“Treat yourself to better vision for Christmas.”

That was how a French ophthalmologist promoted his services online, alongside an offer of a free preoperative consultation. He was the majority shareholder of the aesthetic center where he worked. That promotion was penalized by the country’s national disciplinary chamber back in 2012.

Another physician was penalized in 2015 for receiving a share of subscription revenue from a website offering personalized nutritional advice under his supervision.

The cases predate France’s latest guidance for doctors posting online, but they capture the problem it is intended to address: where does professional communication end and inappropriate promotion or advice begin?

European medical bodies are now moving from providing broad professionalism principles toward more explicit guidance for physicians who communicate online.

For example in January 2025, France’s National Medical Council (CNOM) published its 10-principle charter for physician content creators, requiring clear identification, sourcing, and disclosure while prohibiting personalized medical advice, unvalidated therapies, promoting their own medical practice, using paid methods to improve content ranking, and commercial promotion of health products.

In the UK, a General Medical Council (GMC) spokesperson told Medscape News Europe that its social media guidance builds on Good medical practice, its core document setting out professional standards. Those standards, the spokesperson said, do not change simply because a doctor is communicating online.

The World Medical Association (WMA), meanwhile, urges national medical bodies to establish guidance addressing issues such as confidentiality, conflicts of interest, scientific rigor, and misinformation.

For physicians, the practical issue is not whether social media can be used professionally. It already is. The harder question is what changes when a doctor’s audience expands beyond the consulting room: education can begin to look like advertising, a casual reply can be taken as clinical advice, and a personal brand can carry the authority of a medical title.

Professional Standards Don’t Stop at the Screen

A 2026 study of all 1281 members of the German Society of Plastic, Reconstructive, and Aesthetic Surgery found that 31.8% were using Instagram to post professional content when the data were collected in 2022. Use was particularly common among physicians in private practice, and nearly half of the accounts combined professional and private material.

That mixture is not, by itself, misconduct. But the same study highlighted some of the risks that come with it: patient-identifying photographs or videos require written informed consent, creating content must not distract from a medical procedure, and blurred personal and professional accounts may give patients the impression of a personal relationship. The authors also noted the potential value of physicians posting accurate professional content to counter misinformation.

The GMC makes a similar point from a regulatory perspective. Its social media guidance says that medical professionals should identify themselves when discussing health or healthcare, take reasonable steps to ensure information is not false or misleading, and not misrepresent their experience or qualifications. It also warns that private messages and ostensibly anonymous posts can become public.

A GMC spokesperson made the same point to Medscape News Europe: When doctors communicate publicly — including on social media or when advertising, promoting, or endorsing services or products — they must declare conflicts of interest, avoid exploiting people’s vulnerability or lack of medical knowledge, and make sure their communication is consistent with their duty to protect patients and the public.

The WMA guidance also addresses the way social media can blur professional boundaries. Its statement on social media use says physicians should apply the same scientific rigor online as they would in a consultation, provide factual and understandable information, declare conflicts, and avoid frivolous or insensitive opinions on medical matters. It also cautions that online “friendships” with patients can blur professional boundaries and encourage doctors to disclose personal information that may be inappropriate in a clinical relationship.

When Does Education Become Advertising?

Commercial promotion is one of the least ambiguous areas.

“Physicians are prohibited by EU law and national regulatory codes from promoting prescription drugs to the public,” Morten Magelssen, MD, PhD, professor and head of the Centre for Medical Ethics at the University of Oslo, Osla, Norway, told Medscape News Europe.

Endorsements outside prescription medicines can be less straightforward. Magelssen said physicians are ethically discouraged from advertising nonmedical products when doing so trades on the public trust attached to their medical authority. “Using a medical title for commercial gain creates a conflict of interest,” he explained.

Promoting a doctor’s own services is another contentious area. France’s CNOM charter explicitly says doctors should not use social media to promote their own medical practice. The GMC, by contrast, expressly contemplates doctors advertising their services, but requires them to be open about interests that could influence their recommendations and to comply with relevant law and regulatory codes.

A Patient Is Still a Patient in a Direct Message

Some boundaries are less about money than about the relationship itself. The GMC says that if a patient contacts a doctor about their care through the doctor’s private social media profile, the patient should be directed to an appropriate healthcare setting. Its guidance also stresses that confidentiality applies to social media in the same way it applies elsewhere: even individual details that seem harmless may, when combined, allow a patient or someone close to them to identify a case.

The German plastic surgery study makes that risk concrete. It notes that photographs showing identifiable patient features might increase engagement but publishing them without written informed consent can breach ethical requirements and expose doctors to data-protection penalties. The authors advise written informed consent for identifiable images or video and recommend separating professional and personal accounts.

France’s CNOM charter similarly prohibits personalized medical advice to social media users.

For Francesca Jackson-Spence, MB ChB, a clinical research fellow and PhD candidate in genitourinary oncology at Barts Cancer Institute, Queen Mary University of London in London, England, that means being clear about where general health information ends and individual medical advice begins.

“I think it starts with being transparent about the limits of what you’re sharing,” Jackson-Spence, who has more than 55,000 Instagram followers, told Medscape News Europe. “I always caveat that I can’t provide personalized health advice online.” Doctors should distinguish clearly between evidence-based medical information, personal experience, and opinion, she added, and avoid presenting individual views as universal advice.

The Case for a Medical Voice Online

None of the guidance argues that physicians should retreat from social media. The WMA recognizes its value for sharing medical knowledge and health information, and the German researchers concluded that professional content can help correct misinformation about surgical procedures.

That is also what drew Jackson-Spence online. “Working in cancer research, a big part of my role involves critically appraising medical evidence and translating complex data into patient-friendly information,” she said. The volume of misinformation and sensationalized health claims she encountered made helping to fill that space with accurate, balanced, evidence-based information feel “almost like a duty,” she said.

The challenge is to use social media’s reach without compromising the professional standards that apply everywhere else in medicine.

“Whilst controversial content can often help with exposure on social media,” Jackson-Spence said, “it’s important to remain professional across every post, rather than chasing going viral.”

Jackson-Spence and Magelssen reported having no relevant financial relationships.

Lisa Mulcahy is a freelance writer for WebMD and Medscape.