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A very important article for up-and-coming leaders in the field...Rules to live by...
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Best Practice Recommendation #1: It is our recommendation to refrain from posting political content on your professional account. If this an important position for you, then consider a private personal account. Despite a private account there is no guarantee that posts on private social media will not be shared to a broader public view.
Strength of Consensus: A
Best Practice Recommendation #2: It is our recommendation to refrain from posting any image that could suggest intoxication, impairment, or explicit sexual content.
Strength of Consensus: A
Best Practice Recommendation #3: It is our recommendation to hold Best Practice Recommendations #1 and #2 as a rule when giving “likes and shares”, despite a disclaimer that these are not endorsements. Avoid sharing content that can compromise one’s professional image.
Strength of Consensus: A
Best Practice Recommendation #4: If interacting on a social account with a patient be cautious of the Health Insurance Portability and Accountability Act (HIPAA) and assure you remain compliant with all privacy protection. If possible, limit social interaction with active or former patients, and avoid giving medical advice on these mediums. In addition, it should be noted that “posts do not equal medical advice” is not a legal contract and may not protect you if you make medical opinions in the social media arena.
Strength of Consensus: A
If physicians elect to establish a social media connection with their patients through their professional account, the patients themselves are still using their personal profiles. As such, the physician may have access to private information about patients which may have not been disclosed during clinical encounters.7 In the event that the information gathered will affect a patient’s treatment plan, the physician must approach the patient with honesty on how the information was obtained. This is a sensitive conversation and may negatively impact the physician-patient relationship.13 Thus, it is our strong recommendation that physicians not browse their patient’s social media profiles.
Best Practice Recommendation #5: Physicians should avoid accessing the patient’s social media profile and interacting on any issue that may be deemed personal, medical, or emotional in any way.
Strength of Consensus: A
Best Practice Recommendation #6: Physicians should obtain written consent for use of patient images, photos, or patient testimonials as part of the consent process.
Strength of Consensus: A
Best Practice Recommendation #7: It is strongly recommended that physicians avoid posting procedural images or patient imaging without ensuring all identifying information is removed. When posting images, care must be taken to avoid patient faces and other identifiable features, as well as background persons or items related to the patient.
Strength of Consensus: A
Best Practice Recommendation #8: It is strongly recommended that physicians “pause before posting”. Consider waiting a period of time prior to posting images from recent procedures or surgery; patients browsing social media may be able to identify posts detailing their procedure or surgery in instances where posting occurred soon after their date of service.
Best Practice Recommendation #9: The need for specific guides for physician and industry social media is paramount to better allow for a balanced view of postings. There are several best practices that ASPN makes at the present time that will lead to new standards going forward.
9a. When a company posts an event with physician consultants, the event is obvious to the viewer as company-sponsored. No further disclosure is needed by the physician, but the company should obtain physician permission before the posting.
9b. When a physician performs a new procedure, obtains new training, or reports new outcomes with a company-sponsored device, it may not be possible to avoid branding. In these instances, if any claim is made as to efficacy, either disclosure or supporting literature should be included in the post.
9c. New innovations may lead to many off label uses, studies, and clinical applications of devices and medications. Company-sponsored posts should always indicate if something is off label with appropriate warnings as driven by the respective nation’s regulatory body. Physicians do not have the same responsibility since in normal practice of medicine off label use is often appropriate. It is also not a reasonable expectation for physicians to know the labeling of every device or drug they utilize. If a post presents a new use of a product, with little or no research publications this lack of data should be discussed.
9d. Physicians may choose to disclose that they received fees from manufacturers mentioned in their postings. Since posts are not deemed Continuing Medical Education (CME) there are no disclosure rules that must apply to these actions, therefore the physician’s decision to follow these recommendations are at the discretion of judgement and not legally or professionally binding.
Strength of Consensus: A
Best Practice Recommendation #10: When providing patient education via social media it is critical to offer balanced information concerning the product and appropriate patient selection. When possible, a link should be provided which offers a peer reviewed source or a balanced discussion of the risk-to-benefit ratio.
