MPS editorial in the December/January edition of Medical Chronicle
Doctors are increasingly using social media websites such as Facebook, Twitter and blogs to communicate with each other and with their patients.
While this has clear advantages in being quick, easy and accessible, the blurring of professional boundaries in the virtual world of the internet can lead to potential problems, according to the Medical Protection Society (MPS).
MPS Head of Medical Services Africa, Dr Graham Howarth, highlights his top tips for doctors regarding the use of social media:
Be secure
Maintain strict security settings and be vigilant with your standards.
Use the most secure privacy settings on social networking sites, but remember this is not failsafe and not all information can be protected on the web. Identities can be traced so be careful you don’t inadvertently post comments about your work, patients or your hospital.
Declaring that you are a doctor adds weight and credibility to your views; however with that privilege comes a responsibility not to undermine public confidence in the profession. If you are providing medical opinion and are happy for it to be professionally held to account then you must identify yourself as a doctor.
A social network is not an appropriate place to raise a concern. Even ‘doctors only’ forums have risks as they may be accessed by members of the public, employers, or friends of friends may pass on information attributable to you.
Respect confidentiality
Your duty of confidentiality applies online as well as offline.
Doctors are afforded a privileged position by their access to patients and information divulged in communication with them. To abuse this is to erode trust and confidence in the doctor-patient relationship.
The National Health Act 2003 makes it an offence to disclose patients’ information without their consent and the HPCSA’s official guidance, Confidentiality: Protecting and Providing Information (2008) views confidentiality as central to the doctor–patient relationship. It states that:
“Patients have a right to expect that information about them will be held in confidence by health care practitioners. Confidentiality is central to trust between practitioners and patients. Without assurances about confidentiality, patients may be reluctant to give practitioners the information they need in order to provide good care.“[i]
Posting inappropriate comments/photographs or describing a patient’s care on a social media website could damage your reputation, lead to disciplinary action and attract unwanted media attention.
Even if you do not mention a patient’s name they may be identifiable from information written about them, especially if the case is reported in the local press.
Act professionally
As doctors, you are not only representing yourself but the hospital or practice you work in. You have a responsibility to act professionally at all times and not bring the profession into disrepute.
Consider who may be able to access photographs of you on your personal accounts and whether there is information you would not want your employer to see. Derogatory or flippant comments about patients can be damaging to the public perception of doctors and their trust in the profession.
Maintain boundaries
It may be flattering to receive online contact or a “friend” request from a patient with whom you have a good rapport, but conversing with patients online is inadvisable. Relationships should be kept strictly professional and the doctor-patient boundary should not be blurred.
Be cautious about online contact with colleagues too so as to maintain the distinction between your personal and professional lives.
Criticism: think before you type
Once you post a comment or photograph online you relinquish control of that information, so think carefully before hitting ‘send’ or ‘upload’.
Although critical comments patients make about your care online may be upsetting, potentially damaging to your reputation, or even defamatory, avoid giving a knee-jerk reaction when responding.
It is important to keep a cool head and look at the issues objectively.
Consider treating the comment as a formal complaint. Using the appropriate formal complaint channels will allow you to explore and investigate patients’ concerns and provide an explanation and apology where appropriate.
Doctor–patient confidentiality can prevent you from directly challenging negative feedback; however, such comments can be diffused creatively with a positive response. For instance, if a patient comments “my appointment was late and my doctor seemed in a hurry to get me out the door”, you could reply by stating “we are sorry that you are unhappy with the service on this occasion. As the only practice offering this service in the area, we pride ourselves on serving as many patients as possible.”
Should a user’s feedback reveal a genuine deficiency, use it as an opportunity to improve your practice. Invite the patient to discuss their concerns and provide a point of contact, demonstrate that you have listened to their concerns and are addressing them – the patient may even reply with a positive comment online.
If you are still unsure
If you are still unsure about how to tackle a tricky situation online, talk to your employer, supervisor, medical school or contact your medical defence organisation to discuss the best way forward.
Taking care to avoid these potential pitfalls will help you make the most of social media, which offers exciting new ways to communicate in the ever-changing world of medicine, and has become an integral part of our lives.
[i] HPCSA, Confidentiality: Protecting and Providing Information (2008), para 4