Looking Up Patients Online: Why It's a Bad Idea

By Stoltz, Tyler R.; Joshi, Kaustubh G. | Current Psychiatry, November 2018 | Go to article overview

Looking Up Patients Online: Why It's a Bad Idea


Stoltz, Tyler R., Joshi, Kaustubh G., Current Psychiatry


Searching for someone on the Internet and viewing his or her social media profile is an effective way to obtain information about people, including patients. Following our patients' "digital footprint" may help us understand the context of their lives, reconcile discrepancies in what they have told us, or allow us to confront denial and address incomplete reporting. (1) However, perusing our patients' online profiles could negatively impact treatment and adherence. Consider these factors before looking up your patients' online profiles (1-3):

Inaccurate information. Information on the Internet, especially what you can find on user-generated forums, is largely unregulated; as a result, the veracity of that information cannot be guaranteed. (1) Patients may choose to portray themselves inaccurately on their online profiles, and their identities often cannot be confirmed. Even if some information is accurate, you might discover things that you did not expect to learn about your patients, including important information that they did not share, or even something they lied about. This can create the conundrums of what to do with such information and how to discuss it at the next visit.

Impact on treatment. Despite patients' online activities being displayed for the world to see, many patients do not expect their clinicians to access their online information. They might perceive such perusal as a breach of trust, which might lead some to view the doctor-patient relationship as adversarial. Accessing this information also could create a more intimate relationship than intended. Even if a clinician acquires consent to perform a search, patients may still feel coerced into allowing it because they might feel that declining to grant permission would make the clinician suspect that they have something to hide, or that the clinician would search without consent. (2)

In addition, if patients are aware that their psychiatrists are monitoring them, they might change their behavior. For example, they may delete certain data, add additional information that may not be accurate, or censor future social media posts. Knowing that their clinicians could be paying attention to them around the clock also might motivate certain patients to act out more or become withdrawn.

Possible medicolegal repercussions. If clinicians are able to access their patients' electronic profiles, are they then legally obligated to monitor them? …

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Looking Up Patients Online: Why It's a Bad Idea
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