At least six medical professionals, mostly nurses, have been warned for posting inappropriate comments on social networking websites as district health boards unite to create a nationwide policy aimed at controlling the trend.
In one case last year, a Wairarapa District Health Board staff member was formally warned over an incident which involved inappropriate discussion and medical photos being uploaded to a personal Facebook page.
And an Auckland District Health Board nurse was verbally warned after looking up a former patient on Facebook and emailing the person to check their recovery.
Medical Students' Association president Michael Chen-Xu said there was a fine line in social media use, and it was very easy to cross it.
"The big thing for students and health professionals from our perspective is anything you post online is online for good and it's accessible by anyone."
Mr Chen-Xu said in one incident he knew of a student doctor who accidentally identified a patient by posting details of the case on social media.
"The student was Facebook friends with one of the university staff at the medical school, so he was disciplined as a consequence of that."
Last year a social media guide for medical professionals, compiled by student and practising doctors in Australia and New Zealand, was introduced. It was later adapted for nurses.
The guide said research showed the use of social media by the medical profession was growing.
In one 2010 study, 220 out of 338 (65 per cent) medical students at the University of Otago had Facebook accounts.
Evidence was emerging from studies, legal cases and media reports that social media use could pose risks, the guide said.
"Inappropriate online behaviour can potentially damage personal integrity, doctor-patient and doctor-colleague relationships, and future employment opportunities."
Waikato District Health Board communications manager Mary Anne Gill is leading a project to draft a standardised policy for all DHBs.
She said social media pitfalls for health professionals were obvious.
"Patient confidentiality is absolutely essential. We do not expect any of our staff no matter where they work, whether they are doctors, nurses, lawyers, accountants or comms managers, to be holding conversations about patients or activities related to the DHB in a social media platform that is patient or staff sensitive."
But she cited benefits from the DHB's social media use, and said targeting specific audiences was easier and instant.
Medical Association chairman Dr Paul Ockelford said doctors were not discouraged from using social media but were cautioned about traps.
"A lot of it is common sense, remembering that it is so easy to slip into things which are best avoided."
Wintec chief executive Mark Flowers said the Hamilton polytechnic's nursing school had introduced social media awareness.
Mr Flowers said that when students in a private Facebook group discussed a midwifery incident online this year questions were raised over the security of that discussion.
"People will talk about things whether it's on a phone call or an email or a cafe. The question is who should hear that?"
Posts gone wrong
"Dear Emergency Registrar, Thanks a million for misdiagnosing my patient's perforated bowel as constipation and treating aggressively with laxatives. I'm sure she appreciated the subsequent cardiac arrest and multi-organ failure. Don't worry, she just needs a new set of kidneys and a liver and she'll be right. And with that kind of performance, I'm sure you can help her acquire them. Kind regards, Lowly intern."
In September 2008, a junior medical officer in Britain was suspended from work for six weeks after describing a senior colleague as a "f****** s***" on an online forum. Another colleague saw the post and made a complaint. The junior doctor apologised for the comments and organised for their removal from the website.
Source: Social Media and the Medical Profession
Medical incidents in NZ
Northland One nurse warned in writing in 2010 for describing a clinical event on a website.
Auckland One nurse warned verbally for looking up a former patient on Facebook and emailing them to check how they were.
Waitemata Several cases, the most serious of which resulted in a final written warning.
Manukau One nurse reminded of policy for using Facebook in July 2010.
Waikato At least three health professionals warned about DHB guidelines on social media.
Wairarapa A written warning to one staff member last year over inappropriate discussion and medical photos being placed on a personal Facebook page.
Hawkes Bay Two nurses warned in writing, one for an inappropriate Facebook post in April last year which breached privacy and the other over incorrect information posted on the New Zealand Nurses Organisation Facebook page in June this year.
Nelson/Marlborough Inappropriate comments made on Facebook about a staff member by a Mental Health Service client.