Social media and the medical profession

Sarah J Mansfield, Stewart G Morrison, Hugh O Stephens, Michael A Bonning, Sheng-Hui Wang, Aaron H J Withers, Rob C Olver and Andrew W Perry
Med J Aust 2011; 194 (12): 642-644. || doi: 10.5694/j.1326-5377.2011.tb03149.x
Published online: 20 June 2011

The professional standards of doctors and medical students form the cornerstone of quality patient care and are based on expectations of the community and medical peers. The Medical Councils of both Australia and New Zealand have widely accepted guidelines on good medical practice,1,2 and the Australian Medical Association (AMA), New Zealand Medical Association (NZMA) and Australian Medical Students’ Association (AMSA) also have codes of ethics for their members.

The world within which these professional standards apply is expanding rapidly. Society has embraced user-generated content such as blogging, personal websites, and online social media technologies. Research shows that use of social media websites by the medical profession is common and growing:3 in one 2010 study, 220 out of 338 medical students (65%) at the University of Otago, New Zealand had a Facebook account.4

Our perceptions and regulations regarding professional behaviour must evolve to encompass these new forms of media. Recent studies, legal cases and media reports highlight how the inappropriate use of these media can harm patients and the medical practitioners involved.

As part of our commitment to upholding the principles of medical professionalism, the AMA Council of Doctors in Training, NZMA Doctors-in-Training Council, AMSA, and the New Zealand Medical Students’ Association (NZMSA) have created a guide for doctors and medical students that will help them engage in social media while maintaining professional standards; this guide can be found at In this article, we present some of the issues explored in the guide.

Be careful about what you say and how you say it

Doctors have an ethical and legal responsibility to maintain their patients’ confidentiality. The accessibility and “indexability” of information posted online poses new issues for the maintenance of confidentiality, as well as for the concept of de-identification. While a single posting on a social networking website may appear to be de-identified, this may be compromised by other postings on the same website. In maintaining confidentiality, it must be ensured that a patient or situation cannot be identified by the sum of the information available online.

Before putting any patient information online, the patient’s express consent should be obtained, and such consent acknowledged within the post. Care must be taken to ensure that the patient is properly de-identified; the use of a pseudonym is not always enough.

Breaching confidentiality erodes the public’s trust in the medical profession, impairing our ability to treat patients effectively. It can also result in complaints to medical registration authorities and employers, involvement of the Australian Information Commissioner (formerly the Privacy Commissioner), or legal action. In Australia, medical boards have already investigated doctors for posting information that could identify patients on social networking sites.6

Keep your friends close and others . . . not so close
Doctor–patient boundaries

A power imbalance exists between doctors and patients, and the maintenance of clear professional boundaries protects patients from exploitation.8 Doctors who allow public access to their entire online profiles introduce patients to details about their personal lives beyond what the patient would normally discover within the doctor–patient relationship. Further online interaction may constitute a violation of professional boundaries, and serious indiscretions may result in disciplinary action against the doctor. In general, doctors should avoid online relationships with current or former patients. If a patient does make contact with a medical practitioner in an online context, it is appropriate to send a polite message to the patient explaining that further online interaction would be unprofessional.

Another mechanism used by some doctors is to create an online profile used only for professional purposes or to join a professional social networking site; it is possible to pay companies to manage social networking profiles.

Consider the destiny of data

Provenance: Not commissioned; externally peer reviewed.

  • Sarah J Mansfield1
  • Stewart G Morrison2
  • Hugh O Stephens3
  • Michael A Bonning1
  • Sheng-Hui Wang4
  • Aaron H J Withers5
  • Rob C Olver6
  • Andrew W Perry1

  • 1 Australian Medical Association, Council of Doctors in Training, Canberra, ACT.
  • 2 Australian Medical Association, Victoria Doctors in Training, Melbourne, VIC.
  • 3 Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC.
  • 4 New Zealand Medical Students’ Association, Wellington, New Zealand.
  • 5 Doctors-in-Training Council, New Zealand Medical Association, Wellington, New Zealand.
  • 6 Australian Medical Students’ Association, Canberra, ACT.


Competing interests:

None identified.


remove_circle_outline Delete Author
add_circle_outline Add Author

Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Online responses are no longer available. Please refer to our instructions for authors page for more information.