When a patient seeks medical advice via social media.

Situation

I’m a doctor and have received a follow request from a patient that I recently met during an appointment. Shortly after sending the follow request, the patient sent me a direct message asking for advice about a new rash, and asking whether she can start antibiotics that their partner has left over from a recent prescription.  

I feel uncomfortable accepting the follow request and responding to the private message. Can I ignore these? 

Regulatory advice

If a patient contacts you about their care through social media, you should direct them to an appropriate healthcare setting for further support. 

The General Medical Council (GMC) has specific guidance on the use of social media, including practical advice within its ethical hub. They also offer advice tailored to students and their use of social media and say: 

“You must maintain appropriate boundaries with patients and must not use social media to discuss individual patients or their care.” 

MDDUS advice

It is understandable to want to respond to and offer advice to patients, however, this should be avoided on social media. Where possible, you should try to avoid having patients on your personal social media accounts.  

If you receive a notification that a patient wishes to connect via social media, for example, you may wish to simply ignore this.  However, if they try to connect to seek clinical advice from you, you should respond politely and neutrally, or signpost them to contact a clinician at their GP practice for advice.  

Accepting follow requests or engaging in clinical discussions via personal social media accounts can: 

• Blur professional boundaries 
• Create expectations for informal or out-of-hours care 
• Risk confidentiality breaches. 

Social media platforms are not secure for sharing personal health information. Messages and images could be accessed by third parties or stored in ways that breach data protection laws.  

Providing advice without access to the full medical record or a proper assessment could lead to inappropriate or unsafe care.  

When using social media for either personal or professional reasons, we advise: 

• Review and maintain your privacy settings
• Report any concerns of inappropriate contact from patients if you feel they are placing themselves or your boundaries at risk, to either the social media platform or your own supervisor
• Patient information should not be shared on social media platforms irrespective of privacy settings  
• Follow GMC guidance on the use of social media to prevent risks of professional misconduct.

While not drawn from a real case, this hypothetical example represents a situation that could arise.