Guidance on Use of Social Media for Doctors
This article has been written in collaboration with MDDUS, one of the leading medical defence organisations. MDDUS have offered a £50 discount to locum doctors who join them using a voucher code from Messly, which you can read more about here.
Social media is a great tool for doctors to connect and support each other, build community and keep up to date in their fields of clinical interest.
However, there have been a number of recent high profile cases where doctors have been reported to the GMC or faced investigations by their employer for their inappropriate use of social media. So as a doctor, you might be concerned to know what rules apply to you when engaging on social media.
In this article, we will:
👉 Break down the GMC’s specific guidance on use of social media
👉 Explain the practical implications for doctors, with some do’s and don’ts
👉 Explain the consequences if you breach the guidance
👉 Outline the steps a doctor should take if you think you have made a mistake
The GMC's social media guidance
The GMC published guidance for doctors on their use of social media in April 2013.
These are not additional rules specific to social media, but guidance on how to apply general principles (such as patient confidentiality and maintaining boundaries with patients) to the context of social media.
As the guidance says: "The standards expected of doctors do not change because they are communicating through social media rather than face to face or through other traditional media. However, using social media creates new circumstances in which the established principles apply."
These are high-level guidelines to follow, and it is your personal responsibility to consider how to apply them to all aspects of your work and professional lives. In all cases you will need to exercise your personal judgement to consider how these principles apply to the situation at hand.
Be aware that your employer or deanery may have additional guidelines on social media that you should be aware of, and may provide you with a specific induction session or elearning module on the topic. MDDUS also have a webinar on this topic which you can access here.
Good Medical Practice
The GMC’s Good Medical Practice guidance reminds doctors that:
You must treat colleagues fairly and with respect [...] You must make sure that your conduct justifies your patients’ trust in you and the public’s trust in the profession.
This guidance also applies to your conduct online and so be mindful of this guidance when engaging on social media platforms, especially if the conversation is getting heated! It is important to also show "Respect for colleagues" and the guidance reinforces this point, stating that "You must not bully, harass or make gratuitous, unsubstantiated or unsustainable comments about individuals online".
Although you may consider the conversation to be private, the guidance highlights that when communicating via social media, these communications may become more widely available, so you should bear this in mind.
The general principles of patient confidentiality also apply to your use of social media. The guidance states:
You must still be careful not to share identifiable information about patients. Although individual pieces of information may not breach confidentiality on their own, the sum of published information online could be enough to identify a patient or someone close to them. You must not use publicly accessible social media to discuss individual patients or their care with those patients or anyone else.
From this, it is clear that no patient identifiable information should ever be shared online. See the notes below on using WhatsApp within your clinical teams.
The GMC reminds doctors in their boundaries guidance to ensure that they maintain appropriate professional boundaries with their patients. Doctors must not pursue an improper relationship with a patient.
The ease in which a doctor may be found via social media means that now, more than ever, doctors may be contacted on a personal basis by a patient. This increases the risk that boundaries between a doctor’s personal and professional life become blurred.
The general advice from MDDUS is that it is not appropriate to accept a friend request from a patient. If the contact is for clinical advice, they should be directed to appropriate channels, such as their GP, for clinical advice.
We would recommend you think about your privacy settings as different sites have different default settings and you routinely audit these privacy settings.
Only passing mention of this is made in the social media guidance, with a reminder that the GMC’s guidance on prescribing applies also in the context of social media.
Be careful when engaging with the public on social media, avoid referring to specific medicines, dosages, or devices to ensure that this does not come across as a specific recommendation.
Regarding anonymity, the guidance states that:
If you identify yourself as a doctor in publicly accessible social media, you should also identify yourself by name. Any material written by authors who represent themselves as doctors is likely to be taken on trust and may reasonably be taken to represent the views of the profession more widely.You should also be aware that content uploaded anonymously can, in many cases, be traced back to its point of origin.
Conflicts of interest
Regarding conflicts of interest, the guidance states that:
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.
