The General Medical Council (GMC) guidelines Doctors’ use of social media establish the standards expected from every doctor practising in the UK.
The guide details the principles of conduct for using social media and explains how doctors can put these principles into practice.
Why is guidance needed?
Social media channels offer many new opportunities to communicate with patients. Many of these channels also represent effective outlets to promote healthcare, but they also present many new challenges for healthcare professionals.
Patient confidentiality is a key issue – the very public nature of social media means doctors must take care to avoid unintentional disclosures. A doctor’s professionalism also faces new challenges when communicating via social media, as any comments made relating to patients, colleagues or employers can be unintentionally published to a wider audience. Although many online accounts provide privacy settings for users, there is still little control over the potential reach a seemingly innocent comment may have.
To combat these potential issues the GMC’s guidelines stress that “standards expected of doctors do not change simply because they are communicating through social media rather than face to face”. NHS Employers’ guide for new starters, New to the NHS? Your Guide to Using Social Media in the NHS, advises on the following test: “When using social media, remember if you wouldn’t say it aloud in the canteen, don’t post it online.”
As well as the GMC’s guide to using social media, the organisation you represent may also have their own policies on proper usage, which you must be aware of. It may be a standalone document or found among the policies distributed by your HR or IT departments.
You can also find a list of guidance available by profession – released by colleges and societies – here: www.nhsemployers.org/your-workforce/need-to-know/social-media-and-the-nhs/social-media-guidelines
Right to anonymity
Whilst you may usually choose to remain anonymous, the GMC advise that if you identify yourself as a doctor in publicly accessible social media, you should also identify yourself by name. Material written by those representing themselves as doctors is likely to be taken on trust, and may reasonably be taken to represent the views of the profession more widely. Content uploaded anonymously can in many cases be tracked to its origin.
Ensuring patient confidentiality
It is important to maintain patient confidentiality when using social media – even if you do not identify yourself as a doctor you must still be careful not to share identifiable information about patients. Many doctors use social media sites that are not available to the wider public; these can be useful to find helpful advice and information on areas specific to your profession. However, you must still be careful not to disclose any identifiable information regarding patients.
If responding to online feedback, the NHS Choices website advises that: “Practices can respond to most comments without breaching patient confidentiality. As a bare minimum, a practice can say that patient confidentiality prevents them from going into detail, but that the commenter is welcome to visit the practice to discuss the issues personally.”
Maintaining patient confidentiality online is not strictly limited to comments and messages - newer social media services such as Instagram, Pinterest and Vine focus on multimedia content, including photos and videos. Photos can also be potentially damaging, not just in terms of confidential details they may reveal but also in a wider professional sense. Taking pictures for personal use within a hospital or practice environment is not advised, and if you intend to take pictures for a professional purpose, or for a purpose external to your employers such as university studies or a charitable event, make sure you obtain proper consent from any patients or staff who are present as well as someone in a supervisory role.
For more information on confidentiality see the Medical Protection factsheet ‘Confidentiality – General Principles’
Maintaining boundaries with patients
When discussing the boundaries with patients via social media, the GMC states: “The nature of social media occasionally means that social and professional boundaries can become unclear.
“There may be instances where a patient contacts you about their care or other professional matters though your private profile. If this type of contact occurs you should indicate that you cannot mix social and professional relationships and, where appropriate, direct them to your professional profile.”
Responding to online feedback
As well as the mainstream social media services, websites such as NHS Choices allow patients to provide feedback about their experience of individual NHS services.
The way you respond to comments can have a huge impact on the way the healthcare profession is perceived.
Regardless of the size of the organisation – it might be a hospital, general practice or walk-in centre – responding to patient feedback often requires the same principles. Here, the NHS Choices service has established some guidelines for responding to patient feedback:
- Respond to all comments, good or bad, as it shows you listen
- Be careful not to breach patient confidentiality if you choose to respond
- Welcome all opinions and try not to be defensive if they’re negative
- Do not use the same stock response to each comment. If anything, this looks worse than not responding at all
- Remember, your response will be seen by everyone who reads your practice’s comments, not just the original commenter. Your reply is a good opportunity to market your practice.
You can access the full list of NHS Choice guidelines here
Patients may also comment about you or your service on their own social media profile. If you become aware of this, it is not advisable to respond as, in these circumstances, it can inflame the situation. If, however, you feel the comments are abusive or offensive in any way, you can report them to the social media provider.