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The patient-centered care features quality, affordable, and timely care in a variety of settings – technology is a key part of that – particularly among younger generations and child and adolescent patients. The consumer movement related to new technologies is nearly passing clinicians by, as new ways of communicating with others (text, e-mail, Twitter, Facebook) revolutionizes how we experience life and access healthcare. This paper explores a continuum with healthy, innovative behavior on one end (e.g., social media) and pathological Internet use on the other end – and the range of self-help and e-mental healthcare options being used.  Specifically, it focuses on how social media adds to, yet may complicate healthcare delivery, such that clinicians may need to adjust our approach to maintain therapeutic relationships, interpersonal/clinical boundaries, and privacy/confidentiality.  We suggest planning ahead to discuss expectations about online communication between doctors and patients as part of the informed consent process, offer other do’s and don'ts for patients and clinicians, and review applicable guidelines.  More research is needed on consumer and patient use of technology related to healthcare, as is an approach to basic and advanced measurement of outcomes.