Tick Tock… your livestream time is over.

A plastic surgeon in Ohio lost her medical license after she livestreamed surgical procedures on TikTok. Some of her surgical patients also reported complications after surgery, complications that may have been caused by her distraction. On Wednesday July 12 the Ohio State Medical Board permanently revoked Dr. Katharine Roxanne Grawe’s medical license and fined her $4,500 “based on her failure to meet standard of care.”

In addition to violating medical ethics, this is a massive HIPAA violation.

The board said Grawe, who originally had her license suspended in November, neglected her patients as she livestreamed parts of their procedures, spoke into a camera and answered viewer questions during the surgeries.

Dr. “Roxy” Grawe told the medical board that she used social media to educate the public about plastic surgery. The medical board was skeptical. Dr. Jonathan B. Feibel, vice president of the medical board, said Dr. Grawe’s use of social media “amplified her reckless behavior” and he accused her of using it to enhance her brand, not to educate. He recommended that her license be revoked because of the “life altering, reckless treatment” provided to her patients.

Three of her patients suffered severe complications and needed intense medical care after she operated on them. One woman’s intestine was found to be perforated a week after her surgery, a procedure that Grawe partially livestreamed on TikTok.

“These outcomes were not normal complications like those that exist in the routine practice of medicine, but were rather caused by recklessness and disregard for the rules governing the practice of medicine in Ohio,” Dr. Feibel said.

Social Media and HIPAA

Using social media to market healthcare services is more common today than ever. A 2020 study from George Washington University noted that a survey of more than 4,000 physicians found that 90% use at least one social media platform for personal activities, and 65% used platforms for professional reasons. The GW study concluded however, that a physician’s use of social media may have a negative impact on patients’ trust.

Maintaining confidentiality and trust is fundamental to quality care and HIPAA compliance, but other ethical considerations apply. The American Medical Association (AMA) has a code of medical ethics Professionalism in the Use of Social Media that lists seven key considerations. The first three focus on privacy.

Patients can authorize disclosure of their protected health information (PHI) for social media (and other) purposes but the authorization needs to follow HIPAA.

You can use social media in healthcare as long as you follow HIPAA and the AMA code of medical ethics. Patient privacy is sacrosanct, so stay within the law to maintain trust and keep your license.

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