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GUIDELINE - Physician Use of Social Media

1. Preamble

This document is a guideline of the College of Physicians and Surgeons of Saskatchewan (the “College” or “CPSS”) intended for the guidance of Saskatchewan physicians.

The rapid expansion of social media has created opportunities for physicians but has also created risk.  Physicians may choose to use social media with the following goals:

• to increase patient access to general medical information
• to responsibly advocate for patient care, improvements to the system and patient safety
• to advocate for the profession.

In doing so, physicians must be mindful of their legal, professional and ethical obligations that extend to the arena of social media.  These include the duty to maintain patient privacy and confidentiality; the duty to maintain the appropriate boundaries of a patient-physician relationship; broad-based expectations of professionalism; and the duty to respect copyright laws and other legal obligations.

2. Purpose and scope of this Guideline

This Guideline is not intended to restrict any physician’s right to freedom of speech.  However, it is intended to guide physicians in the appropriate use of social media, taking into account the applicable professional, ethical and legal obligations.  

In this context, “social media” refers to web and mobile technologies and practices through which users search for and share content, opinions, experiences and perspectives online.  Examples include but are not limited to Facebook, Twitter, YouTube, LinkedIn, Instagram, online forums, blogging sites and podcasts. 

This Guideline does not establish any new expectations for physicians; rather, it is intended to provide general guidance and recommendations based on existing professional, ethical and legal obligations and their application in the social media context.

Even in their private lives, especially if physicians choose to self-identify as a physician, they must be mindful that they are still considered “professionals” and may be held to a higher standard than others, particularly if their conduct could have a negative impact on the profession or the public interest.

The term “physicians” in this Guideline includes all physicians, residents and medical students licensed by CPSS.  In addition to following this Guideline, physicians are reminded to be familiar and comply with any other applicable policies such as those established by the Saskatchewan Health Authority, College of Medicine, or the facility in which they work.

3. Guiding Principles

The following guiding principles are applicable:

• Expectations of professional and ethical conduct are the same whether physicians are interacting in person or online through social media.  This can include expectations set out in The Medical Profession Act, 1981, the CPSS Regulatory Bylaws, and CPSS policies, standards and guidelines.
• The confidentiality of information posted on social media can never be guaranteed.
• Physicians who choose to utilize social media may want to consider establishing a separate personal and professional social media presence.

4. General guidelines for physicians using social media

a) Privacy

• Read, understand and apply the strictest privacy settings necessary to maintain control over access to your personal information. However, be aware that privacy settings are imperfect; assume content on the internet is public and widely accessible.
• Respect the privacy of patients, colleagues and co-workers.

b) Confidentiality of patient information

• Do not post identifiable patient information or patient images to social media unless you have informed consent from the patient. Be mindful that an unnamed patient may be identifiable through minimal information such as area of residence and a general description of condition. This applies even in a closed or private online forum.

c) Professional boundaries

• Maintain clear boundaries and avoid establishing personal connections with patients online.
• Do not provide specific clinical advice to individual patients through social media.

d) Professionalism

• Exercise caution when posting personal information on social media platforms.
• Do not post content that could be viewed as unprofessional, particularly if you have chosen to self-identify as a physician.
• Maintain professional and respectful relationships with patients, colleagues and other members of the health-care team.
• As required by paragraph 41 of the CMA Code of Ethics and Professionalism (adopted by Council in Bylaw 7.1 of the CPSS Regulatory Bylaws), you should “provide opinions consistent with the current and widely accepted views of the profession when interpreting scientific knowledge to the public”, and should “clearly indicate when you present an opinion that is contrary to the accepted views of the profession.”
• If expressing an opinion related to medical issues, you should accurately describe your credentials as relevant to the opinion expressed.
• Consider whether there is a need to specify that words/opinions expressed are your own and do not reflect upon an employer/facility/colleagues, etc.
• If engaging in online debate, focus on the issues and avoid disparaging personal comments.

e) Legal obligations

• Be mindful that defamatory statements published online may result in complaints to CPSS of unprofessional conduct or legal action claiming damages for defamation.
• Plagiarism and copyright infringements may also lead to legal action. Always provide credit and links back to original sources when sharing information.
• Represent your credentials accurately and declare conflicts of interest where applicable.

5.  Seeking Advice

If physicians have questions or concerns about their use of social media, they may seek advice by contacting the College and asking to speak with a member of the Registrar’s staff, or by contacting the Canadian Medical Protective Association for medical-legal advice.

RELATED CPSS RESOURCES

College of Physicians and Surgeons of Saskatchewan:

• Regulatory Bylaw 7.1 – The Code of Ethics
• Regulatory Bylaw 7.2 – Code of Conduct
• Regulatory Bylaw 9.1-- Conflict of Interest
• Regulatory Bylaw Part 7 – Advertising
• Guideline “Patient-Physician Communication Using Electronic Communications”
• Guideline “Confidentiality of Patient Information”
• Guideline “Conflict of Interest”

OTHER RESOURCES

University of Saskatchewan College of Medicine

• Post-graduate Medical Education Policy “Appropriate Use of Social Media”

Canadian Medical Protective Association

• Good Practices Guide – Social Media
• Top 10 tips for using social media in professional practice (October 2014; reviewed March 2020)
• Social networks in healthcare: Opportunities and challenges for a connected future (April 2017)
• Social media: The opportunities, the realities (October 2014)
• Emerging trends: Are you socially accountable? (October 2014)
• Technology unleashed – The evolution of online communication (June 2012)

ACKNOWLEDGEMENTS

In developing this guideline, the College of Physicians and Surgeons of Saskatchewan referenced the following documents:

• the College of Physicians and Surgeons of Alberta Advice to the Profession “Social Media”
• the College of Physicians and Surgeons of British Columbia Professional Guideline “Social Media”
• the College of Physicians and Surgeons of Ontario document “Social Media – Appropriate Use by Physicians”.

The College recognizes, with thanks, the contributions of those organizations to the development of this guideline.