The Ethical and Professional Use of Social Media in Surgery: A Systematic Review of the Literature

While certain medical societies have released guidelines on the use of social media, plastic surgery, with its inherent visual nature and potential for sensationalism, could benefit from increasing direction regarding the ethical use of social media. We hypothesized that while general platitudes for use exist in the literature, guidelines articulating the boundaries of professional use are nonspecific. Systematic searches of MEDLINE, Embase.com, and Cochrane Central Register of Controlled Trials were completed on January 18, 2017. Searches consisted of a combination of MeSH terms and title and abstract keywords for social media and professionalism concepts. Additionally, we manually searched the three highest impact plastic surgery journals (ending in October 2017). Two authors screened all titles and abstracts. Studies related to clinical medicine, patient care, and the physician-patient relationship were included for full text review. Articles related to surgery merited final inclusion. The initial search strategy yielded 954 articles, with 27 selected for inclusion after final review. Our manual search yielded nine articles. Of the articles from the search strategy, ten were published in the urology literature, eight in general surgery, six in plastic surgery, three in orthopedic surgery, and one in vascular surgery. Key ethical themes emerged across specialties, although practical recommendations for professional social media behavior were notably absent. In conclusion, social media continues to be a domain with potential professional pitfalls. Appropriate use of social media must extend beyond obtaining consent, and we must adhere to a standard of professionalism far surpassing that of today's media culture.