This document discusses ethics and social media in physical therapy. It defines social media and networking, and identifies their purpose of connecting people. Various social media platforms are discussed, along with statistics on their usage. Ethical and legal issues with social media use are identified, including maintaining privacy and confidentiality. Guidelines are provided for physical therapists to make ethical decisions regarding social media use and to develop a professional online presence.

1. Ethics and
Social Media
Tarang Kumar Jain, PT, DPT, CEEAA

2. Objectives
2
 Define social media/networking & it's purpose.
 Discuss the types of social media and list the statistics
associated with various social media platforms.
 Identify the ethical and legal issues associated with social
media use.
 Associate the ethical decision making analysis in relation to
using social media.
 Discuss considerations for developing a social media
strategy for PT clinics.
 Finally, identify social media do's and don'ts/steps for safer
social networking.

3. Social Media
3
 “Social” – refers to instinctual needs humans have to
connect with other humans
 “Media” – what we use to make connections with other
humans
 “Social Media” – how we can use technology effectively to
reach out & connect with other humans, create a
relationship, build trust
 Media used for social interaction
 2 way communication - interactive dialogue
 Moving from monologue (one to many) to dialogue (many to
many)
 Changing people from content readers into contributors and

4. Social Media Landscape
4

5. Social Networking
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 “It's the way the 21st century communicates today.”
 A social network service is an online service, platform, or
site that focuses on building & reflecting social relations
among people who share interests &/or activities
 Essentially consists of a representation of each user
(profile), social links, & other services
 Most are web based; interact through internet, email, instant
messaging(chatting), or phone applications
 Social networking accounts for 22% of all time spent online
in the U.S.

6. Relationships between Social
Media and Networking
6
SOCIAL MEDIA SOCIAL
NETWORKING
 Social media is
disseminated through  A focus on building
social interaction social relationships
 Based on user among people
participation and
user-generated  Building online
content communities
 A shift in how people  Interactive
discover, share, and communication among
read news and participants
information

7. Why Social Media/Networking
Matters for Physical Therapists?
7
 Become a better clinician
 Contribute to the body of physiotherapy knowledge
 Make professional connections
 Influence healthcare conversations
 Get educated
 Promote better health among the public
 Sell your services
 Peer review research

8. Popular Social Media Platforms
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9. Facebook
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10. Twitter
10

11. Linkedin
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12. Google+
12

13. Ethical and Legal Issues
13
 Despite the range of positive uses of social media for both
individual PT‟s and the profession as a whole, there are also
a number of ethical and legal issues associated with its use
 Social media sites, with user created content, are vehicles to
share professional and private information
 The concern with the rapid increase in rates of use is that
knowledge regarding the potential dangers implicit in this
digital behavior is not growing at the same speed
 The increased rate of casual use couples with a lack of
knowledge regarding the functionality of social media and
platforms, begs for more uniform education on managing
digital dangers.

14. Ethical Issues
14
 Physical Therapists should be mindful that social media
activity can blur the boundaries between personal &
professional lives
 The line separating freedom of speech and inappropriate
posting may be unclear.
 Applicable ethical principles relevant to clinical care &
social media:
 Patient – Clinician Relationship
 Minimizing Intrusions on Privacy – HIPPA, FERPA
 Maintaining Confidentiality
 Self-presentation (Implications of the nature and scope of
information available online)

15. Ethical issues continued…
15
 Ethical questions can be categorized according to 5
primary criteria:
 Who is viewing the social media information?
 How is the social media information accessed?
 For what purpose is the social information used?
 What are the criteria one uses for making judgments about
social media information, and
 What is the nature of “relationships” in social media

16. Legal Issues
16
 Corporate use vs. Employee use of social media
 Some unlawful activities that may be associated with use of
social media
 Freedom of speech
 Search and seizure issues
 Copyright infringement and other intellectual property rights
 Breach of individual publicity and privacy rights
 Obscene or defamatory content/statements
 Several legal risks associated with employee use of social
media
 Claims of discrimination, disparate treatment of
employees, hostile work environment, defamation claims, and

17. Digital Natives vs. Digital
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Immigrants
DIGITAL NATIVES DIGITAL IMMIGRANTS
 Students  Teachers
 Fast  Slow
 Young  Old
 Future  Past, or „legacy‟
 Multi-tasking  Logical, serial thinking
 Images  Texts
 Playful  Serious
 Inductive learning  Deductive learning
 Digital  Analogue
 Action  Knowledge
 Constant connection  Isolation
 The applicability of ethical guidelines might be very different
for digital natives and digital immigrants.