Strength of Consensus: A
Best Practice Guidelines from the ASPN | JPR
Guidance on online persona & professional image, patient-physician interactions online, patient privacy, industry relations, patient education, & brand building
Best Practice Recommendation #1: It is our recommendation to refrain from posting political content on your professional account. If this an important position for you, then consider a private personal account. Despite a private account there is no guarantee that posts on private social media will not be shared to a broader public view.
Strength of Consensus: A
Best Practice Recommendation #2: It is our recommendation to refrain from posting any image that could suggest intoxication, impairment, or explicit sexual content.
Strength of Consensus: A
Best Practice Recommendation #3: It is our recommendation to hold Best Practice Recommendations #1 and #2 as a rule when giving “likes and shares”, despite a disclaimer that these are not endorsements. Avoid sharing content that can compromise one’s professional image.
Strength of Consensus: A
Best Practice Recommendation #4: If interacting on a social account with a patient be cautious of the Health Insurance Portability and Accountability Act (HIPAA) and assure you remain compliant with all privacy protection. If possible, limit social interaction with active or former patients, and avoid giving medical advice on these mediums. In addition, it should be noted that “posts do not equal medical advice” is not a legal contract and may not protect you if you make medical opinions in the social media arena.
Strength of Consensus: A
If physicians elect to establish a social media connection with their patients through their professional account, the patients themselves are still using their personal profiles. As such, the physician may have access to private information about patients which may have not been disclosed during clinical encounters.7 In the event that the information gathered will affect a patient’s treatment plan, the physician must approach the patient with honesty on how the information was obtained. This is a sensitive conversation and may negatively impact the physician-patient relationship.13 Thus, it is our strong recommendation that physicians not browse their patient’s social media profiles.
Best Practice Recommendation #5: Physicians should avoid accessing the patient’s social media profile and interacting on any issue that may be deemed personal, medical, or emotional in any way.
Strength of Consensus: A
Best Practice Recommendation #6: Physicians should obtain written consent for use of patient images, photos, or patient testimonials as part of the consent process.
Strength of Consensus: A
Best Practice Recommendation #7: It is strongly recommended that physicians avoid posting procedural images or patient imaging without ensuring all identifying information is removed. When posting images, care must be taken to avoid patient faces and other identifiable features, as well as background persons or items related to the patient.
Strength of Consensus: A
Best Practice Recommendation #8: It is strongly recommended that physicians “pause before posting”. Consider waiting a period of time prior to posting images from recent procedures or surgery; patients browsing social media may be able to identify posts detailing their procedure or surgery in instances where posting occurred soon after their date of service.
Best Practice Recommendation #9: The need for specific guides for physician and industry social media is paramount to better allow for a balanced view of postings. There are several best practices that ASPN makes at the present time that will lead to new standards going forward.
9a. When a company posts an event with physician consultants, the event is obvious to the viewer as company-sponsored. No further disclosure is needed by the physician, but the company should obtain physician permission before the posting.
9b. When a physician performs a new procedure, obtains new training, or reports new outcomes with a company-sponsored device, it may not be possible to avoid branding. In these instances, if any claim is made as to efficacy, either disclosure or supporting literature should be included in the post.
9c. New innovations may lead to many off label uses, studies, and clinical applications of devices and medications. Company-sponsored posts should always indicate if something is off label with appropriate warnings as driven by the respective nation’s regulatory body. Physicians do not have the same responsibility since in normal practice of medicine off label use is often appropriate. It is also not a reasonable expectation for physicians to know the labeling of every device or drug they utilize. If a post presents a new use of a product, with little or no research publications this lack of data should be discussed.
9d. Physicians may choose to disclose that they received fees from manufacturers mentioned in their postings. Since posts are not deemed Continuing Medical Education (CME) there are no disclosure rules that must apply to these actions, therefore the physician’s decision to follow these recommendations are at the discretion of judgement and not legally or professionally binding.
Strength of Consensus: A
Best Practice Recommendation #10: When providing patient education via social media it is critical to offer balanced information concerning the product and appropriate patient selection. When possible, a link should be provided which offers a peer reviewed source or a balanced discussion of the risk-to-benefit ratio.
Strength of Consensus: A
