Legal risks of social media are many — Look to guidelines

Physicians should take care in online communications including the electronic posting of information and the exchange of information via computers and phones, says Lois Snyder Sulmasy, JD, director of the American College of Physicians’ Center for Ethics and Professionalism in Philadelphia.

“What happens online, stays online — forever,” she says. A new position paper by the American College of Physicians and the Federation of State Medical Boards provides guidance on the use of social networking, blogging, online forums, cell phone photography, electronic searching, texting, and emailing. (To view the guidelines, go to

“Our goal is to help physicians provide the best care to patients and maintain trust in the patient-physician relationship and the medical profession,” says Snyder Sulmasy. Potential liability risks for physicians include confidentiality, privacy and security concerns, risks associated with patient-physician relationships, informed consent and documentation issues, practice of medicine across state lines, and defamation, she says.

“State medical boards are looking at online activities closely,” adds Snyder Sulmasy. “Online activities by physicians is an evolving area, and it could end up the subject of malpractice claims, just as it has become the subject of state medical board disciplinary actions.”

A study in the Annals of Internal Medicine in January 2013 looked at behaviors such inappropriate contact with patients and use of patient images without consent.1 It found that these and other online activities would lead board officials to perform investigations. A March 2012 research letter in the Journal of the American Medical Association (JAMA) found that in response to reports of online professionalism violations such as sexual misconduct and misrepresentation of credentials, 71% of state medical boards have held disciplinary proceedings.2

“Postings and emails create permanent records that can be forwarded and are discoverable, so attorneys may be looking at this in medical malpractice and other types of litigation,” says Snyder Sulmasy.


1. Greysen SR, Johnson D, Kind T, et al. Online professionalism investigations by state medical boards: First, do no harm. Ann Intern Med 2013; 158(2):124-130.

2. Greysen SR, Chretien KC, Kind T, et al. Physician violations of online professionalism and disciplinary actions: A national survey of state medical boards. JAMA 2012; 307(11):1141-1142.