There are many different ways for doctors and patients to communicate in today's world: old-fashioned office visits, cutting edge live video "visits," and pseudo-visits such as Facebook and Twitter.
With each of these kinds of interactions, there are important details that doctors and patients need to be aware of and consider before acting on the advice being shared.
Office visits are the most straightforward. A patient visits a doctor and explains their symptoms. The doctor examines the patient to identify supporting signs, and a subsequent discussion is then held where a diagnosis is made or advice is given as to what the next steps may be.
Video screens have made their debut in hospitals. A robot wheels itself into a patient's room, and a remote doctor's face pops up on a screen. These are cutting edge situations that obviously have limitations as to the extent of information the "virtual doctor" can obtain. Such limitations will undoubtedly be enhanced by local personnel who care for the patient as well.
But it is the Twitter/Facebook type of interactions that seem to be getting the most scrutiny, probably because they are widespread and easy to use. First, it is imperative that we understand the purpose of these forms of media. At its basic level, social media allows people from all walks of life to interact with each other. In the medical context, social media gives people access to doctors where they might not otherwise have such access.
As a physician, I use Twitter and Facebook sparingly for making medically-relevant "suggestions" or advice. I agree that putting advice "out there" is a risk because we do not have a society of people who fully understand and acknowledge the limitations of these forms of communication. In my opinion, patient-doctor communications should not be delivered over Twitter/Facebook. Such media are by definition limited in scope. Therefore, any delivered information is one-sided or incomplete and may result in misinterpretation and bad outcomes.
Anyone who uses social media should understand the need to examine carefully anything being published before sending it out. Having said that, no matter how careful one is, one will sometimes find that a delivered comment/tweet/email/etc should have been better edited. What could address this issue is medical liability reform. Reform that addresses the limitations of social media forms of communication and limits lawsuits to particularly obvious attempts by one party to dupe or harm another would be welcomed. There are many complexities which would need to be discussed however. I certainly cannot hope to solve this aspect of health care here.
I also hope that readers attempt to understand that ANYTHING that is said or written should be interpreted VERY CAREFULLY. In today's world, it is not just a tweeting doctor who might deliver incorrect or partially correct advice due to the limited nature of the form of communication being used. There are many other types of caretakers who may attempt to give advice - nurses, nurse practitioners, physician assistants, chiropractors, etc. Pay attention to the source as well as the information. And when in doubt, make an appointment with an actual physician, sit down with him/her, and describe in full detail, not just 140 characters, what you are experiencing.