been pondering getting a motorcycle, but after hearing what happened to Roger, changed his mind. Later that evening, Dr. Paul went on Facebook and proclaimed, “No motorcycle for me! I see what can happen when you crash your bike into a tree. Too bad. That was a nice bike and a beautiful tooth! I don’t think the scotch and water was worth it, but what do I know?” A couple of days later, Roger called Dr. Paul and was livid about the Facebook post. Apparently, Roger’s wife, who was a Facebook friend with Dr. Paul’s wife, saw the post and told Roger about it. Although Dr. Paul did not mention any names in his Facebook post, several people inferred that the post was about Roger. Before long, the post was “liked” and “shared” several times. Roger was upset that his reputation in town might be ruined. Dr. Paul felt terrible, but the damage was already done. It can be seen in a situation like this that, even without specifying names, it is possible to reveal sensitive information on a social media site. This case is a good example of a situation in which a dental professional can reveal information other than medical information. The unintended consequences of a seemingly innocent Facebook post may have caused significant collateral damage. Dental professionals need to exercise extreme caution when posting anything remotely connected to a patient on public forums that would allow identification by association. Increasingly, more professional societies are setting standards regarding the use of social media and the Internet in professional practice. The ACD has published a position paper on the use of digital communication in dentistry (ACD, 2016). To honor the professional standards of dentistry, the ACD holds that dentists should adhere to the following eight principles when engaging in the use of digital communication, including social media: 1. The professional relationship between dentist and patient should not be compromised by the use of digital communication. 2. Digital communication should not permit third parties to influence the dentist-patient relationship. 3. Dentists should exercise prudence to ensure that messages are professional and cannot be used in unprofessional ways by others. 4. Personal data should be protected and professional communication should be separated from personal communication. 5. Dentists should be generally familiar with the potential of digital communication, applicable laws, and the types of information to which patients have access on the Web. Social media and social networking The digital age has arrived, and it is here to stay. Young adults, including recent dental school graduates, have grown up with computers and other electronic devices. They communicate with others and learn and see the world through a digital lens. The use of digital communication for social media and social networking is a relatively new phenomenon compared with the use of computers themselves for performing tasks. Individuals communicate on many levels using social media and social networking. Digital communication: Social media versus social networking According to Chambers and the Officers and Regents of the American College of Dentists (2012). digital communication can be classified into three general categories: broadcast, relationship, and transaction. Broadcast communication conveys information (e.g., advertising, blogs, public service announcements, online journals) through a one-way digital channel. The entity generating the information is trying to influence or inform consumers, but direct and personal communication between the parties is not usually expected. Dentists and other healthcare professionals may use broadcast digital communication to advertise their practices or gather information. Social media encompass broadcast digital communication, but social media are more than the
6. Practitioners should maintain an appropriate distinction between communication that constitutes the practice of dentistry and other practice-related communication. 7. Responses to criticism on digital media should be managed in a professional manner. 8. Dentists should be prepared to make more accommodations for patients than patients make for dentists in resolving misunderstandings about treatment. As can be seen, privacy and dual relationship issues form the core of these recommendations. The image of the profession as a whole is at risk when individual members engage in unbecoming behavior. The bad behavior of one will reflect on all. Social media as with any other technological advancement can have beneficial applications and those which are inappropriate. Within the context of social media use in the dental profession it is essential that patient confidentiality and date protection remain the highest priority. Similarly, disparaging remarks about current or former employees or about other dental professionals must not be used. Once in cyberspace, such remarks cannot be retrieved (Bahabri and Zaidan, 2021). Although casual conversations with patients in the dental office may include some self-disclosure of personal information about the provider and can actually help build rapport, individuals may take online posts out of context and misconstrue them. Patients may feel vulnerable or distressed if they learn information about a provider that is troublesome to them outside the normal realm of the professional relationship Clinicians who use social media must not use information that is demeaning to themselves or of the dental profession as such comments can form a negative image of both the individual clinician and the entire dental profession (Bhola and Hellyer, 2016). Potential employers also may search a healthcare professional’s Facebook page. What is online is fair game. Any incriminating information obtained could affect potential employment. Facebook claims to have an average of 1.47 billion daily active users as of June 2018 (Facebook, 2018). The chance of leaks of sensitive information on either side of the dental chair is increasingly possible. Dental clinicians and all of their staff members must respect the confidentiality of the patient’s personal dental and medical information and that a breach of this security and trust can to legal problems lead and can also be considered a (HIPAA) violation if confidential patient information is made public (Bhola and Hellyer, 2016). dissemination of information, as the next two categories will show. Relationship digital communication involves an exchange of information between or among parties. The purpose of the exchange of information is to build relationships through the messages conveyed. Facebook, Google+, and LinkedIn are examples of relationship digital communication. Relationship digital communication is primarily what “social networking” entails, but it is also another form of social media. Social networking is essentially online relationship building. It is the active engagement of two or more parties communicating back and forth. Transaction digital communication simply means doing business online. Purchasing items online is now commonplace. Dental practitioners may order supplies online, register for meetings, collect payment for services, and submit insurance claims, to name a few actions in this category. Digital transactions and communication between dental offices and insurance companies are becoming commonplace. Although the practice of engaging in transactions online to transmit financial or patient information is becoming more common, dentists need to be aware that security and confidentiality are still vulnerable and require protection (Bhola and Hellyer, 2016).
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