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NDs Face Issues with Social Media and Texting

Many naturopathic doctors are using social media and texting to communicate with patients and to market their practices. But what innocuous information might be misconstrued? What snap judgments could be made about your practice and/or personal life?

Many naturopathic doctors are using social media and texting to communicate with patients and to market their practices. 

But what innocuous information might be misconstrued? What snap judgments could be made about your practice and/or personal life? 

Social Media

In this digital age, social media use is extremely common. As such, many naturopaths are using social media to market their business. And patients may be checking social media to learn more about you. 

If you decide to participate in social media, create and maintain separate practice and personal pages. It is also important to maintain adequate privacy settings, so patients don’t gain access to your personal information. 

If you receive a social media friend request from a current patient, it may be a good idea to develop a standard response. For example, tell patients that you make it your policy not to friend current or former patients on social networking sites out of respect for the doctor/patient relationship and to safeguard patient confidentiality. 

It may also be advisable to develop a social media policy for your practice. This policy could be incorporated into your new patient packet. That way patients will be aware of the policy upfront and not offended by not being “friended” on social media.

When participating in closed groups, such as “e-corridor” consults (e.g., groups limited to NDs who are enrolled by a moderator), remember that nothing is really “closed.” What you post can be captured in a screenshot and shared. Moreover, de-identify any patients by not listing their names or other identifying information. Use a standard that is HIPAA compliant. 

Social Media Tips

  • Maintain separate practice and personal social media profiles
  • Maintain adequate privacy settings on your personal profile to avoid unwanted access to your personal information
  • Do not initiate or accept “friend” requests from patients
  • If you interact with patients via your practice’s social media profile, maintain the utmost professionalism and maintain patient confidentiality
  • Staff should be skilled in monitoring the social media sites for inappropriate commentary


Texting is inherently casual, and messages can quickly become inappropriate. Even if the patient initiates the questionable conversation, you, as the doctor, must maintain appropriate boundaries.

Additionally, unless there are unusual circumstances, you should avoid providing treatment recommendations or possible diagnoses to patients via text messaging. Patients should instead be encouraged to make an appointment or go to the ER for an emergency.

You must also consider how text messages might be used in the future and out of context. For instance, if you are friendly with a patient who experiences a complication and, in the moment, you joke about treating them again, it might seem funny. Nevertheless, this comment could be perceived in a negative light later on. 

Text communication with patients can also cause privacy/HIPAA violations. NDs must follow appropriate security protocols for the storage and transfer of patient information. 

Nearly everyone has inadvertently sent a text message to an unintended recipient, which can be embarrassing. However, in the context of the provision of healthcare, it can have much more serious consequences. If a doctor unintentionally communicates patient identifying information to someone other than the patient, it could be a privacy violation. Secure text messaging applications are available for substantive patient care conversations.

Text message communication with patients can also create recordkeeping issues. Patient interactions are supposed to be part of the chart and, in some states, they could be deemed to include text messages. If you are not uniform in which messages you keep and which you delete, it could also give rise to an argument that certain messages were intentionally deleted.

It is wiser to use the email function of your Electronic Health Records platform with patients. Even then, keep conversations brief and redirect patients back to live interactions. 

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