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Practising in the Facebook world

MPS Medical Director Dr Rob Hendry warns of the challenges facing the healthcare profession in keeping pace with the information age.

Medicine has always been quick to adopt and adapt new technologies and many advances in care have been due to utilising advances made in other branches of science.

As we enter the new information age, the phenomenon of social networking is changing the way doctors interact with their patients and wider society. Traditional boundaries between private and professional life are becoming blurred and the potential for members to inadvertently fall into medicolegal traps is increasing.

Professional bodies around the world have recognised both the potential for the good that social networking technologies offer and also the risks for the unwary.

Tweeting to one’s friends after a bad day at work or posting details of what you got up to at a party at the weekend on Facebook can often be seen by patients, colleagues and managers. When comments are posted on the blogosphere all control is lost and they are less private than remarks made on the back of a postcard.

Professional bodies around the world have recognised both the potential for the good that social networking technologies offer and also the risks for the unwary

The laws of defamation apply to comments that may have been originally designed to amuse your friends or written in the heat of the moment, but which end up being widely circulated just as much as more traditional channels of communication.

In the UK, the General Medical Council has recently published guidance on social media, which states that where doctors identify themselves as doctors in publicly accessible social media, they should also identify themselves by name because any written material by authors who represent themselves as doctors is likely to be taken on trust. This places an onus on doctors to be thoughtful in what they write.

The full impact of new social media technologies will inevitably develop over the coming years. It is important that the way in which the public can become engaged and informed about health issues is not inhibited. However, the regulation of the profession’s use of new media opportunities may struggle to keep up with the pace of technological change and diverging social expectations of the profession.

MPS has always believed that our approach to indemnity allows us to provide the most flexible and adaptive support to our members, especially during times of rapid change in the world of medicine.

Stephanie Bown

Opinion:
Francis: what next?

Dr Stephanie Bown, Casebook Editor-in-Chief, on what the Francis report and the government response mean for healthcare.

Everyone who has read or been involved in the Francis report into Mid-Staffordshire NHS Trust will be shocked and ashamed at the appalling standards of care, and how many turned a blind eye. The UK medical profession is now in an inescapable, undeniable position where it must reclaim its core professional values and uphold its duty of putting patient safety first.

This is also a wake-up call for the NHS to take more care of its staff, and ensure they are empowered to raise concerns. You can have the best individuals with the best intentions, but in the wrong environment they can succumb to what is the norm – even if that is a culture of complacency.

Delivering high quality communications with patients when something has gone wrong is a skill that should be part of every medical school’s curriculum. This includes understanding the importance of responding in a timely way; the timeframe within which you respond (to an error) may have a profound impact on the ability to achieve resolution and affect the future relationship and trust with the patient or their family.

We were disappointed, then, that the Francis report recommended a statutory duty of candour for individuals, although the government is at least refraining from making any hasty decisions on this. At MPS we continue to stress that the best way of achieving openness is by a cultural shift, rather than legislation.

We were disappointed that the Francis report recommended a statutory duty of candour for individuals

We were disappointed that the Francis report recommended a statutory duty of candour for individuals We will be further highlighting to government that despite the understandable appeal of a legislated duty, this will not achieve the objective of effective open communication. The risk of any legislation is creating a ‘tick-box’ mentality, which does not support the intensely sensitive, personalised and patient-centred conversations that should happen with patients and their families when something has gone wrong.

Legislation whereby patients and their families are only informed when there is a serious injury or death would fail to address the learning opportunities from near misses, which are free smoke alarms for patient safety. The sort of widespread failing that occurred at Stafford Hospital must never happen again, and it should be addressed at every level. It is the responsibility of every board to put patient safety at the top of their agenda.

Understanding human error as an inherent risk in the practice of medicine, and how to identify and respond to it, should be built in as a core competency for every clinician. Errors are an opportunity to learn.

Self-medication: a note from MPS

Doctors have long been warned about the pitfalls of prescribing for yourself in non-emergency situations: a lack of objectivity means you are not assured of safe and appropriate decision-making. Worse still is stealing medication from your hospital or practice stores.

It has recently come to the attention of MPS that the attitudes of both the law and medical regulators are hardening against medication theft, even common drugs such as paracetamol. Once seen as a fairly trivial matter, stealing medication has been seen by MPS to be treated as a criminal investigation.

Stealing medication has been seen by MPS to be treated as a criminal investigation

The GMC says, in Good Practice in Prescribing and Managing Medicines and Devices (2013), para 17: “Wherever possible you must avoid prescribing for yourself or anyone with whom you have a close personal relationship.”

MPS members and medicolegal work

Given the requirement to hold a licence to practise, in order to practise medicine in the UK, we have considered what are the appropriate criteria required by MPS of members who write medicolegal reports and/or act as a medicolegal expert.

Doctors producing medicolegal reports purely from records will not be required by MPS to have a licence to practise, but will be expected by MPS to act within the bounds of their competency and specialty and also will be required by MPS to inform the instructing solicitor whether or not they have a licence to practise and/or intention to maintain it in the future.

Doctors producing medicolegal reports purely from records will not be required by MPS to have a licence to practise, but will be expected by MPS to act within the bounds of their competency

It may well be that possession of a licence to practise in such a situation will lend credibility in the provision of a report, but at the present time it is not a condition that MPS requires.

In addition to the requirement to advise the instructing solicitor whether or not they have a licence to practise and/or intend to maintain it in the future, MPS requires any doctor conducting a current condition and prognosis consultation/examination involving patient contact to maintain a licence to practise.

Whilst this is not a current, explicit GMC requirement, MPS believes it is necessary in order to protect the position of the member should a complaint arise. We hope that by introducing such criteria for members we will ensure the best possible protection for members carrying out such work.

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1 comment
  • By Julie Myers on 14 May 2015 07:27 I think it is definitely good for doctors to be aware of self-medication, since this can lead to legal problems. It is interesting to hear that there is so much medication theft in the medical field. My husband is a doctor and I am not sure if he prescribes medication for himself when he gets sick. It might be a good idea for me to tell him about these possible problems so that he can make sure he is following with all the codes. If he isn't, it might be a good idea for him to get some help from a medicolegal service to be sure that there won't be any problems. Thanks for the great article!

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