Violations of Professionalism Online a Growing Concern for Physicians, Patients

    • March 20, 2012

San Francisco, CA – Violations of online professionalism are prevalent among physicians, according to a new study published in the Journal of the American Medical Association (JAMA). The study, conducted by Robert Wood Johnson Foundation Clinical Scholars at Yale, in collaboration with the Federation of State Medical Boards (FSMB), found that 92 percent of state medical boards in the US have received reports of violations of online professionalism.

“As the use of social media increases, physicians need to consider their online behaviors and how those activities may affect their practice and their patients,” says Ryan Greyson, MD, MHS, MA, the lead author and Assistant Professor of Hospital Medicine at the University of California, San Francisco. “This issue is important, especially considering that social media use among physicians is growing at a faster rate than among the general public.”

The study was based on a survey of the 68 executive directors of all medical and osteopathic boards in the United States and its territories. Greyson and his colleagues found that reported violations included:

  • inappropriate contact with patients online (69 percent);
  • inappropriate prescribing (63 percent); and
  • misrepresentation of credentials or clinical outcomes (60 percent).

In response to these violations, 71 percent of boards held formal disciplinary proceedings and 40 percent issued informal warnings resulting in serious actions such as license limitation (44 percent), suspension (29 percent), or revocation (21 percent). 

Research shows that nearly 90 percent of physicians use a social media website for personal use, and 67 percent use social media professionally.

“Digital media has enormous potential for doctors and patients allowing us more opportunities to share information and establish meaningful professional relationships,” says FSMB Chair Janelle A. Rhyne, MD, MACP. “But physicians also need to be educated about how to maintain the same professional and ethical standards in their online activity. Failing to do so can hurt patients and end careers.”

In April, FSMB plans to release ethical and professional guidelines for the use of electronic and digital media by physicians (and physician assistants, where appropriate) including e-mail, texting, blogs and social networks. The guidelines will address the following areas to help physicians protect themselves from unintended consequences of online engagement and to maintain the public trust: 

  • Protecting the privacy and confidentiality of their patients;
  • Avoiding requests for online medical advice;
  • Acting with professionalism and being aware of potential conflicts of interest; and,
  • Being aware that information they post online may be available to anyone, and could be misconstrued.

“All health care providers, doctors, nurses, physicians assistants and others need to consider their online behavior and how it could affect patients and the practice of health care,” cautions Greyson. “While these guidelines are being developed for physicians, it is critically important that all health care professionals be educated about how to engage online professionally and ethically.”



The Federation of State Medical Boards (FSMB) is a national non-profit organization representing the 70 medical and osteopathic boards of the United States and its territories.

For more than three decades, the Robert Wood Johnson Foundation Clinical Scholars program has fostered the development of physicians who are leading the transformation of health care in the United States through positions in academic medicine, public health and other leadership roles. Through the program, future leaders learn to conduct innovative research and work with communities, organizations, practitioners and policy-makers on issues important to the health and well-being of all Americans. This program is supported in part through collaboration with the U.S. Department of Veterans Affairs. For more information, visit