Facebook "friend" request from patient? French doctors decline

Medical residents and fellows in France who participated in a survey on their Facebook use were very unlikely to accept a patient's "friend" request on the site, fearing it would alter the doctor-patient relationship. But the same survey found that such a concern didn't prevent the doctors from posting personal information about themselves on Facebook.

French researchers received questionnaires back from 202 participants -- 160 residents and 42 fellows, with a median age of 28, all at the Rouen University Hospital in northern France -- for a study that was posted online Dec. 15, 2010, in the Journal of Medical Ethics. One hundred and forty-three respondents, or 73%, had a Facebook profile, though some without a presence on the site answered questions about what they would do on the site.

Among all respondents, 152, or 85% of the 178 who addressed this topic, said they would automatically decline a "friend" request from a patient. An additional 26, or 15%, would decide on an individual basis whether to accept or decline. None would automatically accept. Eight Facebook users had actually received a friend request from a patient, and four had accepted it, according to the study.

The most-often cited reasons for rejecting a patient "friend" request were a need to keep distance from the patient, a wish to protect personal information and photos, a view that accepting such a request would be unethical, and a suspicion that the patient was seeking a romantic relationship.

Almost all residents and fellows believed that doctors should not be forbidden from registering on Facebook, but that they should limit access to their profile to "friends." Eighty-eight participants in the survey said they agreed with the statement that the doctor-patient relationship would change merely if a patient discovered his or her physician was on Facebook. But 139 agreed with the statement that the relationship would change only if the patient had access to the doctor's profile. Some doctors agreed with both statements.

Despite the respondents' concerns, almost all physicians in the survey who have a presence have posted their real name, photo and birth date. A majority also had posted personal photos, relationship status, e-mail address, school and employer information on their Facebook profile.

The vast majority of doctors in the survey adjusted their privacy settings to ensure only "friends" saw their profile. But 17% said they had no idea what their privacy settings were.

Researchers recommended that doctors keep patients away from their Facebook profiles -- and that physicians do not seek out their patients' profiles. They recommended that physicians and patients interact online only to discuss care.

The American Medical Association recently developed its own policy on social media (link).

One recommendation is that physicians create separate personal and professional social media profiles to "maintain appropriate professional boundaries."