18. Ethical Concerns and
Recommendations
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Challenge Recommendation
Managing your identity • Perform “electronic self-audits” to monitor your online presence
and professional image • Maximize online privacy settings for personal profiles and social
networking sites
• Develop “dual citizenship” online with separate professional
(public) and personal (private) networking profiles
• Develop a professional biography for patients and others to
preferentially find when using search engines
Using social media in a • Understand that all posted content should be considered public
professional manner and permanent
• Encourage online behavior of PT‟s, PTA‟s, aids, and office staff to
mirror the standards of behavior maintained in the clinic
• Refrain from posting potentially identifiable vignettes online unless
you obtain patient consent
Communicating with • Preferentially use secure messaging for electronic communication
patients electronically with patients or, where not available, provide informed consent for
and professionally e-mail
• Avoid direct communication with patients via third-party platforms
(e.g., Facebook, Twitter)

19. Ethical Decision Making
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Framework
 Get the Facts
 What are the relevant facts of the case? What facts are not
known? Can I learn more about the situation? Do I know
enough to make a decision?
 What individuals and groups have an important stake in the
outcome? Are some concerns more important? Why? What‟s
the usual and customary action? What are legal implications
regarding this issues?
 What are the options for acting? Have all the relevant persons
and groups been consulted? What is their belief/value
system? Have I identified creative options?

20. Ethical Decision Making
20
Framework…
 Recognize an Ethical Issue
 Could this situation be damaging to someone or to some
group? Is there any barrier keeping one from doing what they
know is right? Does this decision involve a choice between a
good and bad alternative, or perhaps between two "goods" or
between two "bads"?
 Could the situation be labeled as ethical distress, ethical
dilemma or locus of authority challenge?
 Is this issue about more than what is legal or what is most
efficient? If so, how?

21. Ethical Decision Making
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Framework…
 Use Ethics Theories or Approaches to Analyze the
Problem(s)
 Which option will produce the most good and do the least
harm? (The Utilitarian Approach)
 Which option best respects the rights of all who have a
stake? (The Rights Approach)
 Which option treats people equally or proportionately? (The
Justice Approach)
 Which option best serves the community as a whole, not just
some members? (The Common Good Approach)
 Which option leads me to act as the sort of person I want to
be? (The Virtue Approach)
 What principles of personal, professional, and global ethics
are at stake?

22. Ethical Decision Making
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Framework…
 Evaluate Alternative Actions
 What are the alternative actions that could be done? What are
the constraints in performing a specific action(s)?
 Determine what are the ethical issues bearing including
consequences (economic, psychosocial, social, legal-
administrative, and clinical) on the possible alternative course
of action?
 What‟s the benefit/risk ratio for each alternative? Are there any
non-ethical considerations like rules that automatically
invalidate alternatives?
 Benefits outweigh risks, then consider option
 Risks outweigh the benefits, then reject option
 Considering all these approaches, which option best addresses
the situation?

23. Ethical Decision Making
23
Framework…
 ACT
 How can my decision be implemented with the greatest
care and attention to the concerns of all stakeholders?
 Evaluate the Process and Outcome
 How did my decision turn out and what do the people
involved have to say about the decision?
 What were the most challenging aspects? How did this
situation compare with others encountered/heard about?
 What have I learned from this specific situation?

24. Developing Social Media
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Strategy
 Determine the purpose of social media campaign and
marketing strategy.
 Research your audience and the most appropriate social
media channels to reach to them.
 Set up your accounts and determine the best tools to
manage those accounts.
 Develop Social Media Policy and feel free to provide the
policy to your patients/clients
 Example of Keely Kolmes, Psy.D.
 “My Private Practice Social Media Policy”
http://www.drkkolmes.com/docs/socmed.pdf

25. Social Media Strategy…
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 Broadcast messages that resonates most with your
audience and relay offline campaigns on the internet
 Train internal staff on your clinic‟s social media policy
and how to manage those accounts using the tools.
 Develop metrics and institute tracking devices to gauge
success (return on investment – time, money).
 Determine how to deliver promotional content and
campaigns through the channels.
 Monitor changes in social media
technology, channels, and tools and make adjustments

26. Do‟s and Don'ts for social
26
networking
 Do’s
 Use privacy settings to safeguard personal information and
content
 Maintain appropriate professional boundaries
 Create and maintain separate personal and professional
online identities
 Bring unprofessional content to the attention of a colleague or
appropriate authorities
 Be aware of effects on reputation with patients and colleagues
and the impact on the profession

27. Do‟s and Don'ts for social
27
networking…
 Don’ts
 Do not post identifiable patient information online
 Do not present yourself as an official representative of or
spokesperson for a place of employment.
 Do not display vulgar language
 Do not display language, photographs, or videos that imply
disrespect for any individual or group because of age, race,
gender, ethnicity, or sexual orientation.
 Be cautious about presentation of content that may reasonably
be interpreted as condoning irresponsible use of
alcohol/substance abuse
 Do not post potentially inflammatory or unflattering material on
another individual‟s website for e.g. – “wall” on Facebook

28. 28
“We‟re living at a time when attention is the
new currency. Those who insert themselves
into as many channels as possible look set
to capture the most value.”
Pete Cashmore, Founder of mashable.com

29. References
29
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 Association of Corporate Counsel. Workplace challenges associated with employees‟ social media use. Legal Resources. 2010.
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