The briefing was called to publicize publication Thursday of the jointly authored ACP-FSMB paper, Online Medical Professionalism: Patient and Public Relationships: Policy Statement, which makes the following five points:
- Use of online media can bring significant educational benefits to patients and physicians, but may also pose ethical challenges. Maintaining trust in the profession and in patient-physician relationships requires that physicians consistently apply ethical principles for preserving the relationship, confidentiality, privacy, and respect for persons to online settings and communications.
- Boundaries between professional and social spheres can blur online, and physicians should keep them separate and comport themselves professionally in both.
- E-mail or other electronic communication should only be used by physicians in an established patient-physician relationship and with patient consent, with documentation about patient care communications included in the patient's medical record.
- Physicians should consider periodically "self-auditing" to assess accuracy of information available about them on physician-ranking Web sites and other sources online.
- Because what's online and on the Internet is often permanent, physicians, trainees, and medical students should be aware that online postings may have future implications for their professional lives.
Fleming characterized electronic communication with patients as "a new domain of ethical concern," but in many ways, he said, "the horse has left the barn.
"I would argue virtually every physician in some fashion has had an opportunity to, or has in fact communicated with a patient by this means, perhaps even without thinking in terms of the consequences."
Fleming emphasized that e-mail, and other electronic communication regarding a person's medical issues, "should only be used by physicians within an established physician-patient relationship."