The idea that doctors are promoting treatments on social media has gotten some attention from media outlets over the past few years, and associations and states are starting to take notice of the growing “concern.” One of those states is Massachusetts, where in December, the Massachusetts Medical Society adopted a rule requiring its members to divulge all financial relationships regarding any medical procedure or service they review or discuss online. The rules even require physicians to disclose any free products or services they have received from drug companies.
The guidelines like this takes both the Sunshine Act and the American Medical Association guidelines regarding social media even further that one may have imagined. As stated in the Massachusetts Medical Society Social Media Guidelines for Physicians,
Physicians must disclose all relationships they have with regard to the maker or provider or products and services they review or discuss in online communities. This includes discussions and reviews of products and services provided to the physician for free.
This stands in contrast to the American Medical Association guidelines on social media, which are more focused on the patient-physician relationship on social media: that physicians should be aware of patient privacy and confidentiality standards and maintain them in all environments, including online environments; that physicians must maintain appropriate boundaries of the patient-physician relationship in accordance with professional ethical guidelines; and a warning that actions online and content they post may have an impact on physicians’ reputation in the community among patients and colleagues, may have consequences for their medical careers, and may lead to an undermining of public trust in the medical profession.
Once concern with a rule like the one in Massachusetts is that disclosure is not feasible in some forms of social media. Twitter, for example, only allows users 140 characters to get their point across. Sure, physicians can tweet out a string of tweets, some of which get their point out there and others that make disclosure notes, but the layout of Twitter and the way users tend to read through their timeline don’t really lend themselves to such use.
It is also arguable that in social media formats like Facebook, where it is feasible for a disclosure to be made at the outset or the close of a post, a variety of people will either not read the post after a disclosure, and a disclosure at the bottom of a post may result in readers not reading that far down, ignoring the disclosure all together.
And, of course, as with any form of additional disclosure, a valid concern is that disclosing such information will be a source of confusion for patients and colleagues. It is interesting that there is no request for disclosing financial relationships with referring hospitals, health systems or ambulatory surgical centers which also can be a strong interest for physicians.
The Massachusetts Medical Society claim that “Social Media is Different” because social media can connect patients with other patients, without any professional intermediation and that in social networks, everyone is a potential publisher, and that means that professionals are no longer the sole source of information. Similar lines can be drawn between friends interacting in person at social events, or even over the phone. Requesting disclosure on social media was the next logical step for the disclosure movement. Before long, physicians may have to read off a disclosure before they speak with anyone in public including their patients.
In full disclosure, the editor of Policy and Medicine was expelled from his school in the second grade for switching classes with his Identical twin brother. It has been downhill ever since.