Common sense should prevail. Before pressing ‘send’ or ‘post’, it is crucial to consider what you are saying and how you are saying it.
Consider why you are using each site, whether you are posting in a personal or professional capacity, and who will be seeing your posts. Think about the impact anything you post may have on the wider profession, as your views may be taken to represent the views of doctors generally and may impact the public’s trust in the medical profession.
We would suggest that doctors avoid publishing personal opinions on polarising topics and consider if it would be more appropriate to do so on a personal private profile making no reference to your profession.
You might feel like these rules are overly broad and may limit your ability to engage in meaningful discussions online.
However, in order to protect yourself from potential sanctions from the GMC, you should bear them in mind when using social media and if you think something you are writing might risk breaching any of the guidance it may be best not to post it.
❓ Further questions
What kinds of social media does the guidance apply to?
The GMC defines ‘social media’ as “web-based applications that allow people to create and exchange content”.
We would suggest that doctors apply this broadly to all forms of messaging or content sharing platforms, such as blogs, forums, content communities, messaging apps and social networking sites.
Therefore, the advice above on how you present yourself online applies in all contexts and on all platforms, particularly if you are identifiable as a doctor.
What about private groups like WhatsApp?
This recent case demonstrates that the GMC are concerned with not only doctors’ behaviour on professional sites involving patients, but their personal conduct on all social media channels including private messaging apps such as WhatsApp.
WhatsApp and similar messaging applications are widely used personally and amongst clinical teams. It is vital that local data protection guidance is followed, and such messaging applications are only used when there is no practical alternative.
No patient identifiable information should be shared on messaging applications and doctors should seek advice from their employer if they wish to use instant messaging within their team to share clinical information. Doctors should consider the risks to security of information or messages shared, for example the potential they could be screenshotted and shared more widely.
What are the likely consequences of breaching the guidance?
If a doctor acts unprofessionally on social media, this could be brought to the attention of their employer or the GMC, both of whom in turn may investigate the doctor’s fitness to practice.
The GMC’s guidance states 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”.
For example, in the WhatsApp case mentioned above, these doctors received a formal warning on their registration at an MPTS hearing.
Beware that breaches of confidentiality could also lead to civil claims or complaints to the Information Commissioner’s Office (ICO) which may attract criticism and/or significant legal costs.
What steps should a doctor take if they think they have made a mistake?
If a doctor believes they may have acted inappropriately online, it is important to act promptly and be open and honest. You should take steps to put things right as soon as possible and a discussion with a senior colleague is often helpful in this regard.
What actions are required will depend on the individual circumstances and seeking advice as soon as a potential error of judgement is identified can greatly assist in rectifying the matter.
How can your medical defence organisation help?
If you are a member of a medical defence organisation (MDO), they can advise you on any concerns about your use of social media and direct you to the professional guidance to enable you to review how you currently use it.
MDDUS has (paid) training and CPD available on professionalism and the use of social media for both members and non-members to attend these courses for more guidance.
Is there a duty to report other doctors if you believe they have broken a rule?
If you have concerns that colleagues are acting unprofessionally on social media and there may be a risk to patient care, safety or dignity, you have a duty to act on these concerns, as set out in the GMC’s guidance on raising and acting on concerns.
We would suggest you discuss these concerns with your supervisor in the first instance to establish what further action may be required. You should also feel free to contact your own MDO for advice on any concerns you may have.
Messly & MDDUS
Contributions to this article were provided by Dr Emily Shepherd, a medico-legal advisor at MDDUS.
At Messly, we want to help our members easily find good quality indemnity cover from a reputable provider.
We did some ‘secret shopping’ and spoke to doctors and were most impressed with MDDUS. They are one of the larger MDOs, with over 55,000 members, and they offer wide-ranging medical expertise, competitive pricing and have a ‘doctors for doctors’ personal care ethos that can support you in times of need. They also have other health and wellbeing benefits for their members.
They are offering an exclusive discount to those who join them using a voucher code from Messly. To learn more about MDDUS and to redeem your code, click here.
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