Health Professionals' Personal Use of Facebook: Impacts on Client Impressions of Credibility in Canada

Theoretical Background and research questions/hypothesis: Facebook is nearly ubiquitous in North American society for personal and business communication. As people increasingly seek information online, opportunities for collision between private and professional lives have increased substantially. With no universally accepted etiquette for sharing content online, health professionals need to be aware of the impression that social-media content may make on patients in order to avoid reputation damage and potential damage to the practitioner-patient relationship. Previous research shows that a number of health professionals post content that could be considered “unprofessional”. However, “unprofessional” is imprecisely defined in the literature, and perceptions of  “unprofessional” may also be evolving in tandem with relaxed social mores and increased use of social media. Given that credibility (competence, trustworthiness, caring) is widely accepted to be the foundation of the health practitioner-patient relationship, this study aimed to test whether a “potentially unprofessional” versus a “neutral” Facebook profile resulted in different ratings of credibility by members of the general public.

Methods: In this field study, 12 mock Facebook profiles using all combinations of gender (female/male), profession (physician/veterinarian/public health practitioner) and profile content (unprofessional/neutral) were developed. Members of the public were invited to participate in an online survey about first impressions based on online content. After reviewing one of the 12 randomly assigned Facebook profiles, participants rated the health professional on various personality characteristics including credibility. An ANOVA test was performed to compare participant ratings.

Results: Five-hundred and one individuals completed the survey, 62% of whom were female. Participants were, on average, 40 years old (Median 39, SD 12.70, Range 18-74). Health professionals with potentially unprofessional content on their Facebook profiles were rated significantly lower on credibility compared to those with neutral content (p < .001).  

Conclusions: This field study demonstrates the collision that is possible between one’s personal life online and one’s real world professional life. Our results highlight the complexity of clearly defining “unprofessional” behaviours in the online context and the need for broader consultation with the public and health professionals on this issue.

Implications for research and/or practice: These findings have important implications for teaching professionalism to the next generation of health professionals and further our understanding of how technology may impact practitioner-patient relationships and potentially healthcare outcomes.