Is it Healthy to Use WhatsApp and Similar Applications in Doctor-Patient Communication?

Today, instant messaging applications such as WhatsApp have gained an important place in physician-patient communication due to their widespread use. But how healthy is this form of communication?

In this article, we will try to examine in detail the use of applications such as WhatsApp in physician-patient communication.

Benefits

- Ease of Communication and Fast Information Sharing: WhatsApp provides a fast and easy communication channel between doctors and patients, offering benefits such as appointment reminders, sharing test results and quick information in emergencies. This convenience is especially important for patients living in geographically remote areas and busy doctors.

- Potential to Improve Patient Follow-up and Relationship: WhatsApp can strengthen the patient-physician relationship by enabling doctors to communicate more closely with patients. Especially in the follow-up of chronic diseases and patient motivation, this close communication has positive effects. For example, diabetic patients can send regular blood glucose readings to their doctors, consult on diet and medication, and exchange information about their health status.

- Remote Access to Healthcare: WhatsApp can offer remote healthcare access for patients who live in remote areas or have difficulty physically reaching clinics. This has the potential to reduce inequalities in access to healthcare.

But Are There Risks?

- Privacy and Data Security Concerns: Sharing patient information via WhatsApp raises significant privacy and data security concerns. There are concerns about how the app uses personal data. Some studies have found that sharing patient information in WhatsApp groups without patient consent is common. Such data sharing can have serious consequences for patient privacy and medical confidentiality. Secure storage and sharing of patient information is of utmost importance, especially in the healthcare sector. It is often debated whether applications with large user bases, such as WhatsApp, have adequate security measures in place to protect such sensitive data. Data security concerns are not only related to the confidentiality of patient information, but also to the risk of data leakage. Health data in the wrong hands, targeted by malicious actors, can have serious consequences. Therefore, healthcare professionals and those involved in patient care should be extra careful about data security and prefer secure communication channels. Application developers should take steps to ensure the protection and confidentiality of patient information by creating transparent and secure data sharing protocols.

- Legal Liability and Uncertainty: Failure to record medical consultations over WhatsApp and to fully comply with existing legal regulations may put doctors at legal risk. The legal consequences of health problems that may occur after a medical advice given over WhatsApp can be serious for the doctor. Especially in medical errors that may occur due to incomplete information, the doctor may be deprived of a legal basis to protect himself/herself.

- Risk of Crossing Professional Boundaries: WhatsApp can blur professional boundaries, creating situations such as patients constantly texting their doctors after hours or doctors interfering in their patients' private lives. This can make it difficult to maintain healthy boundaries for both doctors and patients.

Ethical Issues:

- Patient Consent and Informed Consent: It is ethically obligatory to obtain the patient's explicit consent before sharing patient information via WhatsApp. However, it is observed that doctors do not show enough sensitivity in this regard and use WhatsApp without obtaining patient consent. This may lead to a violation of patient rights.

- Professional Responsibility and Risk of Medical Malpractice: Responsibility for medical advice given via WhatsApp is unclear and this may create ethical issues. Misunderstandings or incomplete information in WhatsApp communication may lead to medical errors and it may be difficult to determine the responsibility for these errors. Test results or images sent by the patient may always be incomplete when evaluated without an examination. This can lead to errors in the doctor's recommendations for medical treatment. Reducing the quality of images through automatic compression, especially on messaging platforms, can make the patient's current condition appear better or worse than it actually is, which can negatively affect the doctor's decision. For example, poor image quality in some X-rays can lead to misdiagnosis. In my personal practice, I am careful not to comment on images sent from messaging platforms, as I have seen that there are sometimes vital differences between the X-ray images sent to me and the images in the hospital system.

- Obstacle to Equal and Fair Service Delivery: The use of WhatsApp can hinder the provision of equal and fair healthcare for all patients. Patients who do not have access to digital facilities or do not prefer to use these applications may be disadvantaged. This is contrary to the principle of fairness in healthcare.

Additional Key Considerations:

- Digital Literacy: Both doctors and patients should have sufficient knowledge on how to use such apps safely and effectively. Especially for patients who are not familiar with technology, such communication channels can make understanding difficult and lead to misunderstandings. Therefore, it is important to disseminate trainings on the use of digital tools to reduce potential risks.

- Responsibility of Application Developers: Application developers should develop innovative solutions to enhance privacy and security measures when sharing health information. For example, technologies such as end-to-end encryption to protect patient information, as well as the creation of communication platforms specifically designed for healthcare professionals, can be encouraged.

- Physicians' Workload and Professional Burnout: It should also be considered that such communication tools may increase physicians' workload and risk of professional burnout. In order to protect physicians from the pressure of being in constant communication outside of working hours, professional boundaries should be clearly defined. At this point, our patients also have important responsibilities. Once a physician's shift at the hospital is over, their shift on messaging platforms is also considered to be over, and it is only appropriate to reach them in very urgent cases. Messages sent out of office hours may negatively affect the physician's perception of working hours and may also affect the responses to the patient. This may lead to misunderstandings by the patient or their relatives.

Conclusion

While instant messaging applications such as WhatsApp offer some advantages that facilitate physician-patient communication, they also pose significant risks and ethical issues. Therefore, clear legal regulations and ethical guidelines on the use of such applications in healthcare should be prepared, physicians should be trained and patients should be informed.

Personally, I prefer to use applications such as WhatsApp mainly for communication purposes. Except in very urgent cases, I attach great importance to face-to-face patient evaluation because the patient is not only composed of radiological images and tests; he/she is a whole and patient examination is the most important element of a healthy evaluation.