Dear Sir,

We thank the author(1) for his interest in our article(2) – we are heartened that it brings some awareness to our local setting. As physicians, we should maintain our professional standards while maintaining the patient-doctor relationship. A commentary by Cole-Kelly K summarises how we assess the risks and benefits when considering this.(3) As doctors, we strive to provide care in our patient’s best interests. ‘Best’ care includes providing emotional support and being present for the patient. Being a ‘friend’ is, thus, also an important part of the doctor-patient relationship, albeit while maintaining boundaries. If we decline a ‘friend’ request from a patient with the intent of maintaining unbiased clinical judgement for our patient’s benefit, we trust that most patients would understand our good intentions in keeping our ethical and legal obligations. In the same vein, if the friendship might cloud the professional judgement of the managing physician, it would be in the best interest of both parties to refer the friend to a colleague.

With regard to the use of social media, we have to be similarly mindful when navigating this online relationship with our patients. A commentary by Chretien KC shares some considerations prior to accepting social media ‘friend’ requests from patients.(4) It is debatable whether connecting on professional social networking sites such as LinkedIn is more ‘acceptable’ than doing so on Facebook. While specific guidelines on the detailed use of social media are likely to be established given the increased technological connectivity during the pandemic, keeping the main ethical principles in mind remains the cornerstone in helping us to uphold the sanctity of the doctor-patient relationship.

Yours sincerely,


Lim EK. Comment on:Doctors and social media:knowledge gaps and unsafe practices. Singapore Med J. 2022;63:1.
Low JM, Tan MY, Joseph R. Doctors and social media:knowledge gaps and unsafe practices. Singapore Med J. 2021;62:604-9.
Cole-Kelly K. Can friends become patients?. Am Fam Physician. 2002;65:2390-5.
Chretien KC. Should I be “friends”with my patients on social networking web sites?. Am Fam Physician. 2011;84:105-8.