Social Networking 101 for Physicians

The Physician’s Corner

Avoiding The Legal Risks Of Social Networking

By Henry Tulgan, M.D., FACP

Now that online social networking has become so prevalent, it is hard to believe that it is mainly a product of the first decade of the 21st century. Only as recently as 2004, three Harvard University undergraduates created Facebook, a website first designed to put students in touch with one another. The site rapidly spread to other college campuses, and it now includes anyone over the age of 13, recently reaching 350 million users. Another familiar social networking site, MySpace, also dates back only to 2004, and Twitter, a micro-blogging site based on 140-character answers to a simple question – “What are you doing?” – started in 2006.

As social networking has become widespread, particularly over the past two years, numerous health care-related and physician-only networks have emerged. Indeed, social networks are heavily utilized in medical schools, both by students and faculty, in academic health centers and community hospitals, as well as by medical publications, libraries, pharmaceutical companies, nursing groups and health information technologists, to name just a few. The number of practicing physicians on the social networking bandwagon is growing daily. It seems that not a day goes by when I am not contacted by e-mail with a request to join a social network or physician forum.

However, the use of social networks also brings potential liability risks for physicians. Perhaps the most important thing to be aware of is the importance of maintaining the confidentiality of patient information. Disclosure of any identifiable details may be a violation of the Health Insurance Portability and Accountability Act (HIPAA). While this may seem like an obvious concern with the use of a public site such as Facebook – and legal experts advise that physicians block patients’ and former patients’ access to their personal sites – it is equally important to protect against a HIPAA violation when using a physician-only social network.

In addition, it’s essential to regularly monitor all of your sites to avoid failing to respond to a patient question. Such a failure could result in a malpractice action. When using online forums to discuss patient care, physicians must also be mindful of employing suggestions that may not meet standards of care or may not be evidence-based. I have visited several of these sites personally, and noticed that the posters usually use pseudonyms, and therefore it’s not generally possible to know the skill level or background of the respondents.

Attorneys also caution that Internet service provider websites and social networks are under no legal obligation to hold back confidential and personal information if subpoenaed and thus such information could be used in a civil lawsuit. Violation of confidentiality by office employees can also add to risk. And be aware that social networks do not protect against copyright, slander or libel suits. Physicians should also have an understanding as to who will be responsible for defending them in case of legal action: the employer – a group, hospital or health system – or themselves. Recently, physician recruiting has become another online use of this technology. Remember that information sent to one source may become widely disseminated.

Lastly, medical files have been pilfered from social networking sites for the purpose of fraudulent billing of Medicare and Medicaid. Billing information must be carefully monitored to avoid this possibility. Physician use of social networking is here to stay and is likely to grow. However, we should never let our enthusiasm to embrace this technology overshadow the legal risks that accompany it.

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