Professional Obligations when Engaging Online

Reading time: 4 minutes
Illustration of a smartphone and social bubbles

Standards of professionalism apply when engaging online, says new policy

Council approved a new Social Media policy, which sets out parameters for physicians’ conduct on social media, recognizing that physicians are active consumers and creators of online content. This new policy replaces a 2013 statement that set out general guidance on social media use.

The policy recognizes social media presents important opportunities for physicians to enhance patient care, medical education and advocacy. However, the use of highly accessible, informal and fast-paced social media platforms presents unique risks and challenges for physicians to navigate, and raises questions about how physicians can uphold their professional obligations when engaging online.

“The overarching expectation is that standards of professionalism online should be similar to those that already apply to physicians in person,” said Dr. Karen Saperson, a member of the Policy Review Working Group. She noted many of the expectations in the policy mirror existing obligations found in other CPSO policies, such as Boundary Violations, Physician Behaviour in the Professional Environment and Advertising, but place them in a social media context.

“Online, the results of a physician’s actions might be different than if they had occurred offline — for example, something posted by a physician can be screen captured and shared more widely, sometimes out of context and garnering more attention than intended. This different context is important for physicians to be aware of when engaging with others online,” said Dr. Saperson, a professor of psychiatry at McMaster.

“Because physicians hold a position of trust in society, our words carry particular weight and we need to be cognizant of the kind of impact they can have”

Overall, physicians who provided feedback during the consultation on the draft policy generally agreed the profession would benefit from a policy setting out expectations around social media use. Key revisions were also made to the policy in response to consultation feedback.

For instance, the policy was revised to explicitly acknowledge the balancing of freedom of expression and a physician’s professional responsibilities, which includes professional communication.

“Freedom of expression is a right enjoyed by all Canadians, but that freedom is subject to reasonable limits,” said Dr. Saperson. “Because physicians hold a position of trust in society, our words carry particular weight and we need to be cognizant of the kind of impact they can have,” she said.

A physician’s professional communication while using social media is important for preserving the reputation of the profession, fostering a culture of respect, not adversely impacting patient care and avoiding harm to the public, states the policy.

The preamble also clarifies the policy’s focus is on a physician’s professional use, but can apply to personal use depending on several factors. This can include the nature and seriousness of the conduct itself; whether or not the physician was known to be, could reasonably be known to be, or represented themselves as a member of the profession; and the connection between the conduct and the physician’s role and/or the profession.

Key revisions were made to the provisions around professionalism due to concerns about how certain examples included might be interpreted and applied. The concept of “disruptive behaviour” was clarified, noting it is more often identified through a pattern of behaviour, and not likely to include constructive criticism offered in good faith with the intention of improving patient care or the health-care system.

The companion Advice to the Profession document provides further clarification and resources on a range of topics, including the conceptualization of “professionalism” and considerations for physicians engaged in advocacy.

The COVID-19 pandemic highlighted the important role physicians can play in sharing information, as well as the dangers of physicians spreading misinformation. Recognizing the need to tackle this issue, the updated policy includes new requirements around disseminating general health information and prohibits the dissemination of false, misleading or deceptive information. The policy requires physicians only share evidence-based information and not misrepresent their qualifications when making specific statistical, scientific or clinical claims. 

5 things to know about the policy

  1. Acknowledges the importance of physician advocacy, while setting an expectation that activities be done in a professional manner;
  2. Requires physicians only share evidence-based information, be aware of the limits of their knowledge and expertise, and not misrepresent their qualifications when making specific statistical, scientific or clinical claims;
  3. Takes a principled approach towards maintaining appropriate boundaries on social media with patients and medical learners by requiring physicians to consider the power imbalance inherent in these relationships;
  4. Sets requirements to de-identify information, and/or obtain and document express and valid consent when posting information online relating to a patient; and
  5. Indicates that communicating and/or behaving on social media in a manner that involves discrimination is unacceptable.