Navigating social media: A guide for doctors in Ireland 

Social media offers numerous benefits for doctors, but also presents ethical challenges, writes Mr Niall Rooney  

In today’s digital age, social media has become an integral part of our lives, offering numerous opportunities for communication, entertainment, education, and professional networking. Leveraging social media can enhance patient engagement, professional development, and public health education. However, the use of social media also presents unique challenges, particularly concerning doctors’ ethical obligations. This article aims to provide guidance on the responsible use of social media for doctors, with a focus on the ethical principles outlined in the most recent edition of the Irish Medical Council’s Guide to Professional Conduct and Ethics for Registered Medical Practitioners (2024) (the ‘Guide’).

The role of social media in medicine

Doctors and the broader medical profession have a long track record of communicating with the public through mainstream media outlets in relation to important medical issues. Social media platforms such as X (formerly Twitter), Facebook, LinkedIn, and Instagram, offer doctors a powerful tool to share medical knowledge, engage with patients, and collaborate with colleagues. These platforms are often seen as trusted sources of information by large sections of the public and they can be used to:

1. Educate: Share accurate health information, debunk common misconceptions or myths, raise awareness about new and emerging health concerns or encourage healthy lifestyles.

2. Network with colleagues: Connect with peers, join professional groups, and participate in discussions that can cross country or regional boundaries.

3. Engage with patients: Enhance communication with patients and provide updates on healthcare services.

4. Access continuing medical education: Access the latest research in specialist fields of medicine, attend virtual conferences, and participate in online courses.

5. Inform: Share practice information with patients around availability and range of services, opening hours, testimonials, and pricing.

While the benefits are clear, doctors must navigate these platforms with caution to maintain professionalism and adhere to ethical standards.

Ethical considerations in social media use

The Guide provides a comprehensive framework for doctors who wish to have an online presence or to engage online with their patients or the public. Below are some of the key provisions set out in the Guide for doctors using social media to consider:

1. Confidentiality: Patient confidentiality is central to the doctor-patient relationship. Doctors must ensure that any information shared on social media does not compromise patient privacy. This includes avoiding the sharing of identifiable patient information, comments, or images. 

2. Professionalism: The Guide confirms that maintaining public trust in the profession requires doctors to consistently apply professional standards and ethical principles in all their dealings, including communications in public or online. Doctors should therefore maintain the same level of professionalism online as they do in their clinical practice. This includes being respectful, avoiding derogatory comments, and not engaging in unprofessional behaviour. 

3. Boundaries: It is essential to maintain clear boundaries between professional and personal use of social media. The Guide specifically advises doctors to contemplate how their private posts (images, information, comments) might be viewed by patients or the public if they were to be widely distributed. Doctors should, as far as possible, avoid communicating with patients through personal social media channels.

4. Accuracy: The Guide states that patients and the public should be able to trust what a doctor says. Therefore, sharing accurate and evidence-based information is crucial and doctors should promptly correct any incorrect information or advice they may have posted. The Guide confirms that doctors are legally liable for anything they publish and it states that doctors should identify themselves by name when offering any clinical advice online. 

5. Conflict of interest: Doctors must not let financial or other secondary considerations influence or appear to influence their management of patients. The Guide expressly states that doctors must disclose any financial or commercial interests if they are promoting or endorsing specific healthcare products or services.

6. Advertising: The Guide advises that any advertising of services should be responsible, accurate, ethical, legal, and truthful. It states that doctors must not make claims that cannot be substantiated about the effectiveness of treatments. It goes on to state that doctors, when providing information about themselves or their services, must not exploit or damage the trust and confidence that patients and the public have in doctors.

Real world examples to learn from

In 2015, the then UK Health Secretary Jeremy Hunt tweeted a photo of himself standing alongside a number of NHS staff during a hospital visit. He was publishing his plans to impose a seven-day working contract for NHS staff. The seemingly innocuous post landed him in hot water for an apparent breach of patient confidentiality as it transpired that a notice board in the background of the photo contained the names of patients who were being treated on the hospital ward at the time. Mr Hunt’s post was seen by over 70,000 people before it was edited to blur out the noticeboard and his experience is a powerful lesson for all social media users to check and double check their content before posting. 

A notable example of a doctor who has faced serious consequences due to social media misuse was Dr Katharine Roxanne Grawe, known online as ‘Dr Roxy’. Dr Grawe lost her medical license in Ohio in July 2023 after the State Medical Board of Ohio found she had harmed patients while livestreaming surgeries on TikTok. The board cited Dr Grawe’s negligence in patient care, highlighting her habit of filming and answering viewer questions during procedures. They described her actions as reckless, stating she prioritised social media engagement over patient safety.

Top tips for social media use

Doctors are subject to professional and ethical obligations and their status in the public eye demands a high standard of conduct at all times.

To navigate social media effectively while adhering to ethical guidelines, doctors can follow these practical tips:

1. Separate personal and professional accounts: Maintain separate accounts for personal and professional use. This helps to protect patient confidentiality and maintain professional boundaries.

2. Be mindful of privacy settings: Regularly review and update privacy settings on social media platforms to control who can see posts and personal information.

3. Think before posting: Consider the potential impact of your posts on patients, colleagues, and the public. Avoid sharing content that could be misinterpreted or deemed unprofessional. Always check content for accuracy before posting.

4. Engage respectfully: Participate in online discussions with respect and professionalism. Avoid engaging in heated debates or responding to negative comments in a confrontational manner.

5. Stay informed: Keep up-to-date with the latest guidelines and best practices for social media use in the medical profession. This includes regularly reviewing the Irish Medical Council’s guidelines and other relevant resources.

6. Groups/organisations/practices should consider developing a social media policy: Establish clear guidelines for social media use that outlines acceptable behaviour, confidentiality protocols, and procedures for handling online interactions with patients. 

7. Do not respond online to negative or abusive posts. It can be tempting to correct untrue or incomplete information posted by a patient for example in a negative online review or comment, but the advice remains not to engage online as to do so would often breach patient confidentiality. You should also contact your indemnifier for assistance and advice in such situations.

Conclusion

Social media offers numerous benefits for doctors, from enhancing patient engagement to facilitating professional development. However, it also presents ethical challenges that must be navigated carefully. By adhering to the principles outlined in the Guide, doctors can use social media responsibly and effectively. Remember to maintain patient confidentiality, uphold professionalism, and share accurate information. With these guidelines in mind, doctors can harness the power of social media for clinical learning, to improve healthcare outcomes, and foster a positive online presence.

Medisec’s team of medico-legal advisors are available 24/7 to offer advice on the use of social media or indeed any of the wide range of medico-legal challenges facing doctors in practice in Ireland.

References available on request