JAMA: Regulators need to address physician online practices

Most U.S. medical licensing authorities reported incidents of online professionalism violations by physicians, many of which resulted in serious disciplinary actions, according to a survey published March 21 in the Journal of American Medical Association.

S. Ryan Greysen, MD, division of hospital medicine, University of California, San Francisco, and colleagues surveyed 68 executive directors of all medical and osteopathic boards in the U.S. and its territories about violations of online professionalism reported to them and subsequent actions taken.

With a response rate of 78 percent, 92 percent indicated that at least one of several online professionalism violations reported had ever been reported to their board. “The most common violations reported were inappropriate patient communication online, eg, sexual misconduct (69 percent for less than or equal to one violation[s]); use of internet for inappropriate practice (63 percent) and online misrepresentation of credentials (60 percent),” the authors wrote.

In response, 71 percent of boards held disciplinary proceedings, including formal hearings and issuing of consent orders. “Collectively, serious disciplinary outcomes of license restriction, suspension or revocation occurred at 56 percent of the boards.”

"Professionalism is a core competency required for maintenance of licensure and specialty recertification. Regulators and physicians should therefore address emerging online practices," the authors concluded. "In addition, as state licensing boards monitor physicians for breaches of professionalism, categorizing online professionalism violations separately could be of value to better gauge the extent of this problem. Our findings highlight the need to promote physician understanding and self-monitoring of online professionalism and to create consensus-driven, broadly disseminated principles to guide physicians toward high-integrity interactions online."