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Think before you tweet

Post date: 01/09/2014 | Time to read article: 3 mins

The information within this article was correct at the time of publishing. Last updated 14/10/2021

What happens on tour stays on tour, but what happens on Twitter stays on Google forever. Doctors should be cautious when posting on social media sites, says Jack Kellett assistant web editor.

It was once dismissed as the latest craze of a young generation, but in recent years the social media phenomenon has exploded, embodying a far broader representation of society.

There have been positive stories in the media around healthcare – the much popularised story of Stephen Sutton’s battle with cancer, although tragic, was incredibly heartwarming, and gave patients a real insight in to how healthcare is delivered to the terminally ill.

In contrast it would not have been appropriate for Stephen’s doctors to post on social media about Stephen without his consent, as it would have breached his confidentiality. This may seem fairly obvious, but more and more junior doctors are getting into trouble by posting nameless comments about their patients, who have then been able to identify themselves. Juniors have also got into trouble posting inappropriate material that questioned their professionalism, eg, the lying down game.

In response to this wide tide of complaints, the GMC issued guidance around social media. Doctors’ use of social media can be applied to any social media network, with the underlying message that the standards expected of doctors do not change because they are communicating through social media rather than face to face.

Inappropriate comments

Social media sites blur the boundary between an individual’s public and professional life – many indecent posts that have landed doctors in trouble are the result of a perceived lack of understanding when it comes to the privacy settings on their accounts.

In 2012 a surgeon updated his Facebook status when he finished work. He wrote: “Back and causing chaos. Been on call this week. Been in theatre… slaughtering the innocent.” His comments were flagged to the wife of a patient who died while under his supervision. She was understandably distressed and made a complaint to the health board. The surgeon was disciplined and forced to issue a public apology to the family.


An ill-advised post does not simply bring an individual doctor’s reputation into question; it subsequently impacts on the reputation of the medical profession as a whole. Your trust or health board will take an equally dim view of you posting less than flattering comments about patients – it’s safer to exercise caution. It is worth noting that defamation law can apply to any comments posted on the web made in a personal or professional capacity, so think before you Tweet.

What next?

In the future we may see hospitals and practices impose stricter policies on appropriate usage, but for now you should follow the GMC’s guidelines on how to use social media professionally and responsibly.

Another area for doctors to consider is the popularity of newer networks, such as Instagram and Vine that focus specifically on alternative forms of media like photos and video. This may cause further misunderstanding as to what is perceived to be a breach of confidentiality.


Dr A, a CT1, wrote on Facebook that he was in close proximity to people using drugs. He joked that he may have attended work whilst affected by such substances after his numerous nights out. His comments were picked up and he was referred to the trust/health board where he had conditions placed on his practice.


Dr A’s attitude and subsequent actions could have put patient safety at risk and brought the profession into disrepute. His trust would have had no choice but to investigate his actions.


Following the death of a patient, Dr S engaged in a conversation with another doctor on his Facebook wall about what happened. The conversation was brought to the trust’s attention and both doctors faced internal disciplinary proceedings.


Most social networking sites have limited privacy settings. Although Dr S did not identify the patient by name, hospital or treatment, the fact the patient could have identified themselves meant that Dr S and his colleague had breached patient confidentiality. It is important not to share identifiable information about patients, even when using professional blogging sites, which are not accessible to the wider public.


While working in emergency medicine, F1 doctor Dr G wrote a blog about her experiences. Although all of her posts were anonymous and she made up a lot of her stories, her trust were unhappy with her comments as it identified key members of staff within the hospital. She was called into a meeting with her trust and the matter was investigated.


Before setting up a blog tread cautiously and consider all the following pitfalls: breach of patient confidentiality; defamation; breach of contract – your trust or board may not be happy with what you have to say, as was the case with Dr G. It would have been sensible for Dr G to obtain the permission of the trust/board management and their educational supervisor before she created the blog.

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