You may entrust your doctor with your life, but is it OK to "friend," tweet or text him or her? For many patients, these might be natural impulses: Who hasn't wondered about that person behind the white coat?
While some physicians willingly friend patients -- and endorse social media as a way to bring them closer to patients -- others say it crosses a boundary.
Bryan Vartabedian, an assistant professor of pediatrics at Baylor College of Medicine and a consultant on social media strategy and policy, says that as long as both doctors and patients know the rules of engagement, social media is fair game.
Rules of the Game
"We are prohibited by law from having patient-specific conversations [on social media]. I simply can't engage in that space," Vartabedian says. "It's kind of like when I am at a cross-country meet with my son and I see a patient I know. Families know it's not the right place to talk about their child's care."
Vartabedian does have a few exceptions to his own no-"friending" rule. "I have what I call my breaking-bread threshold. If my wife and I would have dinner with them, or exchange Christmas cards, they've crossed that threshold."
He generally recommends that doctors avoid engaging with patients through social media on a personal level, but do so on an institutional level. "Pediatricians have Facebook pages for their practices," Vartabedian says. "They use it as a space to talk about the availability of flu vaccines or new office hours."
Especially for millennial moms, he adds, Facebook is often the primary means of communication -- but it does not replace consultation, say, about a baby with a persistent fever.
Some doctors shy away from social media because they worry patients will seek clinical advice on it. "What do you do when patients reach out on Twitter and ask about medication dose?" he says. "That's a common concern that keeps doctors offline."
"My general recommendation is that we don't practice medicine online," says Farris Timimi, the medical director of the Mayo Clinic Center for Social Media in Rochester, Minnesota.
[ Read: 5 Tips for a Smooth Doctor's Visit .]
Partnering with Patients
But Timimi does, through the Mayo Clinic, use Facebook, Twitter (especially Twitter chats), Instagram, Pinterest and Google Plus to provide general information to patients. He says that these platforms are an efficient way to partner with patients.
For example, in one week, Timimi may counsel 20 diabetic patients on the same issues. With social media, instead of repeating himself, he will make one recording and post it on YouTube. "The patient can watch it before their visit; they can forward it to their kids or spouse or whoever takes care of the patient and does the grocery shopping," he says.
This elevates the patient-doctor conversation. "Instead of beginning the conversation at ground zero, it's much higher."
And studies have shown that patients with access to social media have better clinical outcomes than those without it, Timimi adds. "Patients who are informed have the capacity to be their own expert of their disease. The value of the educated consumer is profound."
For patients, too, staying plugged into social media keeps them in critical conversations -- particularly if they suffer from rare diseases or live in remote areas, Timimi adds.
Humanizing the Doctor
Timimi calls social media "a critical part of any physician's armatorium." Apart from using social media as a tool to disseminate information, "I think there's a real upside to patients seeing the other side of a physician's life," he says. "There's an element of transparency that humanizes the doctor and I think could potentially draw a closer relationship between the doctor and patient."
Like anything else, savviness in social media involves training, Vartabedian adds. His blog, 33 Charts, on social media and medicine, includes social media guidelines for doctors.
At the Mayo Clinic, Timimi offers a one-and-a-half day crash course in using social media. "Health care providers hold human lives in their hands. They can be trained to handle Twitter," he says.
Still, social media transgressions do occur. And the top three offenses that doctors commit, according to the Federation of State Medical Boards, are prescribing without a previous patient relationship, misrepresenting credentials and creating inappropriate relationships -- the same ones that also occur offline.
But violations of patient privacy rarely happen, Timimi says.
Tips for Patients
Patients should be the ones to initiate social media engagement with physicians, Vartabedian says. "Now when you go to the doctor, an important question for patients to ask is, 'How can I communicate with you?'"
Some doctors are more old school and limit communication to the telephone. Others send text messages, although that is "trickier," he adds, because it's not considered privacy-protected.
Timimi says that patients engaging with doctors other than their own in the virtual space should make sure that those doctors are not anonymous. "They should be transparent about who they are and what they represent," he says. "If it's an established community, always consider going back to a more reputable source [in that community]."