The use of social media in healthcare practice has become ubiquitous. While this brings numerous benefits, it also adds several previously unknown risks to the modern healthcare arena.
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By Dr Volker Hitzeroth, Medicolegal Consultant at Medical Protection Society
It is no exaggeration to state that social media has transformed the practice of medicine.
Every healthcare service and every patient interaction has been affected by the rise of social media whether it be Facebook, Instagram, LinkedIn, X (formerly known as Twitter) or TikTok.
While this has brought with it many benefits, especially in a country like South Africa, it has also raised numerous concerns and introduced previously unknown risks to everyday medical practice.
Anyone working in the healthcare environment should become aware of such risks and be able to manage their use of social media to maintain the high standards expected of the profession.
An inability to do so may result in adverse consequences such as a bad review, a complaint before the HPCSA or even a claim in defamation.
In order to guide practitioners and protect the public, the HPCSA has published a booklet called HPCSA: Ethical Guidelines on Social Media (Booklet 16). The booklet is very helpful, and in addition to HPCSA: The General Ethical and Professional Rules of Conduct (Booklet 2) as well as the numerous other HPCSA published Ethical Guidelines Booklets, provides a helpful framework for healthcare practitioners. It would be prudent for every practitioner to familiarise themselves with their content.
The HPCSA’s definition of social media includes various online tools and electronic platforms including social networks, content sharing platforms, personal and professional blogs, internet discussion forums as well as the comment sections of websites. In short, everything that a practitioner does electronically may be included in this definition, from simple emails, SMS’s and WhatsApp’s, to Facebook, LinkedIn and TikTok.
The HPCSA’s guidance in relation to social media examines the following themes:
1. Patient confidentiality and privacy:
Patients are entitled to privacy and confidentiality – with very few exceptions. Appropriate and correct informed consent, in writing, must be obtained before any patient’s personal information is published. Identifiable patient information should also be removed.
Any disclosure should be kept to a minimum when it is published, and healthcare providers must be aware that such published information may be shared onwards and disseminated. The patient’s right to confidentiality extends beyond their demise. The Protection of Personal Information Act (POPI Act) also has relevance to social media as it governs all information processing in the republic.
2. The practitioner – patient relationship:
A common risk with social media is that the doctor–patient relationship becomes blurred, and the usual firm professional boundaries become increasingly elastic resulting in further ethical dilemmas. When a practitioner is approached by a patient in a non-professional capacity, they should be cautious and consider the circumstances and implications before accepting such a request.
Similarly, any inappropriate patient approach calls for the polite re-establishment of the professional boundaries with a brief explanation regarding the reasons for doing so. Furthermore, it is recommended that, except for emergencies, health care advice should not be given by social media but rather during a clinical consultation. Finally, any health care advice that is shared on social media should be evidence–based, scientifically sound and generic in nature while a recommendation to consult a healthcare practitioner is also made.
3. The health profession’s image:
It is worth emphasising that a practitioner’s personal online activity may reflect on their own professionalism as well as the profession as a whole. It is therefore important that all social media activity, whether personal or professional, does not bring the profession into disrepute. Practitioners should avoid defamatory comments, hate speech and the infringement of copy right.
Similarly, practitioners should not cast aspersions on the probity, skill, or reputation of a colleague. The traditional boundaries between trainees and teachers apply also online. Finally, practitioners are advised to include disclaimers in their social media profile explaining that the views expressed are their own and not those of the profession or the relevant healthcare facility.
4. Conflicts of interest:
Healthcare practitioners should never endorse any hospital, facility, product, or medicine in a manner that unfairly promotes certain practices, establishments, or products for financial or other gain. Practitioners must abide by the HPCSA’s rules on advertising and may not engage in canvassing or touting.
5. Precautionary measures when using social media:
It is expected that practitioners take all reasonable security measures. Complete anonymity and confidentiality are never assured. All privacy settings should be appropriately adjusted. Despite such measures, it should be remembered that any post on social media may be copied, reproduced, captured, or shared by the recipient.
It is equally important to remember that anything shared on social media is likely to remain there in perpetuity and cannot be easily or completely removed. Finally, practitioners should not use social media while stressed, tired, upset or under the influence of alcohol.
While there are numerous risks associated with the use of social media this should not prevent healthcare practitioners from making use of the opportunities that social media offers. Given the current situation it is not possible for a practitioner to ignore or sidestep social media anymore. It has become part and parcel of our modern society and part and parcel of modern medical practice.
The challenge facing healthcare practitioners is to be able to use social media responsibly and professionally, to be aware and alert to the associated risks and to manage their social media use in such a manner as to benefit from its advantages and minimise the medicolegal risk associated with inappropriate use.
References:
• HPCSA: Ethical Guidelines on Social Media (Booklet 16)
• HPCSA: The General Ethical and Professional Rules of Conduct (Booklet 2)
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This article was originally published in and is republished with permission.