Beware the social media trap


A useful tool in some regards, clinicians should use caution in posting and interacting with patients online.

Social media is full of fun and games-until it’s not. A few mistaken keystrokes can end a career, and clinicians have to be mindful about the ethical and legal risks of an online presence.

Jonathan M. Fanaroff, MD, JD, FAAP, director of the Rainbow Center for Pediatric Ethics at Rainbow Babies and Children’s Hospital and professor of pediatrics at the Case Western Reserve University School of Medicine in Cleveland, Ohio, led a session titled, “Fired for Using Facebook: Law, Ethics, and Professionalism in Social Media,” which was presented on October 27, 2019 at the 2019 American Academy of Pediatrics (AAP) Annual Conference and Exhibition in New Orleans, Louisiana. The goal of the session was to highlight the professional liability risks associated with social media use. The AAP is working on a clinical report titled, “Ethical Considerations in Social Media,” which was also discussed in the session.

Fanaroff says he hopes the session will help clinicians understand the personal and professional risks associated with social media use.

“With over 2 billion monthly Facebook users, pediatricians must be aware of the benefits, as well as the risks, of social media,” Fanaroff says.

The Federation of State Medical Boards has cited growing concerns over physician use of social media, and a number of clinicians have been fired and disciplined by state medical boards for violating professional liability rules, Fanaroff notes.

There are benefits to social media use, he notes. Clinicians can learn from experts and peers through shared knowledge and expertise, discuss practice management issues, and share clinical experiences. However, there is also a fine line between benefit and risk. Sixty percent of conduct complaints involving medical students were related to student posting unprofessional content online, according to Fanaroff. These include instances of violated patient confidentiality, use of profanity, discriminatory language, depictions of intoxication, and sexually suggestive postings. Students aren’t the only ones at risk, either. Fanaroff says online professionalism issues are common issues addressed by state medical boards, with complaints ranging from inappropriate online contact with patients to inappropriate prescribing. Consequences in these cases can range from warnings to license revocation, he adds.

Boundaries are key, and respecting patient privacy and professional conduct extends to social media, he says. In his presentation, Fanaroff advised clinicians to be aware of the risks of interacting with current or past patients on social media sites, and limit any online patient interactions involving discussions about the patient’s medical treatment.

Additionally, clinicians have to be aware that anything they post on social media sites may be disseminated to a much larger audience and possibly be taken out of context. 

Providers also have to aware of the distraction that social media and electronic use can create. He cites a poll noting that half of technicians running bypass machines admitted to texting during procedures, and shared an example of a resident who was distracted by a text message while placing orders to discontinue anticoagulation therapy on a patient. Her distraction resulted in the order not being completed, and the patient was injured as a result.


Fanaroff says healthcare providers are best served remembering that social media is everywhere, and postings may never disappear. Lines are easily blurred between personal and professional lives online, and professional boundaries should be a priority, he says.

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