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Over 4.8 billion people in the world now use social media, and on average they spend more than two hours a day on it.1 It is hardly surprising then that healthcare professionals also have many interactions with both their colleagues and patients on social media, some of which inevitably gives rise to medicolegal problems.
Most breaches of privacy are unintentional and can be avoided by keeping in mind that you have very little control over what happens with information you post on social media. Sharing identifiable material with colleagues in what you believe is a private group is risky, as others may then post this material more widely without your knowledge. For example, interesting radiological images often have the patient’s details visible, and we have witnessed cases where these disclosures have come to the knowledge of the patient, who then went on to complain that their privacy had been violated. While it is helpful to seek the opinions of colleagues on complex cases, it is rarely necessary to share the patient’s details. This is especially true when the patient is a celebrity or well-known public figure.
All the regulators across the countries we work in stress the importance of maintaining patient confidentiality. However, we have seen an increasing number of cases where members have inadvertently made such an error.
Particular care needs to be taken with images of children or patients who lack the capacity to consent.
One of the most common situations we come across is images being posted of ‘before’ and ‘after’ treatment on aesthetic and dental clinic websites. The results may be impressive, and the patient delighted with the outcome, but without the patient’s prior written consent, such photographs should not be used. Likewise, patients should never be incentivised to consent to social media publication of sensitive material in the form of discounted products, services, or procedures.
Somewhat controversially, the General Medical Council (GMC) in their revised guidance on Good Medical Practice advise doctors to treat their colleagues with kindness, courtesy, and respect.2 Precisely how they will judge doctors when allegations of ‘unkindness’ are made remains to be seen, but it is likely that anything posted on social media that sounds pejorative may be used as evidence of unprofessional behaviour.
It is always dangerous after a trying day to post your innermost feelings about those you work with. Remarks that you may have made in private can be very embarrassing and possibly quite damaging when looked at in the cold light of day.
Sadly, we have seen examples of doctors in training making disparaging remarks about the units they are working in and their colleagues, which they thought were being posted in a private forum, coming to the notice of their Deaneries with unfortunate consequences.
Of course doctors have lives beyond medicine and are parents, members of sports clubs, and are often active in their communities. Because so many of our non-work-related interests nowadays involve interacting with others on social media, there is always a risk of blurring the professional boundaries.
The GMC states: “You must consider the potential risks involved in using social media and the impact that inappropriate use could have on your patients’ trust in you and society’s trust in the medical profession. Social media can blur the boundaries between a doctor’s personal and professional lives and may change the nature of the relationship between a doctor and a patient. You must follow our guidance on the use of social media.”
This guidance goes on to state: “If a patient contacts you about their care or other professional matters through your private profile, you should indicate that you cannot mix social and professional relationships and, where appropriate, direct them to your professional profile.”
While doctors may think that when they are off duty they should be treated like anyone else, there is a risk that others will still regard them in a position of authority and privilege.
Increasingly we are seeing doctors and healthcare facilities being reviewed on social media – just like restaurants, hotels, and hairdressers. It is likely that this trend will grow, and in the future, part of being a professional will be developing the skills required to deal with unfavourable reviews.
Although such reviews may seem unfair, and even offensive at times, social media is not the forum in which to manage a dispute with a disgruntled patient or their family.
When we are contacted by members who are the subject of such reviews, our advice is to remain calm and professional, and where possible to take the matter offline. An expression of concern and an offer to address any issues the complainant has in private is usually the most appropriate way forward. However, potentially defamatory comments may require specialised advice, as most social media platforms allow users to report false and defamatory information for removal.