Doctors using social media – Fitness to practise implications and pitfalls

Good medical practice & other GMC guidance

It is important to note that the standards expected of doctors do not change because they are communicating through social media as opposed to face to face or through other traditional media.

Good medical practice

The Good medical practice states, amongst other things:

• 36 You must treat colleagues fairly and with respect.
• 65 You must make sure that your conduct justifies your patients’ trust in you and the public’s trust in the profession.
• 69 When communicating publicly, including speaking to or writing in the media, you must maintain patient confidentiality. You should remember when using social media that communications intended for friends or family may become more widely available.
• 70 When advertising your services, you must make sure the information you publish is factual and can be checked, and does not exploit patients’ vulnerability or lack of medical knowledge.

Doctors’ use of social media

The GMC has produced guidance for doctors on their use of social media.  When using social media, doctors must be careful to ensure social and professional boundaries do not become unclear or blurred.  Doctors must ensure they follow the GMC’s Maintaining a professional boundary between you and your patient when using social media.  This guidance states, in relation to social media:

“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.”

Maintaining doctor-patient partnership, when using social media means that “Patients should be able to trust that their doctor will behave professionally towards them during consultations and not see them as a potential sexual partner.”

Use of social media and fitness to practise

The GMC makes clear that doctors must be prepared to explain and justify their decisions and actions including those that relate to their use of social media.  Social media can blur the boundaries between public and private life in ways that would be more obvious in real life situations and this presents a heightened risk for doctors.

However, fundamentally the issues that may arise through the use of social media does not change; privacy and confidentiality, maintaining professional boundaries, respect for colleagues, anonymity and conflict of interest.

The GMC’s guidance goes on to say that “serious or persistent failure to follow our guidance that poses a risk to patient safety or public trust in doctors will put your registration at risk.”

Social media pitfalls – dos and don’ts

Maintaining boundaries

• 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.
• If, as a result of the above, there is a professional breakdown, doctors should consider whether it is appropriate to end their professional relationship with a patient.
• You must not use your professional relationship with a patient to pursue a relationship with someone close to them.

Respect for colleagues

• Report sexualised, unprofessional and/or otherwise inappropriate online behaviour towards patients by colleagues.

Anonymity

• GMC guidance makes clear that doctors who identify themselves as a doctor in publicly accessible social media, you should also identify themselves by name.

Conflict of interest

• When you post material online, you should be open about any conflict of interest and declare any financial or commercial interests in healthcare organisations or pharmaceutical and biomedical companies.

Maintaining confidentiality

• You must not use publicly accessible social media to discuss individual patients or their care with those patients or anyone else.
• Doctors must also take care when discussing “individual pieces of information” because the sum of published information online could be enough to identify a patient or someone close to them.
• The same laws of copyright and defamation as written or verbal communications, whether they are made in a personal or professional capacity.
• You should be aware of the limitations of privacy online and you should regularly review the privacy settings. Remember, social media sites cannot guarantee confidentiality.
• People, colleagues and organisations you are friends with or follow can see your posts and information.  You should regularly review these.
• Take extra care when posting photos online, you may inadvertently be sharing information such as location, identity of other people or other personal information in the background.
• When using professional social media sites that are not accessible to the public, be careful not to share identifiable information about patients and/or colleagues.