An issue that has been been discussed in other venues is whether doctors and their patients should be “Facebook friends”. There have been various posts on other sites, but last night’s #HCSM chat brought it up. The quick consensus, especially from the medical folks, was that this would be a bad idea. Too many potential conflicts and too many possible lines can be crossed–at least on a personal/private Facebook page. I expressed my concerns–I consider Facebook a private space: I interact with friends and family, people I know. I consider Twitter a different creature altogether: I am throwing my comments, thoughts and opinions into the public forum and allowing the public to decide if they listen or not. Facebook is, for me, a much calmer arena. A place where my nieces can tell me what they’re up to for the weekend, or where my friends can invite each other to barbecues. I don’t consider any of these to be public issues. As a result, I’ve done my best to lock down my Facebook profile so that only my “approved” friends can see postings and activities on the account.
There are potential serious concerns as well, such as unprofessional behavior that may show up on Facebook pages (an issue seen in a recent study of medical students’ social media presence) or breaches of patient confidentiality (as seen in California, where medical staff posted pictures of a seriously injured patient directly on Facebook). There are clearly limits which we all agree must not be crossed, but there are others that fall into a more difficultly-defined gray area.
The answer, for many professionals, is to have two different Facebook pages: one personal for friends and family, and another public page that can be the official and professional contact site for patients to interact with their doctor. This allows patients to have a way to interact with their physician in a less-official capacity.
Not all were in agreement. Some participants felt that that physicians and other medical professionals should be willing and able to be completely open on the web. They raised the issue of whether anything should be posted online if one does not want it to be seen, and noted that patients hire their physicians as much as physicians opt to work with patients. There was also a sense of frustration: patients clearly want to have a more direct (and a more personable, if not personal) relationship with their health care provider. Current medical practice does not easily allow the necessary time for patients and doctors to develop a therapeutic bond easily; Facebook (or other) interactions could allow patients and doctors to have a stronger connection.
The issue can also be complicated when a friend becomes a patient: how does that change the doctor/patient relationship, Facebook sharing, etc. My thoughts are different in that situation: if you were already a friend, someone I’ve known in real life, then you likely know much about my family, my other friends, etc. We already trust each other, and we already communicate outside of our professional doctor/patient relationship. To me, this is very different from accepting friend requests from patients–that is the situation where I feel uncomfortable becoming “Facebook friends”.
The conversation did open a theme that is sometimes lost in the discussion of health care and social media. It is clear to me that there is a strong need for patients to connect with and interact with their physicians, and to form the necessary therapeutic bond. Conversations and interactions allow us to form the relationships that humanize us and that humanize health care systems. Health care providers’ Facebook personal pages may not be the best option, but it seems evident that there must be some other way to meaningfully extend doctor/patient interactions.
How can we leverage social media techniques and platforms to encourage productive communication and interaction between health care providers and patients? Can we use professional Facebook pages more effectively? Is Twitter a better means of interaction, given that the short posts and updates limit the amount of information that can be transmitted–is that a positive or a negative? How can technology effectively personalize health care?