There are a plethora of physician assistant (PA) and nurse practitioner (NP) Facebook pages. Although many of them are private and require approval from a moderator, others are open to the public. However, even the ones that are allegedly private should be approached with the knowledge that a post in a private room can be made public by anyone who knows how to take a screenshot of the page.

Ideally, social media affinity sites should possess the potential for PAs and NPs to network with others, allow PA/NPs to learn from each other, and discuss current clinical issues. Although I’m not active in any social media groups, I have been in the past. I’ve seen some of the positive potential realized, but mostly, I’ve seen things that I found troubling.

One example occurs on Facebook pages where discussions threaten to veer into protected health information. I’ve seen many instances where a PA or NP posed a clinical question with enough detail that if a family member or patient read the post, it would be possible for them to identify themselves or someone they know as the patient in the prompt. When I see such instances, I wonder what it says about the training of medical providers, including PA/NPs. Are we missing something about confidentiality in our curriculum?

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A recent phenomenon I’ve seen on PA/NP sites is concern that nonprivate Facebook pages focused on PA/NP matters might portray these providers as less-than-competent clinicians. For example, in certain social media groups, I’ve seen PAs or NPs ask questions such as, “What do you think is the best antibiotic for treating adult cellulitis?” or “What is your choice of antidepressants for treating panic disorder?” A discussion might follow where PAs/NPs offer advice about treatments they have had success with. It might, therefore, be reasonable to have a conversation about such garden-variety treatments.

Lately, though, I’ve seen concern among responders to such exchanges related to the negative light these treatment-based questions shine on the sophistication of PA/NPs. Frequently, responses will be critical of the original PA/NP who posted the question, noting concern about how a provider might not know how to treat such conditions or not know how to access a reliable and evidence-based resource about treatment options.

Other negative online responses to these types of questions voice concern about those who oppose the trajectory of the PA or NP practice. Such people could potentially take screenshots of these posts and present them to regulators, legislators, and association leaders who make decisions about the scope of practice of PAs and NPs in an attempt to undermine the full practice of these clinicians.

I’ve seen little evidence of social media threads affecting practice decisions, but it’s not hard to imagine that PA/NP skeptics might find such information appealing and useful.

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In the end, concerns about Facebook posts risking breaches of confidentiality, as well as the undermining of the PA/NP practice, make pertinent the need for any provider to use caution when posting about patient care. Discussions about patient scenarios should only occur in manners that eliminate the chance that protected health information or patient identification might be revealed. In addition, it seems intuitive that any Facebook posting on a provider page, whether open or private, should be done in a fashion that portrays the profession in a bright and capable manner.