Staying safe on social media

Dr Emma Davies and Dr Ellen Walshe discuss the risks and benefits for medical professionals of using social media and what the Medical Council’s new ethics guide has to say on the issue

Healthcare professionals are using a range of social media platforms in a variety of ways – to build and improve social and professional networks, to share health-related information, and to engage with future health policies and priorities.

Medics are also increasingly becoming social media ‘influencers’, using their presence on social media to generate interest in topics, brands, or products, for example. While this can present some risks, such as clinical advice being taken out of context, harassment, and criticism online, or patients directly messaging a doctor for personal advice, it can also bring about benefits, such as facilitating public access to information and helping to raise awareness of public health campaigns.

Despite the many positive benefits of social media, whether you are using it to promote healthcare or to just connect with friends or peers, it is important to know how to keep your professional life safe. At Medical Protection, doctors often ask us if they could be criticised for comments on social media made outside of a work context. The short answer is yes. We have seen cases involving members who have faced medico-legal issues that have all stemmed from personal online activity.

There is always going to be a fine balance between freedom of speech, and your rights to have an opinion as a member of the public, and the public’s expectation of how a doctor should behave. For example, after a bad day at work, or a political decision on an issue you are personally passionate about, doctors like anyone can see social media as an outlet to voice their opinions or frustrations.

If anything, use of social media for our personal lives can be riskier than using it in our professional lives, as there can be a tendency to let our guard down. Even though doctors are posting as themselves, in a personal capacity, the public are likely to see them solely as doctors.

Before commenting or sharing on a social media platform, it is always useful to ask yourself:

• Would I say this out loud to a group of patients, peers, or a family member?

• Could this comment be viewed as offensive?

• Am I about to make a comment that could be perceived as prejudiced against a person’s race, sexuality, gender, religion, or other protected characteristic?

• Could what I am about to say put the reputation of my profession at risk?

• Does my employer have any guidelines or policies on the use of social media?

• How might the Medical Council view this comment from a doctor?

New Medical Council guidance

The Medical Council has set out guidance on social media use in the past. However its updated Guide to Professional Conduct and Ethics for Registered Medical Practitioners (the ‘Guide’), published in January, goes further and describes doctors’ obligations regarding social media in a professional and personal capacity more clearly.

The Guide says that using social media to communicate can bring significant benefits to patients, the public and colleagues, and makes it clear that how or whether a doctor uses social media in their private lives is a matter for them to decide.

It states that maintaining public trust in the profession requires that doctors consistently apply professional standards, ethical principles, and respect for persons, to all online communications.

It goes on to say that doctors should consider the possible impact on patients and the public’s perception of the profession, before making comments publicly via media, online or in-person.

The new Medical Council guidance also touches on social media influencing, stating that if clinical advice is given online, a doctor should always identify themselves by name, reminding doctors that they are legally liable for anything published on their own social channels.

It also reminds doctors that researching and following the personal behaviours of patients online or on social media platforms may threaten the trust needed for a strong patient-doctor relationship and should not be undertaken.

Deviating from the professional standards required of a doctor on social media carries significant risk

‘Private’ messaging

Another common question we get at Medical Protection is whether use of private messaging platforms removes medico-legal risk.

Closed professional networks are a useful way to share experiences and case studies, set up expert or learning groups, and get advice or help. But it is important to avoid sharing any information that could make the patient identifiable. Also remember to keep all conversations professional and respectful, as conversations could be requested as evidence by, for example, a coroner.

As the Guide states, while settings on many platforms allow information to be shared only with a closed group of friends, family, or peers, this privacy cannot be guaranteed.

Social media sites cannot guarantee confidentiality, regardless of the privacy settings used. Doctors should not publish information or comments about, or images of, individual patients from which those patients might be identified on publicly available platforms.

Before posting, doctors should consider how comments, information or images they post might be viewed by patients or the public, if they were to become more widely available.

Indemnity

Deviating from the professional standards required of a doctor on social media carries significant risk. These risks include the potential for a clinical negligence claim (for example, if individualised medical advice was provided) and complaints (including to the Medical Council). 

Medical Protection would be unlikely to assist with claims arising from any material published or broadcast by you, or on your behalf, or to which you have contributed. This is because it is not directly arising from your professional relationship with patients. In the unfortunate event you were the subject of a complaint to your regulator as a result of social media activity, you can approach Medical Protection for assistance in the usual way.

Doctors and medical professionals also need to be aware their employer, training programme, or medical school may have their own policies on social media use and ensure they follow these.

It is also vital to ensure you are familiar with what the new Guide has to say on the topic.

Summary

Social media is undeniably a vital communication tool that continues to grow. When used with caution, both in line with the Medical Council’s and your employer’s guidance, it can be a fantastic outlet to promote the profession, support and educate patients, and indeed ourselves as medical professionals.

While we as doctors are entitled to our opinions, it is important to remain professional in any public communication and social media is no different.

When you consider posting, commenting, or sharing content on any social media platform – including private messaging apps, take a moment to consider the above guidance, particularly whether what you are about to say is in the best interest of the profession, whether there are any confidentiality or ethical risks, and the impact your post or comment may have on you and your patients.

If you have any concerns around social media use, contact Medical Protection or your medical defence organisation for advice.