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Maintaining a professional digital profile

The following case scenarios provide a reminder that professional identity and patient confidentiality apply online as well as offline

Blurring-the-boundaries-on-facebookBlurring the boundaries on Facebook

Christian, an intern, was halfway through completing a module in the Emergency Department. He was working one Friday night when a young female patient was brought in by two of her friends, having had a fit in a local bar.

Christian took a history from the patient, and realised that she had been a geography student at his university. Christian visited her the following day on the medical ward to follow up on her medical management. They seemed to get on well, so Christian invited her to be a friend on Facebook.

After a while, the relationship soured, and the patient complained to the medical school about Christian’s conduct in contacting her and starting a relationship as a result of meeting her as a patient.

Learning points

  • Always maintain professional boundaries, which social networking can sometimes blur.
  • Do not accept current or former patients as friends or followers.
  • Exercise caution when accepting friend requests from colleagues.
  • Use the most secure privacy settings on social networking sites where available – but remember that not all information can be protected on the web.
  • Certain behaviours might affect your professional reputation, and possibly trigger an investigation by the regulator, for example irresponsible drinking. Certainly don’t publicise such behaviour online.
  • You have a duty to maintain the standards expected of a healthcare professional

A-false-sense-of-anonymityA false sense of anonymity

Anesu, a com serv intern in urology at a large city hospital, is beginning to think about applying for posts after Community Service. She has recently attended a conference, where one of the speakers highlighted the advantages of blogs specifically aimed at medical professionals as a learning resource to share best practice.

Anesu decides to create a blog to showcase her research work to potential employers. She tells some of her friends about the blog, who visit the site and leave messages under one of the opinion pieces. The comments quickly become jokey as the interns reply to one another and some use inappropriate language to recount specific instances of treating difficult patients. An intern supervisor sees the blog and reports the intern who made the offensive posts to the HPCSA.

Learning points

  • MPS’s advice would be to tread cautiously and consider all the following pitfalls before putting digital pen to paper: breach of patient confidentiality; defamation; breach of employment contract.
  • It is sensible to obtain the permission of your employer or educational supervisor before setting up a blog.
  • Remember that the internet is not a private space. When interacting with medical blogs and social networking sites, or when taking part in forum discussions, remember that anonymity is a myth, even if you use a pseudonym. You should write everything as if you are signing it with your name.
  • Maintaining patient confidentiality applies online too. Don’t post informal or derogatory comments about patients or colleagues on public internet forums, even if they are anonymous. The National Health Act (2003) protects the health information of patients, as well as the fact that they attended a health facility, as confidential.
  • Unguarded comments about patients, your place of work, or other staff members can lead to sanctions by your employer or the HPCSA. Comments of a racist, sexist or bigoted nature, posting inappropriate images, or sharing extreme views are also unacceptable.
  • You could face trouble if you harm someone’s reputation by publishing incorrect or potentially damaging information online.
  • Beware of jokes or activities that can seem like harmless fun online, but could backfire in reality.
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