Should social media be used professionally? Will it give you more credibility or the opposite: will it tamper with medical ethics and legal obligations you have? The answer is: it depends.

Very often, social media creates the illusion of safety and comes across as a harmless way of communication, where liability can be avoided by simply removing a “bad” post from your Twitter or Facebook page. Such false perceptions can get you in trouble, says Lorraine Fleck, lawyer at Fleck & Chumak LLP in Toronto. According to Fleck, evidence from social media is now widely used in court and everything that you share on the Internet can be found even long after you remove your post.

“Evidence is evidence — it doesn’t matter if it’s in digital or paper form,” she says. “Evidence from social media accounts may be relevant in a lawsuit and a court can compel the disclosure of such evidence.”

If you are using patient testimonials on your social media or blog, Fleck recommends obtaining your patient’s written consent prior to posting their comments; otherwise you may be successfully sued for breaching confidentiality and privacy laws. Further, testimonials can result in competition and advertising law violations. For example, Fleck says, testimonials from fictional patients violate Canadian unfair competition laws. Canada’s Competition Bureau has made enforcements against fake online testimonials and reviews one of its priorities.

To be on the safe side in the digital world, Fleck generally recommends against posting anything you would not like other people to find out about in real life. As straightforward as it sounds, many people forget this rule once they are logged into their Facebook accounts.

While the College of Physicians and Surgeons of Ontario (CPSO) recognizes the value of social media in improving patient care and medical education, the institution insists that doctors comply with their professional expectations, relevant legislation and codes of ethics. On its website, the CPSO advises medical professionals should “exercise caution when posting information online that relates to an actual patient,” refrain from providing medical advice to specific patients and not establish personal relations with them or people close to them to maintain appropriate professional boundaries.

The College of Naturopaths of Ontario, which is the regulatory body for the naturopathic profession, doesn’t yet have a specific set of guidelines for NDs when it comes to using social media.

“The College of Naturopaths of Ontario, which received official proclamation on July 1, 2015, will be developing a social media policy to help guide members in the use of their social platforms,” says Andrew Parr, registrar at the College.

Generally, accredited professionals have been hesitant to integrate into the use of social media because of its public form, says Rochelle Grayson, a consumer and digital media executive and technology, media and professional programs instructor at the University of British Columbia.

“Very few doctors are using social media now. Part of the reason is because it’s a regulated profession.”

Following the profession’s rules, regulations and protocol, a lot of doctors make their Facebook and Twitter profiles too formal, which social media is not, Grayson says.

“In social media, people are interested in getting to know the whole person, if a doctor has hobbies or if there is something that they are passionate about. We are now connecting with professionals at all levels, we want to know the person as much as we want to know their professional expertise.”

Many healthcare practitioners tend to stay away from social media “without really understanding how things work” and what they don’t realize is that this is just a new communication tool, Grayson says. She believes social media presents a variety of opportunities for naturopathic doctors. In addition to a conservative LinkedIn, traditional Facebook and Twitter, you can benefit greatly from visual media, such as Instagram. Grayson says social media can serve as an excellent marketing tool for your practice and a great way to network with your peers in Canada and in other corners of the world.

“It’s about education and about building your brand, about it being a vehicle to show your expertise, connecting with other doctors. For naturopathic doctors, education is probably the easiest way to get out there and to inform people on what naturopathic medicine is and how it’s used.”

Since 1995, health research in Europe has been dominated by a scientific evidence-based system (EBM), which includes a methodology based on industry standards, chemical mono-substances and conventional medicinal classifications. To support EBM, the industry introduced a set of four criteria that claim to define a perfect health-care model. Known as the Big Four, the criteria included quality, safety, effectiveness and efficacy.

Today, EBM is becoming a growing marketing strategy as a result of its direct association with science, experts and quality products. In the meantime, a number of political figures that are involved in the public health sector recognize the individuals that are exclusively working on a scientific level, i.e. evidence-based. This leads to the discrimination of the global experience-based system of natural medicine. Though EBM seems to contribute to global economic growth, the reality is quite the opposite: constantly growing prices as well as toxification and frequent side effects from the products.

Dr. Sean Murphy, a member of the Acupuncture Foundation Professional Association (AFPA) in Ireland, addressed this crisis and the challenges the European healthcare systems face at the European Traditional Chinese Medicine Association (ETCMA) General Assembly in Prague earlier this year.

“The rates of common diseases, such as diabetes, obesity, cardiovascular disease, cancer, etc. in European countries, are increasing dramatically, the patient’s satisfaction with conventional medical care is decreasing and at the same time, we are looking at a future with steadily increasing health-care costs.”

Currently, trends in natural medicine, including complementary and alternative medicine (CAM), traditional medicine and naturopathy (TM&N), and traditional and complementary medicine (T&CM) show that the EBM system is not applicable, as its methodology does not include the values and specifications needed to do proper research on natural medicine.

Methodology specifically developed for CAM and TM&N should be based on a holistic approach. Firstly, an interdisciplinary research from the fields of anthropology, biology, physics, sociology, history, arts and medicine is needed. This will provide qualitative research, field studies, person-centred and individual research methods. Secondly, this specific methodology should include information about intangible cultural heritage from all over the world — on regional and/or a healthcare system level. The third and most important aspect deals with the patient, particularly their health literacy, relationship with the doctor, level of awareness when it comes to natural medicine and the patient’s desire to explore alternative medicine. The fourth aspect should be viewed from the economic and political perspective. The freedom of choice when it comes to health coverage, income, access to care and treatments available would show the real value of the Big Four.

Currently, some parts of CAM and TM&N are evidence-based (with the EBM methodology) and are included in the conventional public health system. Further changes in the public health system could help integrate natural medicine into healthcare.

More research and new methodology require both sufficient money and time investment. The European Union’s CAMbrella-project has shown that there are scientists working toward this direction. Today, the industry is in desperate need of a new methodology, one of the reasons being an increased political demand for scientific studies. By putting our efforts together, we can bring natural medicine to a new, “lege artis” level.

CAMbrella is a pan-European research network for complementary and alternative medicine (CAM). A three-year project, started in 2010, CAMbrella’s goal was to develop a roadmap for future European research in CAM that is appropriate for the health care needs of EU citizens, and acceptable to the EU Parliament as well as national research funders and healthcare providers. More info: www.cambrella.eu

Nora Laubstein

Founding member and since 2007 President of the Association for Natural Medicine in Europe e.V. (ANME). Practicing in the field of traditional European naturopathy (TEN) since 1995, Laubstein is a member of the Deutschen Naturheilbund, general secretary of the Selbsthilfekontaktstelle SEKOS-Gelnhausen, advisor on the Union Deutscher Heilpraktiker-Hessen board.