02
Aug
10

Health Care Ethics and Communications Online: When Doctors Google Patients

These days patients are almost expected to Google their medical providers. Does the same hold true for physicians regarding their patients? I recently read an LA Times article “You, your doctor and the Internet,” written by Judy Foreman. In an short excerpt of the article, Foreman writes about a physician, a psychiatrist none the less, who Googled a patient. The article states:

“’There may be times when it’s appropriate for doctors to Google patients,’ says psychiatrist Benjamin Silverman, chief resident of the McLean Hospital adult outpatient clinic.

“Silverman has a patient who stopped going to therapy without explanation. ‘I was concerned,’ he says. ‘I Googled her.’

“The patient was not upset, but Silverman felt he had crossed some kind of boundary. So he told her. ‘If we were going to continue treatment,’ he says, ‘I thought it was necessary for her to know that I had done this.’ ”

Since I did not write or research this article, I don’t know what information we are missing. For example, what happened after Silverman Googled the patient? Was a personal contact made? Why did the patient come back to therapy? Was it because of a contact made or was it simply spontaneous with no connection to the online actions? And of course we have no idea why the patient was in therapy to begin with, but does it matter? McLean Hospital is an outpatient treatment facility for mental health and substance abuse issues. That tells us enough. Having worked with numerous mental health practitioners on developing PR and marketing programs, I know the influence these professionals carry and the hesitation most have with putting undue pressure on their patients.

Which leads me to disagree with Silverman. I believe there are no times when it is appropriate for a physician to Google a patient. While the Internet goes a long way of breaking down personal boundaries, if a patient is choosing to leave therapy or to leave a certain practice, that choice is the patient’s and the doctor should leave it alone. While the debate in my office continues about the efficacy of Silverman’s actions, I personally would not approve of physicians, especially psychiatrists, looking into patients personal lives through channels that were not approved for disclosure in an official therapy related capacity.

Just because you can, doesn’t mean you should.

Health care facilities need to clearly distinguish what online behavior is appropriate and what isn’t. While your social media rules may be clearly written (or maybe not), it is important that you don’t forget to include reminders about overall acceptable behavior with online communications – behaviors that didn’t exist before “Google” became a verb.

What do you think? Is it OK for doctors to Google patients? What about when the intent is clearly to influence a patient to return to treatment? Does it depend on the type of medical service being provided? Let us know your thoughts!


13 Responses to “Health Care Ethics and Communications Online: When Doctors Google Patients”


  1. August 4, 2010 at 4:40 am

    This is a great question. Obviously, there is a lot to be learned about patients by monitoring their social networks. What do they say via Twitter? What do they put in Facebook?

    On the one hand, that’s way too much work for the physician (not addressing the ethical question)…but perhaps a great business opportunity (aggregate and sell that data to the plans). Divorce lawyers are using this data as are tax collectors (and likely life insurance underwriters).

    Ethically, this could be murky, but what is the “contract” between the physician and the patient. Is it purely a transaction or is there an implied care management aspect?

    I’ll have to ponder and blog more on this later at http://www.georgevanantwerp.com.

  2. August 6, 2010 at 4:48 am

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  3. August 6, 2010 at 8:07 am

    Health care facilities need to clearly distinguish what online behavior is appropriate and what isn’t. While your social media rules may be clearly written (or maybe not), it is important that you don’t forget to include reminders about overall acceptable behavior with online communications – behaviors that didn’t exist before “Google” became a verb

  4. August 18, 2010 at 9:41 am

    George, these are all great questions and I apologize for the delay in responding to them. I think that if a physician is following or monitoring a patients social networks, the patient needs to be advised of this before hand, not after it has happened. Very simply, when a client signs a HIPPA agreement or a payment agreement, they should also be told if the doctor is active on social networks and the patient should be aware that the doctor may run across their information online. Just as a fair warning. However, actively looking for patient information online still seems (excuse me choice of words) “icky”, if not completely unethical.

  5. August 18, 2010 at 9:45 am

    Again, as with George, please accept my apologies in the delay to responding to your questions. I don’t think I have all of the answers here, but why would a doctor need to review a patient’s Facebook or MySpace activities? What would be the point? While the lines of personal and private information are blurred with the infusion of social networks, I still believe doctor’s should respect some level of privacy for patients…. or at least tell the patient before hand that the doctor is active in social networking and may run across additional personal information about the patient not provided during the parameters of the medical visit.

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