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Why Can’t We Be Friends? Social Media and Physiotherapy Practice

Social media has been around for less than 20 years, yet its impact on society in that time span has been significant. People from around the world and from all walks of life use platforms such as Facebook, Twitter, Instagram, LinkedIn, and countless others to stay connected with friends and family, share silly cat videos, and more. Increasingly, social media is used by businesses and professionals to market their services.

Social media use among physiotherapists is very common in Alberta, with physiotherapists employing a wide range of social media platforms to connect with current and potential patients, peers, and others. Physiotherapists often use social media posts to market their services, keeping members of the public informed about new techniques they offer, or to advise patients of staff changes or hours of service. Many physiotherapists also use social media platforms to share general health information with patients and the public or to share information and research updates with fellow physiotherapists from around the world.

The potential benefits of social media are significant and wide ranging; however, there can be challenges and down sides to the use of these platforms as well. This article will focus on what you can expect when interacting with physiotherapists social media platforms and the risks of becoming Facebook Friends with your physiotherapist.


Physiotherapists are required to meet certain expectations regarding how they conduct themselves in in-person interactions. Those expectations include:

  • Conducting and presenting themselves with integrity and professionalism
  • Communicating openly, honestly, respectfully, and effectively during all professional interactions
  • Being truthful and accurate when promoting themselves and their services
  • Maintaining appropriate boundaries with patients, colleagues, students, and others

eProfessionalism reflects the expectation that you and other members of the public can expect that physiotherapists will meet these same requirements when they interact with you online. However, some characteristics of social media platforms can make this challenging.

By their nature, social media platforms encourage information sharing and it can be easy to step over the line between the right amount of information to share and too much. Add to that the informality and asynchronous nature of social media communication and the lack of non-verbal cues in online exchanges, and it is easy for miscommunication to occur.

Why Boundaries Matter

One concern that gets a lot of attention from regulators is that of maintaining appropriate boundaries between patients and health professionals when interacting online and in-person. We all want to feel like we have a positive working relationship with the health professionals that provide us with treatment. Having a positive relationship with a health-care provider is known to help to improve health outcomes. However, when either you or your physiotherapist start to see the relationship as a friendship rather than a professional relationship, problems can arise:

  • Your physiotherapist may make assumptions about the cause of the problem for which you are seeking care or other aspects of your history, based on what they know about you from personal interactions.
  • You may be reluctant to share important health information, or incorrectly assume your physiotherapist already knows certain things about your health history because of your personal relationship.
  • Your physiotherapist’s familiarity can lead to corners being cut during the assessment process due to assumptions made based on incomplete information.
  • The personal relationship can affect your physiotherapist’s judgment and decision making, which could result in too much, too little, or generally inappropriate care decisions.
  • If questions arise about your physiotherapist’s judgment or impartiality, it can result in questions from insurance companies as to whether the physiotherapist’s recommendations are based on your needs, or your personal relationship. This can, in turn, create problems for you when it comes to accessing funding for your physiotherapy care.

How Boundaries Get Blurred Online

The expectation is that appropriate professional boundaries be maintained at all times – both with in-person and online interactions. With social media, when physiotherapists use a platform for more than one reason (for example to promote their business and to connect with friends, family, and colleagues), there is a risk that they may share information that is personal in nature and best not shared with patients. The same is true if a physiotherapist accepts friend requests from patients.

One way that physiotherapists can address this issue is to create a personal profile that is separate from their business profile and tailor the information they post on each, or to use different social media platforms for different purposes or to interact with different groups. Another way that physiotherapists address this issue is to avoid accepting friend requests or following current or former patients on social media platforms.

If you send a friend request to your physiotherapist and they decline the request, it isn’t because they don’t like you or value your business.

Other Concerns with Social Media Interactions

Another problem has to do with private information being shared online. This can happen due to a patient commenting on a post made by the physiotherapy business (e.g., regarding a specific health condition or treatment), or the physiotherapist replying to a comment or question posted online.

The privacy rules that govern physiotherapy practice mean that a physiotherapist should not post private patient information online. Posting this information online is a breach of patient privacy. Similarly, patients and members of the public should be discouraged from posting private health information online. Physiotherapists are advised to avoid replying to specific health questions on social media platforms because offering advice without completing an assessment creates safety risks for the patient. An appropriate physiotherapy assessment requires the collection of a lot of patient information, and that cannot be done through a social media platform in a manner that respects your privacy and protects your health information.

If you post a question or ask for advice about your health on a physiotherapist’s social media page or profile, you should expect the physiotherapist to suggest you book an appointment so that your concern can be assessed and appropriately addressed.

What if we are already social media friends?

As a rule, physiotherapists are advised to avoid providing services to people with whom them have a close personal relationship. In most cases, rather than treating you themselves, it would be more appropriate for your physiotherapist friend to refer you to a colleague they trust and know will be able to address your physiotherapy needs.

In some cases, for example if your physiotherapist friend works in a rural or remote community where there are no other physiotherapists, or if your physiotherapist provides a service that is not available from someone else within the community, they may be the only available treatment option. In this case, your physiotherapist will need to work hard to treat you like any other patient, and to make sure that online interactions, whether personal or professional in nature, are appropriate and protect your privacy.

This can be challenging for both you and your physiotherapist, but it is essential to making sure that you get the care that you need and that professional expectations are met.

Page updated: 25/04/2022