Social Media Black Hole

The GMC’s latest advice around social media has caused much debate. Here chair of the GMC, Professor Sir Peter Rubin responds to the criticism, and new GP Dr Laura Davison comments on the guidance

We recently published the latest version of our core guidance for doctors Good Medical Practice, setting out the standards we expect from every doctor practising in the UK.

This is the fifth edition of the text, first published in 1995 and last updated in 2006. This timetable may seem excessive, but the world in which we’re operating has altered dramatically in the last few years: financial resources are dwindling, while patients’ needs and expectations are greater than ever. So it’s only right that we keep our guidance on standards up-to-date to reflect these changes.

Since publication, there’s been lively debate on the particular piece of guidance that states if we’re identifying ourselves as doctors in online discussions about health issues, we should say who we are, just as we normally do when writing to the correspondence columns of newspapers.

I want to stress that this isn’t a requirement: no-one is going to get struck off for failing to reveal their identity. The GMC isn’t concerned with what doctors tweet about food, fashion or football, and we acknowledge that everyone has a right to remain anonymous in their private life, outside practice. But by its very nature – social media is anything but private.

Declaring we’re doctors adds weight and credibility to our views. With that privilege comes a responsibility not to undermine public confidence in the profession, whether we’re discussing waiting lists or transfer lists. The GMC isn’t out to curtail anyone’s freedom to express their opinion on medical issues; a large part of Good Medical Practice is about better engaging with colleagues and patients, and better reporting of problems – something we all need a timely reminder of in light of the Francis report.

"This isn’t a requirement: no-one is going to get struck off for failing to reveal their identity"

But I would suggest that a social network is not the place to raise a concern. If doctors with concerns find it hard to speak up locally they can contact our confidential helpline (0161 923 6399). If we’re going to get the best for patients, particularly in financially constrained times, we need to embrace digital technology and use it to our advantage. Reading Good Medical Practice and using it to guide the professional judgments we make every day will help us do that.

This latest edition is a document that’s shorter and easier to navigate. It’s set out in a different way, corresponding to the four areas that will be assessed as part of revalidation – another big change rolling out from this year. There’s additional guidance too, for example, we’ve made explicit doctors’ duties when basic care needs aren’t being met, and added new ones including mentoring and raising concerns.

I want to focus on what I believe has been one of the most profound changes over the last decade: the proliferation of social media. Platforms like Facebook, Twitter and blog sites offer us a plethora of new ways in which to engage with fellow health practitioners, the media and the public. But as well as offering us opportunities, they present some challenges, which are acknowledged for the first time in Good Medical Practice.

The Apprentice columnist and new GP Dr Laura Davison

The GMC recently issued their most modern technophilic guidance yet on the expectations of doctors – the guidelines on doctors’ use, or misuse, of social media. As a fan of social networking I was initially outraged by this blatant oppression of my right to free speech.

I angrily publicised my dissatisfaction on blogs and profiles having to then frantically attempt to delete them for fear of a sudden GMC manhunt after ill-thought-out tweets. I felt silenced, that we had lost our freedom to make comments that doctors could no longer voice their daily work gripe with friends on their Facebook profile, no longer tweet their comedic observation of the working day, no longer identify their true job on dating websites.

Forcibly driven underground to meet in secret and send texts to other underground rebels who dare to think critically about their day on the NHS front line and share moments of medical hilarity or intrigue. However, if you actually take ten minutes to read the three-page social media guidance, it actually is mostly common sense, aiming to mainly protect doctors, rather than force a muzzle on us.

"If you actually read the guidance, it is mostly common sense, aiming to mainly protect doctors, rather than force a muzzle on us"

Their main point is the “standards expected of doctors do not change because they are communicating through social media rather than face-to-face”. There is no anonymity online. Your standards of good medical practice should remain the same on Planet Cyber as they do on Planet Earth. They advise us of the ease and global accessibility of any of the social network sites. Anyone, anywhere, could view you, contact you, track your career or even location. Anyone can take your comments out of context and be judged to represent your life view or sweepingly generalise the entire profession’s view.

You need to be vigilant with your standards and review your security settings and beware of the blurring between personal and professional life in the free realm that is the internet. If you are providing medical opinion and are happy for it to be professionally held to account then you must identify yourself as a doctor. If you don’t, if you are making a personal opinion or comment, it’s best not to publish it.

Think you’re safe commenting on Facebook? Think again. Despite the enhanced security settings and personalisation of this site, as my mother has proved on a daily basis, even beginners are excellent Facebook stalkers and comments can be shared and shared again. The guidance rightly states that no site guarantees total privacy. Off the cuff comments and hilarious in-jokes to your medical friends may be misconstrued by the uninitiated roving eye. Cue the battle between chubby thumbs-up buttons being pressed and antagonistic comments.

"Anyone can take your comments out of context and be judged to represent your life view or sweepingly generalise the entire profession’s view"

Think of it this way; as they used to say in the war, “loose lips cost lives”, well, careers in this case, and while bantering in public places with your medical chums be aware you never know who’s listening. Most of us know to rein in the medical gossip. You never know who’s eavesdropping. The same applies to public access social network sites. You never know who’s reading. I recommend a quick read of the guidance for reassurance and some reaffirmation of your good practice.

Dr Davison practises in Buckinghamshire.