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Your digital footprint

Marie Ennis-O’Connor explains the importance of medical professionalism in a digital age

Medical students worldwide are well versed in the use of social media as a supplementary learning tool and as a means of socialising. The ease with which social media moves between socialisation and education regularly blurs the line between the two. This can lead to future problems in maintaining professional boundaries online, so it’s important to be mindful of how you will use social media as a medical professional.

According to a recent survey by Pennsylvania State College of Medicine1, the social media savvy of many incoming medical students may lead to unintended medical privacy and confidentiality breaches. The survey found that overall students seemed to be conscious of the potential dangers of social media use and had a good understanding of how it could be used or misused in a professional context. However, when faced with a professional dilemma, there was a dichotomy between what the students said they would do versus what they thought they should do. Though 39% of students said that they should tell a hypothetical peer to remove drunken pictures and foul language from Facebook, 41% said they would actually do nothing.

The Irish Medical Organisation’s position paper on social media2 reminds doctors and students of their digital footprint: “Anything that has once been typed or posted and immortalised on the internet can always resurface.” Be aware that images or personal views posted on the internet create a lasting digital footprint with potentially serious implications for your professional career. The growing trend is for employers to screen potential employees online and while you may not associate the content you currently post online with your future career placements, it has been reported that online activity can affect placements in residency programmes.

Aside from career implications, social media misconduct may also compromise the public’s perception of the medical profession. Relationships between doctors and patients that are not based around clinical care can raise a number of significant ethical issues. Take care never to breach patient confidentiality. Patient privacy breaches can cause much greater harm when occurring online given the potential wide reach of social media and the permanency of digital information. Most improper disclosures of patient information are unintentional. Although individual pieces of information may not alone breach patient confidentiality, the sum of published information online could be sufficient to identify a patient or someone close to them. Avoid posting content regarding patients. Even if they, their case, or symptoms have been anonymised, there is still the chance of identification. No content on social networking sites should ever reference patients or their specific case.

To maintain appropriate professional boundaries, consider separating personal and professional content. Adjust your privacy settings on Facebook so that only friends and family can see your content; however, be aware that the content you generate online can still reach a public domain regardless of your intention for the information to be public or private. This also applies to content others may post on your behalf. On Facebook your friends can “tag” you in a photo that you may not wish to have in the public domain. Change your privacy settings so that you cannot be tagged in this way by others. Should you receive a friend request from a patient, politely re-establish professional boundaries by directing them to your Facebook practice page (you can also ignore the request without the person knowing).

Professionalism is a longstanding foundation of the medical profession, and as the healthcare conversations increasingly move online the challenge is how to redefine professionalism for a digital age. Increasingly doctors will be called on to contribute their expertise and experience as the internet becomes the medium of choice for patients researching health information. This is an opportunity to expand the reach of healthcare information and deepen the practice of medicine. The professional standards expected of doctors do not change because they are communicating through social media. Rather social media presents new circumstances to which the established principles still apply.

The way you use social media today is laying the foundation for your professional future tomorrow. If you are looking for some guidance, take note of the 12 word social media policy created by the Mayo Clinic Center for Social Media3:

  • Don’t Lie, Don’t Pry
  • Don’t Cheat, Can’t Delete
  • Don’t Steal, Don’t Reveal.

Following these simple rules can prevent most social media missteps, and help you maintain your professionalism in a dynamic and constantly evolving digital age.


  1. PubMed website, Medical Student Views on the Use of Facebook Profile Screening by Residency Admissions Committees, accessed 27 August 2014
  2. Irish Medical Organisation, IMO Position Paper on Social Media (April 2013)
  3. Mayo Clinic Social Media Health Network, A 12-Word Social Media Policy, accessed 27 August 2014.

Marie Ennis-O’Connor is a digital health strategist, social media consultant and keynote health speaker. A founding member of Health 2.0 Dublin, part of the Health 2.0 international movement, she is a regular contributor to health publications on the effective use of social media in healthcare.

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Disclaimer: Information in this article was correct at the time of publishing
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