Posting Photos of Patients in Social Media

According to Digital Global Overview [1], Philippines is the leading nation in terms of the amount of time spent using the social media. We spend 4.17 hours daily on social media. Almost 58% of our population are active social media users, doctors and medical students included. Social media is one of the most powerful platforms for information dissemination if not the most powerful. This platform allowed easier health promotion and education online, professional networking among healthcare professional and sharing experiences online. However, as medical students and future healthcare professionals, there is a limit to the kind and amount of information that we can post online especially if it concerns our patients. 

Pics or it didn't happen. Almost every detail of our lives are documented online. It is very tempting to capture our milestones in medical school and post it in our social media accounts. Of course, we want to celebrate and tell the world everything that we learn and accomplish in medical training. However, for us medical students and professionals, there are stricter rules when it comes to posting in social media. We should always maintain confidentiality, professionalism and privacy of our patients. 

According to Palacios-Gonzales, clinical photographs can be taken by a clinical photographers or doctors [2]. Doctors should only use clinical photography for the patient's care or for medical education and research. Other than this, the author did not mention any other ethical use of clinical photography. Personally, I find posting pictures of patients for advocacy and campaign acceptable because this will be beneficial for the patients. It will be useful in spreading awareness about certain disease, removal of stigma or gathering funds for specific patient groups. 

In some medical schools and hospitals abroad, posting pictures of patients online even with consent is not allowed. It is considered unethical because doing so will not actually help or improve the prognosis of the patient. If you really need to post pictures of your patients online, an informed consent should be obtained from the patient. When getting informed consent, the patient should know why you are taking the picture, the patient must be competent to reason about the possible outcomes of accepting the proposed procedure and the patient's consent is not forced, manipulated or improperly influenced. The patient should be notified that once the image is posted online, the picture and information can be copied, stored and distributed without the knowledge of the person who uploaded the photo or video.

Just be careful in posting pictures of your patients online. Just keep in mind that we have a data privacy act in the Philippines which is a policy to protect the right of privacy of a person. Violating this can result to penalties such as fine and imprisonment. Be careful when posting selfies inside the hospital because there is a possibility that patients or patients' information can be captured at the background of your selfie. There have been several cases of doctors accidentally taking pictures of patients behind them during a selfie. There were incidents abroad of medical students posting pictures of patients online without consent and they were expelled from the university. 

We should always keep in mind patient confidentiality. Breaches of confidentiality or patient privacy on social media can occur in several ways [3]. 

• When you post a video or photo of a patient, even if they cannot be identified. 
• When you post photos or videos that reveal room numbers or patient records. 
• When you post anything that pertains to the description of your patients, their medical conditions and treatments. 
• When you refer to a patient in a degrading or demeaning manner.

Our patients entrust their bodies to us. They share even the most confidential information about them in order to help us arrive at an exact diagnosis. Some of our patients might not want their pictures or diagnosis posted online. Even though our patients cannot be identified by posting diagnostic results  such as histopathology slides, X-ray, CT scan etc, online, it is still unprofessional to discuss it or post it online. Always think before you click. Always bear in mind the pitfalls and risks of posting photos taken in clinical settings on social media. Reflect whether what you post online will benefit your patients or not.

Sources

[1] https://wearesocial.com/sg/blog/2017/01/digital-in-2017-global-overview

[2]Palacios-Gonzales C. 2014. The ethics of clinical photography and social media. Med Health Care and Philos. DOI 10.1007/s11019-014-9580-y

[3] http://everynurse.org/nurses-using-social-media/