Social Media Use in Medical Practice

Social media is increasingly used by doctors for:
- Building professional presence
- Peer networking
- Sharing clinical information and experiences
Platforms include both public networks and closed professional groups.
While offering benefits, social media introduces legal and ethical complexities.

⚖️ Professional Obligations Apply Online

Medical Board of Australia’s Code of Conduct remains applicable:
- Encourages consulting colleagues
- Requires responsible use of information
Online activity does not diminish duties of confidentiality, privacy, or professional conduct.
Informal advice online may mirror “corridor consultations” or “curbside consultations” but lacks direct relational context.

Dr B posts a query in a closed social media group for doctors:
- Describes a rare case with recent results
- Shares age, gender, diagnosis, lab results
- Seeks updated treatment advice
- Receives helpful resources and links from colleagues
Raises medico-legal questions around:
- Confidentiality of shared info
- Consent
- Reliability and responsibility of informal online advice

Confidentiality	Privacy
Ethical duty to protect patient information obtained in the course of care	Legal duty under Privacy Act 1988 (Cth) and Australian Privacy Principles (APPs)
Applies to direct disclosures between practitioner and patient	Governs collection, storage, and sharing of health information
Breach = professional misconduct	Breach = contravention of legislation, possibly reportable or actionable

APP 6 permits sharing health information:
- For the primary purpose (treatment), or
- With the patient’s consent
If patient data is sufficiently de-identified, privacy legislation does not apply.
But risks of re-identification remain, especially:
- In rare conditions
- With combined demographics
- When practice location or clinician identity is public

Best practice: Always seek explicit patient consent before sharing online.
Document in clinical notes:
- Purpose of the post (e.g. peer advice)
- Platform used (e.g. GP-only closed Facebook group)
- Confirmation of de-identification
- Summary of what information was shared
- Patient’s agreement
If using advice, document links/resources or note guidance incorporated.

Despite de-identification, patients may still be identifiable if:
- Rare condition described
- Photos/images included
- Demographics shared (age, location, gender)
- Colleagues or patients can infer the case based on context or online trace
AMA advice: ensure a patient or situation cannot be identified by the sum of online information

Treating doctor:
- Bears ultimate responsibility for advice obtained and decisions made
- Must apply clinical judgment to peer suggestions
- Should not rely blindly on informal advice
Peer advice does not absolve legal responsibility

Current legal consensus (based on limited case law):
- No doctor–patient relationship formed
- No legal duty owed by responding doctor (unless advice is specific, directive, and relied upon)
US case Hill v Kokosky (2004):
- Two specialists gave informal advice to a treating doctor
- Court found no liability: advice was not directive and no therapeutic relationship existed
In Australia, NSW Health Care Complaints Commission has endorsed reasonable use of online peer platforms for advice

Online posts may be:
- Screenshotted
- Shared externally
- Revealed in litigation or complaint processes
Social media profiles often link professional and personal identities
Conduct online as if:
- The patient, family, or regulator may see your comments
- Posts may be admissible in court or tribunals

Maintain professional tone and language
Do not post beyond your scope of practice or expertise
Avoid speculative diagnoses or therapeutic advice unless confident and informed
Safer to link to:
- Current clinical guidelines
- Evidence-based resources

Doctors should only respond to queries that are within the scope of their experience and skills.
Respond to the information provided and be aware that any comments may ultimately be seen out of context.
Always be professional; even in a closed group assume that the patient or their family or other colleagues may see any comments.
If a doctor is offering their own clinical experience, they should ensure that they have appropriate patient permission to share any details.
It can be helpful for responding doctors to post links to current guidelines or other useful resources for the treating doctor to pursue, which avoids the risk of exceeding professional expertise or the information provided.

Technology outpaces the legal system; clarity on liability in online advice remains limited.
Most informal online opinions are low medico-legal risk if:
- Doctors act within professional bounds
- Posts are de-identified and consented
- There is no formation of a therapeutic relationship
Social media can support collegiality and clinical decision-making when used ethically.