When does physicians’ online branding, advertising go too far?

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The April issue of the AMA Journal of Ethics® (@JournalofEthics) considers plastic and reconstructive surgeons’ potential conflicts of interests in commercial self-promotion and advertising, the roles of some plastic surgeons in endorsing aesthetic norms that can be harmful to patients, and standards according to which plastic and reconstructive surgeons should be trained.

Take a moment to consider this question: Is it ethical for plastic surgeons to post photos and videos of procedures on social media?

  • Yes, if the surgeon receives consent to post the photos and videos from the patient before the surgery takes place.
  • Yes, if the surgeon provides the photos and videos to the patient and receives permission to post them after the surgery.
  • Yes, even if the patient has not consented, if the photos are deidentified.
  • No, this is never acceptable.

Give your answer and find responses to this question in the April issue of the AMA Journal of Ethics, which also explores ethical questions in plastic and reconstructive surgery involving informed consent, risk disclosure, and the roles of values such as cosmesis and functioning in clinical decision-making.

Articles include:

When is Advertising a Plastic Surgeon’s Individual ‘Brand’ Unethical?” Advertising a plastic surgery practice on social media is fraught with practical and ethical challenges. In this article, the authors explore the range of potential harms to patient well-being and the pitfalls of social media activity, especially marketing. They also consider the relative benefits that such online patient-clinician relationships can provide.

When is Posting About Patients on Social Media Unethical ‘Medutainment’?” In plastic surgery, platforms like Facebook, Snapchat and Instagram are especially attractive for practice promotion and instantaneous connection with potential patients. However, considerable risks and ethical dilemmas lie in wait for plastic surgeons who use patients’ photographs and videos for advertising. It is critical for plastic surgeons who use patients’ images for this purpose to facilitate fully informed consent, consider both context of use and the patient-physician power differential, and put patients’ interests ahead of their own.

Can Plastic Surgeons Maintain Professionalism within Social Media?” Social media allows patients to compare themselves to a much wider, if not global, set of peers that might further exacerbate their anxieties about their appearance. Plastic surgeons should ensure that using patients’ images does not violate their privacy or create unreasonable expectations about possible post-surgica results; nor should plastic surgeons’ marketing objectify women or reduce women’s humanity to their body parts.

Facial Disfigurement and Identity: A Review of the Literature and Implications for Facial Transplantation.” Facial disfigurement can significantly affect personal identity and access to social roles. Although conventional reconstruction can have positive effects with respect to identity, these procedures are often inadequate for more severe facial defects. In these cases, facial transplantation (FT) can offer patients viable reconstructive options.

However, FT’s effect on personal identity has been less well examined, and ethical questions remain regarding the procedure’s psychosocial ramifications. This article reviews the literature on the different roles of a person’s face as well as psychological and social effects of facial disfigurement. This article is associated with an enduring continuing medical education activity that the AMA has designated for AMA PRA Category 1 Credit™.

Listen and discuss

In the journal’s April podcast, plastic and reconstructive surgery resident Shane Morrison, MD, and medical student Cedar Neary discuss the meaning of surgical justice and how plastic surgeons can use this concept to deliver better care to their patients in the field of gender-affirming surgery. Listen to previous episodes of the podcast, “Ethics Talk,” or subscribe in iTunes or other podcast distribution platforms.

Meanwhile, the AMA Journal of Ethics Discussion Forum will explore ethical risks and benefits of using social media for marketing and education. The discussion runs from April 11–18. Join the discussion forum to learn from experts on the topic and ask questions.

Submit manuscripts and artwork

The journal’s editorial focus is on commentaries and articles that offer practical advice and insights for medical students and physicians. Submit a manuscript for publication. The journal also invites original photographs, graphics, cartoons, drawings and paintings that explore ethical dimensions of health or health care.

A look ahead

Upcoming issues of the AMA Journal of Ethics will focus on trauma surgery ethics, ethics in burn care, and religion and spirituality in health care practice. Sign up to receive email alerts when new issues are published.

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AMA member Magda Houlberg, MD, chief medical officer at Howard Brown Health in Chicago.
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