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Keywords: Facebook, social media, ethics, professionalism, British Medical Association.
Citation: Grajales FJ III. One step forward, two steps back: why can’t we protect doctors who put patients first? J Participat Med. 2011 Aug 8; 3:e36.
Published: August 8, 2011.
Competing Interests: The author has declared that no competing interests exist.

To the Editors:

I am a patient, researcher, and medical professional. I have worked with the World Health Organization and the World Bank as an “expert” in social media. I believe that we can use social media to humanize medicine and empower patients. Recently, I was shocked to receive an email from my doc. He had to “unfriend” me from Facebook because of a new hospital policy.

Last May, the British Medical Association (BMA) issued a statement condemning patient relationships on Facebook. Their rationale is that social technologies “increase the potential of clinical exploitation” because a physician may gain access to information that was not disclosed during a clinical encounter.[1]

At the core of this issue is our expectation of privacy. My doc and I, whom I haven’t named to protect his identity, had a mutual agreement. Our “friendship” outside the clinical space would serve to complement rapport, and the Facebook platform would not be used for medical purposes.

At last, I had found a positively deviant doctor. He put patients first.

It took less than two months for the system condemn our behavior.

In case you are wondering, I fully supported and understood my doctor “unfriending” me. However, when are we going to protect those doctors who want to go above and beyond the standard of care? Perhaps the BMA will not sanction our connection through a Google + circle in the future or perhaps the system will never change.


  1. British Medical Association. Using social media: practical and ethical guidance for doctors and medical students. Available at: Accessed July 21, 2011.

Copyright: © 2011 Francisco J. Grajales III. Published here under license by The Journal of Participatory Medicine. Copyright for this article is retained by the author, with first publication rights granted to the Journal of Participatory Medicine. All journal content, except where otherwise noted, is licensed under a Creative Commons Attribution 3.0 License. By virtue of their appearance in this open-access journal, articles are free to use, with proper attribution, in educational and other non-commercial settings.