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Social media sites such as Facebook and Twitter can be easy, effective and efficient ways for physicians to connect with their patients, colleagues and others in the outside world. Unfortunately, those sites also can be easy, effective and efficient ways for physicians to get themselves in trouble with their patients, colleagues and others in the outside world.

The tricky part of social media is figuring how to maintain the sort of energetic and personalized presence expected on the sites without stepping over the line into legal and ethical troubles, or without saying something inappropriate that merely reflects badly on yourself.

To help walk that fine line, the American Medical Association recently enacted policy that provides physicians with guidance on social media conduct. The recommendations were approved during the AMA House of Delegates Interim Meeting in November.

The policy outlines some considerations doctors should make before they venture into social media -- or should make now that they're involved with it. The guidance covers not only professionalism in social media, but also professionalism for any online presence a physician might have.

Among the policy's recommendations:

• Physicians should not post identifiable patient information online and should otherwise be aware of standards of patient privacy and confidentiality that should be maintained in every setting, including online. Any interaction with patients online, as it is in the real world, should be in accordance with professional guidelines affecting the patient-physician relationship.
• Physicians should use any available privacy settings on social media and other websites, but they also should realize that safeguards are not absolute, and that any content put online is likely to stay there permanently. Therefore, doctors routinely should monitor their Internet presence (such as by running their name through a Google search) to make sure their personal and professional information on their own sites -- and others' -- is accurate and appropriate.
• To make it easier to maintain professional boundaries, physicians should consider separating personal and professional presences on social media and elsewhere online.
• If physicians see colleagues posting content that appears to be unprofessional, they should alert the doctors so they can remove it or take whatever appropriate action is necessary. If the doctors do not take action, and the content significantly violates professional norms, physicians must report the matter to the appropriate authorities.
• Physicians must recognize that any social media presence and actions online can negatively affect their reputations and consequences for their medical careers. The same goes for physicians-in-training and medical students.

The message to take away from this policy is not that physicians should avoid social media. With 500 million users worldwide on Facebook, for example, social media can be a great way to meet your patients and colleagues where they already are, and to spread messages about yourself, your practice and the health issues you care about.

Social media can give great power to what you have to say because of the ability to say something to hundreds or thousands of people at once, who then quickly can spread what you said to hundreds or thousands more.

That power is all the more reason to be careful what you are communicating. The AMA policy adopted in November addresses quite a few of the specifics, but the essence is easy to remember: If you wouldn't say or do something off-line, you probably shouldn't say or do it online, either.

The print version of this content appeared in the Dec. 27 issue of American Medical News.

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