An FY1 doctor saw a 19-year old female patient during a busy Friday evening shift in A&E. The patient and her friend had been heading out for the evening when she twisted her ankle.
The FY1 doctor took a careful history and the patient's friend commented that an injured ankle was the price to pay for wearing 'gorgeous heels that make her legs look good'. The FY1 doctor laughed along with the patient. He examined her ankle, diagnosed a sprain and provided analgesia, advice and reassurance.
The following day, the FY1 doctor was surprised to find that he had received Facebook friend requests from the patient and her friend. He accessed the patient's profile and found a 'check in' from A&E the previous night indicating that she had been treated by a 'seriously hot' doctor.
Feeling flattered, the FY1 doctor telephoned the MDU medico-legal advice line and asked whether he could accept the friend requests. He explained that he was new to the area and wanted to make friends, but a fellow FY1 doctor had told him that he should decline the requests.
The FY1 doctor admitted that he considered the patient to be attractive, and would be interested in meeting up with her again.
The MDU adviser asked whether the doctor had invited the friend requests. He explained that he hadn't, but that he did have an unusual name and his Facebook profile picture was a clear image of him, and so his profile would not be difficult to find.
The MDU adviser explained that in its guidance, Maintaining a professional boundary between you and your patient, the GMC explains that a doctor must not pursue a sexual or improper emotional relationship with a current patient. The guidance goes on to explain that personal relationships with former patients may also be inappropriate, depending on the length of time since the professional relationship ended, the nature of the professional relationship and the degree of vulnerability of the patient.
The doctor explained to the MDU adviser that he would not have any ongoing professional relationship with the patient. However, it was still a very short time since the professional relationship had ended.
Although disappointed that he could not accept the friend requests, the doctor concluded that it would be inappropriate to begin a personal relationship with the patient or her friend.
A doctor must not pursue a sexual or improper emotional relationship with a current patient.
The MDU adviser encouraged the doctor to check his privacy settings to ensure that patients would be unable to access his personal contact details, photographs and information.
He was also advised not to post any information that could identify a patient, including in any conversations with colleagues in online discussion groups.
The MDU adviser explained that the GMC has published guidance on doctors' use of social media which states that social media creates risk where social and professional boundaries blur. The guidance states that it would be inappropriate to engage in conversation with a patient about clinical care through a social media forum, and that any patients who make contact in this way should be advised to contact the doctor through an appropriate professional route.
Finally, the FY1 doctor was advised that the GMC states that doctors should follow their employer's policy on using social media. She advised him to check his trust's intranet for a copy of their policy.
This is a fictionalised case compiled from actual cases from the MDU's files.