Physicians fail to disclose conflicts of interest on social media

November 12, 2012

As the use of Twitter and other social media by physicians and patients rises, more and more physicians seem to forget to do what many consider crucial for building doctor-patient trust: disclose potential conflicts of interest. However, physicians are not entirely at fault: prominent medical societies have failed to lay out comprehensive guidelines for physicians on when and how to disclose a conflict of interest when utilizing social media.

In a commentary published online in the , Matthew DeCamp, M.D., Ph.D., a in the Johns Hopkins University School of Medicine's Division of General Internal Medicine, argues that some use social media to give advice to patients and the public without revealing drug industry ties or other information that may bias their opinions. Without serious efforts to divulge such information—standard practice when publishing in medical journals and recommended in one-on-one contacts with patients—DeCamp says consumers are left in the dark.

"As physicians and patients increasingly interact online, the standards of appropriate behavior become really unclear," says DeCamp, who also holds a fellowship at the Johns Hopkins Berman Institute of Bioethics. "In light of norms of disclosure accepted throughout medicine, it's surprising that major fail to adequately address this issue."

Among the national organizations that have issued social media guidelines are the American Medical Association and the Federation of State Medical Boards.

DeCamp acknowledges that use of social media has the potential to improve patient care and trust by increasing patient access to information, but vigorous online "boundaries" are needed to not only assure privacy and confidentiality, but also to protect patients from misinformation and biased advice.

In an office setting, for example, when doctors prescribe a , professional guidelines say they are ethically bound to tell patients if they have any financial relationship—such as receipt of consulting fees—with the company that manufactures the drug. Guidelines also call for disclosure when they publish studies about blood pressure medication, and require them to fill out a detailed disclosure form. But online, it's "an unacceptably gray area," DeCamp says.

One reason may be difficulty in determining just how to disclose within the constraints of the online world, DeCamp notes. The popular social media tool , for example, allows each entry to be just 140 characters long. But a generic disclosure—"The author has no to report related to this tweet"—has 70, leaving little room to discuss the research itself.

DeCamp says one solution is the use of electronic tags that disclose and follow the information tweeted—and re-tweeted—by a physician. At the very least, he says, doctors should post potential conflicts in their online profiles, and consumers should be wary of posts and advice from anyone claiming to be a doctor.

One social networking website known as Sermo.com is open to physicians only and is designed to facilitate discussions of treatment options. But DeCamp says the relative anonymity of the site means users don't know about the potential conflicts of peers they encounter there, and whether information is biased because of financial conflicts. Although the site recommends voluntary disclosure, it is not required or monitored, he says.

Healthtap.com is billed as a free virtual "house call" service linking patients with physicians who quickly provide online answers to patients' questions. Although physicians are identified by name, and the site terms require physicians to disclose, studies suggest physicians sometimes fail to disclose in the online realm. Patients again might be unable to tell whether conflicts have biased the answer.

The absence of stricter guidelines for online doctor-patient interactions is especially puzzling, DeCamp says, given the move to ever-stricter disclosure requirements offline. There has been a movement from simple disclosure to better efforts to manage and eliminate conflicts.

While some professional guidelines do recommend disclosure in social media, DeCamp says, they don't lay out how it should be done, while many ignore the topic altogether.

"The history of conflict of interest in medicine is such that you don't want to be late to the table," DeCamp says. "You need to be proactive so that your undisclosed conflict doesn't end up on the front page of The New York Times. Conflicts need to be disclosed and it's surprising that we have so far to go regarding disclosure and management on ."

Explore further: Disclosure of financial conflicts of interest may worsen medical bias

Related Stories

Disclosure of financial conflicts of interest may worsen medical bias

April 24, 2012
"Journals, professional associations, clinical guideline developers, and others need to worry not just that disclosure provides a band-aid to the real problem of the [conflict of interest] itself, but that any attempt to ...

Spine society assesses adoption of conflicts of interest policies

October 29, 2012
(HealthDay)—The North American Spine Society (NASS) has adopted strict divestment and disclosure policies with no detrimental effects, according to research published online Oct. 22 in The Spine Journal.

Researchers recommend 'dual citizenship' on social media

April 18, 2011
With ubiquitous social media sites like Facebook and Twitter blurring private and professional lines, there is an increasing need for physicians to create a healthy distance between their work and home online identities, ...

Recommended for you

Exploring the potential of human echolocation

June 25, 2017
People who are visually impaired will often use a cane to feel out their surroundings. With training and practice, people can learn to use the pitch, loudness and timbre of echoes from the cane or other sounds to navigate ...

Team eradicates hepatitis C in 10 patients following lifesaving transplants from infected donors

April 30, 2017
Ten patients at Penn Medicine have been cured of the Hepatitis C virus (HCV) following lifesaving kidney transplants from deceased donors who were infected with the disease. The findings point to new strategies for increasing ...

'bench to bedside to bench': Scientists call for closer basic-clinical collaborations

March 24, 2017
In the era of genome sequencing, it's time to update the old "bench-to-bedside" shorthand for how basic research discoveries inform clinical practice, researchers from The Jackson Laboratory (JAX), National Human Genome Research ...

The ethics of tracking athletes' biometric data

January 18, 2017
(Medical Xpress)—Whether it is a FitBit or a heart rate monitor, biometric technologies have become household devices. Professional sports leagues use some of the most technologically advanced biodata tracking systems to ...

Financial ties between researchers and drug industry linked to positive trial results

January 18, 2017
Financial ties between researchers and companies that make the drugs they are studying are independently associated with positive trial results, suggesting bias in the evidence base, concludes a study published by The BMJ ...

Best of Last Year – The top Medical Xpress articles of 2016

December 23, 2016
(Medical Xpress)—It was a big year for research involving overall health issues, starting with a team led by researchers at the UNC School of Medicine and the National Institutes of Health who unearthed more evidence that ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.