Dear Sir,

I read the article titled ‘Doctors and social media: knowledge gaps and unsafe practices’ by Low et al with considerable interest.(1) They highlighted the inadequate knowledge about social media policies in a large tertiary healthcare centre, especially regarding inadequate privacy settings, such that private matters can be leaked into the public domain.(2)

However, I am particularly gratified that most doctors will reject a ‘friend’ request from their patients, as this would contravene Section C12 of the Singapore Medical Council Ethical Code and Ethical Guidelines (SMC ECEG) on the relationship of doctors with patients and those close to them.(3) It states, “if you are active in social media, you must ensure that exposure of your personal life and your words and behaviour do not diminish your professional standing before patients or the public, or bring the profession as a whole into disrepute”.

Perhaps the conundrum in practising doctors’ minds also relates to the reverse – that of a true friend (a friend in their social circle or someone they know through social media) requesting the doctor to be his/her doctor. This could be worse when this friend is female and the requested specialist is a male gynaecologist or psychiatrist. The SMC ECEG and the accompanying handbook on medical ethics highlights that in this situation, there is a “power imbalance [in the doctor-patient relationship] due to the asymmetry of information and influence between the parties, usually in the doctor’s favour”. Herein lies the dilemma that the doctor cannot have these friends as his patients and close friends at the same time. He will have to shunt these friends to other colleagues, and this act has often been perceived as an unfriendly gesture by these female friends.

Yours sincerely,

Low JM, Tan MY, Joseph R.Doctors and social media:knowledge gaps and unsafe practices. Singapore Med J. 2021;62:604-9.
Guseh JS, 2ndBrendel RW, Brendel DH.Medical professionalism in the age of online social networking. J Med Ethics. 2009;35:584-6.
Singapore Medical Council Ethical Code and Ethical Guidelines, 2016 Edition. Available at: Accessed February 11, 2022.