Is It Inappropriate for Attendings and Residents to be Friends on Facebook and Other Social Media Accounts?

Facebook and other social media accounts are commonly used, as they provide a way for friends and family to interact on a regular basis. Considering there can be long distances that separate friends and family, social media can be a great method to stay in touch. Social media makes it possible to congratulate individuals, and celebrate birthdays, anniversaries, and major life events. On occasion, attendings and residents are friends on social media, and whether this is appropriate or not has not been clearly defined.

Although social media friendships allow attendings to show their support and encouragement for residents, there are some potential problems. For example, if a resident is on call and is tagged in a photo in which the resident is at an establishment that serves alcoholic beverages with friends, one may question if this is an inappropriate situation for the resident. What could be construed as alcohol may in fact be a nonalcoholic beverage. However, if the resident then makes a medical/clinical mistake and the attending had viewed the photo, is the attending responsible for following up and investigating the situation further? While this may be a matter of contention, there are other potential issues that may arise with social media friendships between attendings and residents. What if an attending sends a resident a “friend request” and the resident does not accept the request? This places the resident in a potentially uncomfortable position, given the existence of a supervisor-subordinate relationship. Likewise, if a resident sends an attending a “friend request” and the attending fails to reciprocate this request, while accepting requests from other residents, this could be seen as favoritism, thus further confusing the supervisor-subordinate relationship.

Although the first author (an otolaryngology attending) was “friends” with several current residents in the training program, for the reasons previously outlined, he has chosen to “unfriend” residents he is currently supervising. An explanation was given to the residents, so as not to offend any of them, explaining that there is a potential concern with crossing the attending-resident boundaries. It seems that with the importance of honoring the integrity of the attending-resident relationship, it is possible that an “unfriending” of residents could be necessary. Considering the fact that it is unclear as to whether there is an ethical dilemma, social media relationships between attendings and residents is an area for future research.