The optometric profession has long recognized its ethical responsibilities to patients, colleagues, other health care professionals, and the public. The American Optometric Association (AOA) has historically provided statements of ethical aspirations and standards of expected professional behavior. The Code of Ethics, Optometric Oath and Standards of Professional Conduct are the current documents guiding the ethical behavior of AOA members. These documents are frequently expanded on through policy resolutions adopted by the House of Delegates.
With full deliberation, I freely and solemnly pledge that:
I AFFIRM that the health of my patient will be my first consideration.
I WILL practice the art and science of optometry faithfully and conscientiously, and to the fullest scope of my competence.
I WILL uphold and honorably promote by example and action the highest standards, ethics, and ideals of my chosen profession and the honor of the degree, doctor of optometry, which has been granted me.
I WILL provide professional care for those who seek my services, with concern, with compassion and with due regard for their human rights and dignity.
I WILL place the treatment of those who seek my care above personal gain and strive to see that none shall lack for proper care.
I WILL hold as privileged and inviolable all information entrusted to me in confidence by my patients.
I WILL advise my patients fully and honestly of all which may serve to restore, maintain or enhance their vision and general health.
I WILL strive continuously to broaden my knowledge and skills so that my patients may benefit from all new and efficacious means to enhance the care of human vision.
I WILL share information cordially and unselfishly with my fellow optometrists and other professionals for the benefit of patients and the advancement of human knowledge and welfare.
I WILL do my utmost to serve my community, my country, and humankind as a citizen as well as an optometrist.
I HEREBY commit myself to be steadfast in the performance of this my solemn oath and obligation.
It shall be the ideal, resolve, and duty of all optometrists:
TO KEEP their patients' eye, vision, and general health paramount at all times;
TO RESPECT the rights and dignity of patients regarding their health care decisions;
TO ADVISE their patients whenever consultation with, or referral to another optometrist or other health professional is appropriate;
TO ENSURE confidentiality and privacy of patients' protected health and other personal information;
TO STRIVE to ensure that all persons have access to eye, vision, and general health care;
TO ADVANCE their professional knowledge and proficiency to maintain and expand competence to benefit their patients;
TO MAINTAIN their practices in accordance with professional health care standards;
TO PROMOTE ethical and cordial relationships with all members of the health care community;
TO RECOGNIZE their obligation to protect the health and welfare of society; and
TO CONDUCT themselves as exemplary citizens and professionals with honesty, integrity, fairness, kindness, and compassion
Adopted by the House of Delegates as:
Substantive Motion M-1944-1, June 1944; Modified June 2005; Repealed June 2007
Modified and Adopted as Resolution #1969, June 2007
Article written by Carolyn Carman O.D., and Douglas Totten, O.D., Ethics and Values Committee, November 2012
Updated September 2020
The use of social media is increasingly utilized in both the business place and the private sector as patients and practitioners become more comfortable with internet technology and tools. The ability to readily share information and quickly reach large numbers of people present both advantages and challenges. James E. Paramore, O.D., former chair of the AOA Ethics and Values Committee, has stated, "(Doctors of optometry) need to be aware of how to uphold the same professional and ethical standards in their social media participation as they do in the rest of their practice. Failing to do so could hurt patients and possibly harm optometric careers."
Social media can be described as interactive platforms that enable individuals to share user-generated content. Social media can be presented in several formats including internet forums, microblogs, podcasts, wikis and other bookmarking applications. Sites such as Facebook, Twitter, Instagram, LinkedIn, Snapchat, YouTube, TikTok and WhatsApp are among the most commonly used network websites.
To help preserve the doctor-patient relationship, maintain patient privacy and ensure the security of information, the following guidelines are recommended for doctors who use social media in their personal and professional lives.
- Doctors are discouraged from interacting with current or past patients on personal social media accounts . As stated in the AOA Standards of Professional Conduct, Standard B.6, “Optometrists should avoid intimate relationships with patients as such relationships could compromise professional judgment or exploit the confidence and trust placed in the optometrist by the patient." While a social media “friend” may not meet the definition of “intimate relationship,” there is still a risk associated with sharing details of your personal life with patients or interacting with patients in an overly casual and familiar manner on social media, which undermines the esteem with which you are viewed as a professional. In a worst-case scenario, interactions on social media could be viewed as giving medical advice in the absence of a proper examination of the patient, or you may be seen to be sharing personal patient information with third parties.
