up to $250,000 and/or imprisonment. Share health news and tips, but medical care is best face-to-face, not on Facebook. Ultimately, patient confidentiality is upheld by physician integrity and common sense.

But doctors are warned to go beyond such ethical safeguards. They are advised to separate their personal and professional lives. So some docs have separate personal and professional Facebook pages. Will that protect physicians from tarnishing themselves and harming their patients?

Can physicians maintain privacy in a world wired for accessibility? Will medical hierarchy survive the digital age? Does Facebook undermine physician professionalism? How far should we go to protect physicians from friendly patients?

But the bigger question is: Why fear patients at all?

I'm a family doc. I'm trained to care for patients physically, emotionally--and socially. A patient once explained, "An ideal physician is a friend who happens to be my doctor." I'm no fan of professional distance. Physician closeness is often the best medicine for patients. I've taken a dying man out for breakfast and a woman with fibromyalgia to a writing conference. I attend patient funerals, go to patients' homes for Thanksgiving--and yes, I'm Facebook friends with my patients.

Sharing personal information can actually strengthen the doctor-patient relationship. I love looking at Joanna's wedding album. I "like" the photos of her daughter smiling in a bubble bath. I enjoy commenting on Misty's midnight political rants. Facebook has given me a magnificent view of my patients' inner worlds. Some patients have scheduled follow-up appointments via Facebook. Some docs have solved medical mysteries by perusing a patient's posts.

So why hide from each other?

Is it possible to be too vulnerable? Today I posed this question on my page: "Anyone think it's not okay to be Facebook friends with your doctor?" Bettie replies, "Why not? They have seen everything else! LOL! Haha." Maybe it's liberating to trade professionalism for humanism, privacy for transparency.

We live in an age of authenticity. Join Facebook. Share that photo of you dancing with your dog in a pink tutu. I just posted a photo of a goat wearing a stethoscope in my exam room. It's 2013. Go ahead. It's safe for doctors to be human.

Still suffering from Facebook phobia? Maybe it's time to Facebook your physician for an appointment.

Pamela Wible, MD, pioneered the first community-designed ideal medical clinic
in America. She is author of Pet Goats & Pap Smears and writes for The Oregonian.
Contact Dr. Wible.

by mohammad ashori | January 23, 2013 6:16 PM EST

Thank you Pamela for a great article. In my opinion it's easier for a female doctor to do what you recommend than a male doctor. I am 34 and also a family physician. I'm very open and honest with my patients but on my facebook I definitely let it all out. I could see how some of my patients may be offended by my posts, I could see how I would want to openly disagree with their view points about one of their posts, I could see how a patient may friend me just because they have a "crush" etc.

by Cheryl Reinhardt | January 29, 2013 1:51 PM EST

Wow, you must have great patients. I've only given my personal phone number to a handful of patients over the years, when I was extremely concerned about them and wanted them to have access, and have been regretted that decision 100% of the time! Inevitably it results in innapproriate calls at terrible times about trivial concerns. In one case I couldn't push back the calls and had to change my number-never again! I feel strongly there must be boundaries or people will always take advantage of you. I'm 50/female & I don't even post on facebook, but I'm very concerned about the lack of privacy and the dangerous amount of details that my teen posts on her site. I can imagine this would also apply somewhat to a health professional using Facebook. I'm happy you have such trust in your clients!

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