The Canadian Medical Association is warning doctors to tread carefully when using social media.

In recently-issued guidelines, the CMA warns the use of Facebook or Twitter can pose legal and disciplinary problems for individual doctors, but there's also the potential for benefits to the health-care system.

"There is growing debate about whether the medical profession should play a role in using social media to communicate more effectively with individual patients and the patient community at large," the guidelines said.

The CMA's biggest concerns fall under doctor-patient confidentiality and the blurring of the doctors' personal lives with their professional lives.

"Social networking sites cannot guarantee confidentiality. Anything written on a social networking site can theoretically be accessed and made public," the report said.

"Having an online profile or identifiable presence on social media can have the same degree of positive or negative impact on a physician's social reputation as being active in any other public venue."

But the CMA also says there are potential benefits to be found in status updates and comments under 140 characters.

"Social media can provide patients and the public with quicker and easier access to medical expertise, often in a way that is more current, clear and concise than traditional media sources," the CMA said.

Health organizations around the world have been looking at social media not just as an avenue to promote health information but also to gather data, perhaps allowing for a better model to predict infectious disease outbreaks.

The last 15 years have seen an upheaval in the traditional patient-doctor power dynamic. A number of websites allow patients to rate and comment on their doctors anonymously, giving complaints – valid or not – a public forum. Physicians also have to deal with patients entering their offices armed with a tremendous amount of medical information -- valid or not – gleaned from the web.

The website, Twitterdoctors.net, lists over 1,300 physicians on Twitter in order of their influence. Not surprisingly, Dr. Mehmet Oz is ranked at the number one position.