It was probably inevitable.

Social media is so entwined with every aspect of our lives that it is becoming an active driver of Medical Board disciplinary work.

One recent case involved the posting of an operating room photo of a licensee and members of the surgical team, a draped patient’s naked abdomen visible in the background. The comments on the post included irreverent remarks by the licensee that would have been embarrassing- perhaps humiliating- to the unidentified patient.

Another case stemmed from a negative online review one licensee wrote disparaging a colleague’s competence after a contentious interaction over a mutual patient. In responding to the Board’s inquiry, the licensee who wrote the review refused to delete it, evidently seeing nothing wrong with medical professionals airing dirty laundry via Facebook recommendation.

Negative incidents involving physicians and social media most often flow from a failure to recognize that professionalism and the ethics of the medical profession extend to social media. The expectation of professional conduct does not end when a shift is over, or when the white coat comes off. There’s simply no walking away from one’s status as a medical professional.

To have any hope of maintaining this standard, medical professionals must actively question their words and actions, including on social media, to ensure they uphold an appropriate standard of professionalism. NCMB has no interest or intention to dictate what may or may not be appropriate, but the Board does have a position statement that provides general guidance on protecting oneself from inadvertent lapses on social media.

A relatively simple and straightforward way to self-regulate is to ask (ideally before posting anything on social media): Would I say this in front of a patient if we were face-to-face? Would I want my own physician to post something like this? Do I want to explain this to the medical board? If in doubt, just don’t post. Nothing is private on social media no matter what your settings say. Derogatory content or comments have a way of finding their way into the light.

NCMB doesn’t actively monitor medical professionals’ social media activity, but Board Members and staff do review it when patients, colleagues or others complain about a licensee’s online antics. Based on the still small but increasing volume of cases that involve social media of one kind or another, I have every reason to believe this will continue.

If you are not familiar, I highly recommend reviewing relevant guidance documents on maintaining professionalism on social media. In addition to NCMB’s own position statement entitled Professional use of social media, NCMB recommends reviewing the Federation of State Medical Boards' policy on Social Media and Electronic Communications, which was recently revised by a committee chaired by a former NCMB President, Cheryl Walker-McGill, MD. Finally, the AMA Code of Medical Ethics Opinion 2.3.2 - Professionalism in the Use of Social Media is another useful resource on this topic.

And, in case you are wondering, neither of the cases mentioned above resulted in public action against a licensee. NCMB did vote to issue confidential letters to the licensees involved, expressing the Board’s concerns and expectations for professional conduct.

The bottom line is that medical professionals are held to a higher standard of conduct because of the ethical and professional obligations inherent in the practice of medicine. Be mindful of this in all you do, online or otherwise.