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Answers for Action:
Here’s some advice for Facebook 'friend requests'
e-Reports, September 20, 2010
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Q: I’ve received an an e-mail request from a patient who wants to add me as a friend on Facebook. What do I do?

A: Most medical/legal and risk management experts would say proceed with extreme caution.

You’ve heard ad nauseum that patients who perceive they have a good relationship with their physicians are less likely to sue, even in the event of an adverse outcome, and heard more times than you can count that communication is the cornerstone of your relationships with your patients. But that advice is proffered for the therapeutic, professional setting.

So how do you navigate the boundary between therapeutic and personal – or social?

When asked about the topic, Hayes V. Whiteside, M.D., medical director and senior vice president of Risk Management at ProAssurance, said, “As a physician, I understand the perceived value of the ways in which patients tend to rely on Facebook to communicate with family and friends.

“However, we physicians need to be sure of a couple of things: One, communication about a patient’s therapeutic course happens face-to-face, in the practice setting. And two, ethically, that we don’t blur the line between therapeutic care and the social relationship.”

Generally, the best advice is to keep your professional and personal lives separate when using Facebook – and not accept friend requests from patients. Facebook friends typically have access to all other friends, to photos posted, and also to notes and messages posted on your wall. No matter how tightly you lock down your privacy settings, there’s no guarantee of privacy. The following examples demonstrate the risk.

In 2007, Facebook launched an ad service called Beacon that reported to Facebook about its members’ activities on third-party partner websites – even if a person did not have a Facebook account open at the time of viewing those sites, and even if the person declined to have “their activity broadcast to their friends” in newsfeeds, according to a Nov. 30, 2007, PCWorld report. After a class action lawsuit in 2009, Beacon was shut down.

Earlier this year, a glitch – later fixed – allowed users to view others’ private chats. And a May 31 TIME magazine article stated that often when Facebook changes privacy settings, the site “tended to automatically set users’ preferences to maximum exposure and then put the onus” on users to lock them down again.

If keeping your own privacy settings – well, private – on Facebook isn’t tough enough, imagine the potential HIPAA violations that could occur if you’re exchanging medical information with a Facebook patient friend.

Risk management experts have further tips for physicians who want to use Facebook as a service; watch upcoming ISMA Reports for more on this issue.

Physicians insured by ProAssurance may contact our Risk Management department for prompt answers to liability questions by calling (800) 292-1036 or via e-mail.

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