A common solution is to maintain separate personal and business social media pages, and avoid mixing the two. Professional pages should be reserved for sharing information about your practice and perhaps general health information. Use a personal email address rather than a professional email address for logging on to social media accounts for personal use. Users who view a professional email address attached to a personal online profile may misinterpret the doctor's actions as representing the medical profession or a particular institution. It is to be expected that doctors have some friends who also are patients—if these friends also are social media connections, limit your personal interactions to your personal page and avoid discussing health matters there.
- Online interactions with patients for the purpose of discussing medical treatment should only occur on encrypted and secure platforms to maintain patient confidentiality. There are dedicated platforms specially designed for appointments and accessing records, for example, and for sending secure and encrypted email communications. Be careful not to accidentally disseminate private, patient-doctor information via an unsecured method.
- Social media can be used as a valuable tool for doctors to gather online, share their experiences and discuss topics in eye care and medical treatments . These types of professional interactions with colleagues provide a beneficial means for peer-to-peer education and discussion. It is the responsibility of the doctor to try to ensure that professional networks they use are secure and accessible to registered users only. These websites should be password protected to safeguard against the general public from having access and considering the discussion as medical advice. Doctors also should confirm that any medical information obtained from a professional, online discussion is supported by current medical research before incorporating it into a patient care regimen.
- Patient confidentiality and privacy should be protected at all times, especially on social media. These sites have the potential to be viewed by the public, and any breaches in confidentiality could be harmful to the patient as well as in violation of federal privacy laws, such as HIPAA. While doctors may discuss their experiences, they should never provide any information such as names, code names or pictures that could be used to identify a patient.
- At times, doctors may write online about their experiences as a health professional, or they may post comments on a website as a physician. When doing so, doctors must reveal any existing conflicts of interest. They also should disclose their professional credentials.
- Doctors should be aware that any information posted on social media may be circulated—possibly unintended—to another audience, may be taken out of context or may continue to be accessed online in perpetuity. They should consider they are representing the optometric community when posting online. Doctors should always act professionally and take caution to avoid posting statements that could be misinterpreted easily or are unclear. Remember that when interacting with colleagues, it is possible to conduct oneself in a manner that is casual, friendly and professional at the same time. Avoid participating in online discussions that would reflect badly on you or the profession. When in doubt, it’s better not to post!
- Doctors who allow employee internet access should have a written policy about social media use. Office policies should promote education, training and awareness for responsible use of social media and internet use. Employees should be informed about any employer's intention to edit, modify, delete or review internet communications. This should be tied into office HIPAA policies and training for employees.
- It cannot be emphasized enough that doctors and staff should adhere to the same principles of professionalism online as they would offline. Harassment of any type, negative comments about competitors or former staff members, or any other unprofessional conduct should be avoided at all times.
In summary, doctors who use social media should limit personal interaction with patients on personal social media accounts, maintain professional doctor-patient boundaries, and comply with patient privacy and confidentiality standards. Employees should be well informed about office policies on social media use, as well as HIPAA regulations. "(Doctors of optometry) have acknowledged that professional standards guide the traditional optometrist-patient relationship in face-to-face interactions. The online relationship is no different," said Morris S. Berman, O.D., MS, longtime member of the AOA Ethics and Values Committee. Doctors of optometry should follow the AOA Standards of Professional Conduct and should apply them with any type of communication or media used.
Social media do's and don'ts
Should I accept requests from patients to connect on personal social media platforms?
Not recommended. A better idea may be to use your practice website to share general or eye health information, give directions and promote your practice. If you choose to use social media for business purposes, consider creating a separate account for your personal profile to use with selected friends, family and colleagues who also are personal friends only. While businesses may benefit from professional interactions with patients and vendors on business social media pages, doctors should use discretion when deciding who becomes a personal social media “friend.” It is not recommended to accept "friend requests" from patients on your personal Facebook page.
Should I respond to personal medical questions on social media?
Not recommended. Those with online health questions should be directed to schedule an office visit, phone consultation (or telehealth session) or encrypted communication using a software or app for that purpose.
Should I post any information about my patients?
Never. This would constitute an unethical and potentially illegal practice.
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