What you need to know about communicating with patients through social media and email

The Internet has created new, innovative ways to research and communicate. A large number of Indian doctors are now using the Internet for purposes such as Google searches for clinical and business information, community building and branding, and communicating via email and social media for business and personal purposes.


Neelesh Bhandari, MD“The importance of email and social media communications with patients is a growing trend that cannot be underestimated.”
-Neelesh Bhandari, MD, physician entrepreneur focused on communication technology in healthcare and author of the blog Digital Medicine


Doctors need to be cognizant of special considerations when it comes to interacting with patients online though email and social media. The importance of these communications is a growing trend that[s2If !is_user_logged_in()]…

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Key Point: The emerging world of social media and email communications brings up issues specific to doctor-patient communication via these media. It’s important to follow established professional standards about communicating with patients even when doing so via the Internet. Be sure to separate your personal and professional activities online as you would in real life.

Communicating with patients via email

Email communications can be a quick and convenient way to share information with patients. However, you should also be aware of the limits and liabilities of conducting medical communication via email. The American Medical Association (AMA) offers practical guidelines about email communication with patients that also are helpful for Indian physicians (http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion5026.page).

Highlights of the AMA guidelines include:

  • Email correspondence should only be used with patients with whom you have already established a doctor-patient relationship (ie, current patients only, not prospective ones).
  • You have the same ethical responsibilities to patients during email exchanges as you do during in-person, phone, and other types of encounters. Information communicated via email should meet established professional standards.
  • Email communications with patients should include a standard notification/disclosure to patients about the limitations and potential risks of email, including privacy and confidentiality issues, difficulty in verifying identities, and delays in responses. Patients should accept those limitations if they would like to correspond with you via email, but keep in mind that this type of disclaimer does not absolve you of an ethical responsibility to protect patients’ interests. The guidelines state: “Medical advice or information specific to the patient’s condition should not be transmitted prior to obtaining the patient’s authorization.”

Emerging issues in the world of social media

Social media such as Twitter and Facebook can be an excellent way to network with other healthcare professionals, to establish yourself as a medical thought leader, and to build your medical practice. Social media are now being widely used by doctors as well as patients.

At the same time, doctors who use social media face new ethical issues regarding online physician-patient relationships. It’s important to separate your personal and professional use of Twitter, Facebook, and other social media. For example, you could have two Facebook accounts: one personal one with high-level privacy settings on which you only “friend” personal friends and family members (no patients), and a business page for your medical clinic of which patients can be “fans” by “liking” your page.

The AMA has posted some guidelines for doctors’ use of social media tools and blogging in a professional capacity: http://www.ama-assn.org/ama/pub/meeting/professionalism-social-media.shtml.

Some of the take-home points include:

  • Don’t post identifiable patient information online.
  • Use privacy settings where available for personal social media use, but know that these settings are not absolute and that information could become public. You should monitor your Internet presence to ensure, where possible, that information posted by and about you is accurate and appropriate.
  • If you interact with patients on the Internet, be sure to maintain appropriate boundaries of the patient-physician relationship in keeping with professional ethical guidelines. It is recommended that you separate personal and professional content and activities online when using social media.
  • If you come across content posted by or about physician colleagues online that appears to be unprofessional, you should bring the content to the attention of the individual, so that he or she can remove it and/or take other appropriate actions.
  • Be aware that anything that you post online has the potential to negatively affect your reputation, could have an impact on your professional reputation, and could potentially damage the public’s view of the medical profession (Editor’s Note: of course, the opposite is true as well—positive and informative content that you post could enhance your reputation and the reputation of the medical profession).

A consortium of Australian and New Zealand medical associations also has issued collaborative guidance on this issue. Here’s the link to the 14-page PDF of the Physician Social Media Guidebook that they created: https://docs.google.com/file/d/14SvUaFIWND0WUucJcj7QqFZfj28tbMCpKepflvBHofF1Ps_t0zC5gpzm9-V7/edit?hl=en&pli=1. It is one of the most practical and useful guide of its kind.

Email and social media are powerful, exciting tools. If you harness their power and use them appropriately for patient communications, you can increase efficiencies, build your practice, and learn a lot along the way.

Neelesh Bhandari, MDDr. Bhandari is a physician entrepreneur focused on communication technology in medicine and healthcare. He is based in the New Delhi area of India and serves as Chief Consulting Officer of Digital MedCom Solutions. Dr. Bhandari also runs the blog Digital Medicine, which is focused on “Ensuring optimum use of technology in medicine.”

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