Results of a survey published in a research letter in JAMA this week, reveal that sexual misconduct and prescribing without an established clinical relationship are among the most common ever reported online violations of professionalism by doctors in the US.

For their survey, Dr S. Ryan Greysen, of the University of California, San Francisco, and colleagues invited 68 executive directors of all medical and osteopathic boards in the US to respond to questions about violations of online professionalism by physicians reported to them and the subsequent actions taken.

48 out of the 68 surveyed (71%) responded, and the majority (92%) said that at least 1 of several examples they were given of online professionalism violations had ever been reported to their board.

Among the most common violations reported were inappropriate patient communication online (including, for example sexual misconduct, 69%), using the Internet for inappropriate practice (for instance, prescribing to people with whom there is no established clinical relationship 63%), and online misrepresentation of credentials (60%).

Respondents also answered questions about how they dealt with the reports. 71% of boards have held disciplinary hearings. Of these, 50% have been formal hearings, and 40% were settled by the doctor agreeing to sanctions without a hearing (consent orders).

40% of boards have also issued formal warnings, while 25% said there was at least one case where no action was taken.

56% of boards had taken serious disciplinary actions, such as restricting lincenses to practice, suspension, and revocation.

Greysen and colleagues write that while concerns about doctors violating their professionalism online have caused organizations like the American Medical Association to write guidelines about how to use (and not use) social media, “there is no information about oversight by licensing authorities for physician uses of the Internet or disciplinary consequences for violations of online professionalism”.

Written by Catharine Paddock PhD