Study reveals doctors' unethical online practices

Boards taking serious disciplinary actions

Physicians misrepresented their credentials online, violated patient confidentiality, had inappropriate communications with patients online, and used the Internet to prescribe medications to patients with whom they had no therapeutic relationship, according to a study of violations reported to state medical boards.1

"My colleagues and I were definitely surprised at how frequently boards were taking serious disciplinary actions such as restriction, suspension, or revocation," says Ryan Greysen, MD, MHS, MA, the lead author of the study and assistant professor of hospital medicine at University of California, San Francisco. "I think it underscores that boards do see this issue as within their responsibilities to regulate." The researchers published a previous study on unprofessional online content in 2009, focusing on medical students because they thought they would be more frequent users of social media.2

"We began wondering about whether this was just an issue among medical trainees or if this was happening among licensed physicians as well," Greysen says.

Next, the researchers partnered with the Federation of State Medical Boards to see how the issue was playing out on a national scale. "They immediately appreciated the importance of this issue. They were proactive in forming new policy and guidance in response to our study data, even before it was published," he says. (To view the FSMB's 2012 policy on social media, go to: http://fsmb.org/pdf/nr-social.pdf. To view the AMA's 2011 policy on physician use of social media: http://www.ama-assn.org/ama/pub/meeting/professionalism-social-media.shtml.)

Education is needed

New social media policies should make it easier for state boards to adopt more consistent standards for oversight, says Greysen. "I think we will see increased awareness about this issue at the regulatory level," he predicts. "Nonetheless, I think the larger issue going forward will be less about how to more effectively monitor or report physician online behaviors, and more about how to educate and prevent unprofessional behavior online."

Many hospitals, medical schools, health care systems, or other large practices have their own policies about social media use by physicians and other healthcare professionals at their institutions. "It makes good sense for physicians to familiarize themselves with these more 'local' policies as well," Greysen says.

References

  1. 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.
  2. Chretien KC, Greysen SR, Chretien JP, et al. Online posting of unprofessional content by medical students. JAMA. 2009; 302(12):1309-1315.

Sources

  • Humayun J. Chaudhry, DO, MS, FACP, FACOI, President and CEO, Federation of State Medical Boards, Euless, TX. Phone: (817) 868-4000. Email: hchaudhry@fsmb.org.
  • Ryan Greysen, MD, MHS, MA, Assistant Professor of Medicine, University of California, San Francisco. Phone: (415) 476-5924. Email: rgreysen@medicine.ucsf.edu.
  • Toby Schonfeld, PhD, Director, Master of Arts in Bioethics Program, Center for Ethics, Emory University, Atlanta, GA. Phone: (404) 727-1752. Email: toby.schonfelf@emory.edu.