Can physicians be among the billion-plus social media users and still maintain their intact personal and professional boundaries?

Despite recommendations from professional organizations that say physicians should have separate personal and professional identities in order to respect their doctor-patient relationships, an editorial in the Aug. 14 issue of JAMA argues the line between professional and personal profiles can be blurred, as long as content they post is appropriate for public consumption.

“Separation of identities online is operationally impossible,” wrote the editorial’s authors, Matthew DeCamp, MD, PhD, Thomas W. Koenig, MD, and Margaret S. Chisolm, MD, of Johns Hopkins University in Baltimore. “With minimal information, searching the web can quickly connect professional and personal content.” Additionally, personal and professional identities are part of each other, so, they argued, separation makes little sense.

Rather than being a risk to their professional integrity, combining online presences is what physicians prefer. It is also “inconsistent with the concept of professional identity, and potentially harmful to physicians and patients.”

Physicians may see the blurring of online identities as facilitating transparency and open communication with patients. They may envision social media as a way to capture the “small-town physician” relationship with patients. In addition, a strict separation of the professional and personal may cause patients to be less trusting and not see their doctors as people.

“Resolving the online identity crisis requires recognizing that social media exist in primarily public or potentially public spaces, not exclusively professional or personal ones,” the authors wrote. Instead of determining whether a post is professional or personal, physicians should assess whether it’s appropriate.

Medical training should include social media and how it can be used to develop professional identity.

“Absent this approach, the professional transgressions motivating guidelines will persist and the potential benefits of social media will remain unrealized,” the authors concluded.