Asking for medical advice on social media

Dr Chao-Yuan | Medicolegal consultant, Medical Protection Society

There may be times when you have a difficult medical case you would like to seek collegial advice on. With the availability of medical groups on social media, there are now opportunities to access colleagues from different backgrounds and specialties in forums, which often provide a friendly and supportive environment.

What are the considerations when asking for medical advice in these forums, and do the Medical Council of New Zealand (MCNZ) and employers have a position on this?

MCNZ has published a statement on the use of the internet and electronic communication, which says:

“Consider issues of privacy, security, and sensitivity when you communicate any health information electronically and ensure that you comply with the Health Information Privacy Code 2020. Information on social media can spread quickly and widely. Be careful with the information you share where that can be accessed by any member of the public.” 1 “An agency that holds personal information must ensure… (b) that, if it is necessary for the information to be given to a person in connection with the provision of a service to the agency, everything reasonably within the power of the agency is done to prevent unauthorised use or unauthorised disclosure of the information.”3

There may be unintended consequences of posting health information on a Facebook page regarding patients. A close relative of the patient might be a member of the group and recognise the case described. Comments might be made that are inadvertently perceived as negative and then shared with the patient. This can lead to potential breach of patient privacy and result in complaints.

What if you have patient consent?

Consent for such posts on social media can be difficult. This is because Facebook or WhatsApp groups often contain hundreds of members and, although they may be described as a ‘closed group’, they are not secure. Right 6 of the Code of Health and Disability Services Consumers’ Rights states the consumer has the right to be fully informed: When you discuss consent with a patient, would you be asking for consent to be posting their information on a Facebook page with ‘X’ number of members all from different backgrounds? Would you also be explaining that there is potential for their health information to be shared with individuals outside the group? Informed consent is therefore difficult to achieve.

In addition to the Code of Health and Disability Services Consumers’ Rights, Principle 5(b) of the Privacy Act 2020 states:

As a health professional it would be incredibly challenging to fulfil the requirements for the storage and security of health information posted on social media.

Once you have some suggested management strategies as advised by a social media group, there may also be obstacles for implementing them. For instance, what if the advice you receive is not recommended in your region, or you are not able to prescribe the treatment?

(1) Every consumer has the right to the information that a reasonable consumer, in that consumer's circumstances, would expect to receive, including… (b) an explanation of the options available, including an assessment of the expected risks, side effects, benefits, and costs of each option.2

1 MCNZ. (2021). Use of the internet and electronic communication. https://ww.mcnz.org.nz/assets/standards/4874967a0f/Statement -on-use-of-the-internet-and-electronic-communication.pdf 2 Health and Disability Commissioner. (1996). Code of Health and Disability

Services Consumers’ Rights. https://www.hdc.org.nz/your-rights/about-thecode/code-of-health-and-disability-services-consumers-rights/ 3 Privacy Act 2020 No 31 (as at 12 April 2022). Public Act Part 3: Information privacy principles and codes of practice. https://www.legislation.govt.nz/act/ public/2020/0031/latest/LMS23376.html