Social media platforms can be a fantastic mechanism to
develop your professional presence, share information and network with your
colleagues. Bearing in mind some important considerations will ensure you can
make the most of social media and also comply with your legal and professional
considerations when using social media
Getting engaged in social media now involves choosing from
hundreds of different platforms, from professional networking sites such as
LinkedIn, social networking platforms like Facebook, blogs, microblogs such as
Twitter, and content-sharing platforms such as YouTube and Instagram. Referral
tools such as WOMO and True Local, discussion forums and message boards and
messaging platforms such as WhatsApp also fall within the broad category of
The key issues to consider are:
- The different privacy settings and defaults of
each platform you use.
- How your professional and legal obligations
affect your use of social media.
- How posts, even those you think are private,
could reflect on your professional reputation if seen by a patient, colleague
or potential employer.
- Your rights and obligations in relation to
comments made about you online.
- Your obligations to comply with policies
covering your employment.
It is vital to understand your security settings and review
them regularly for each different site or platform you use, particularly as the
default settings change periodically and new functions are added.
Some platforms are completely public and should be used
cautiously. Even on those platforms with privacy settings, certain parts of
your profile, such as your name, profile photo, list of friends or connections,
gender, geographic location and pages or networks to which you belong may be
considered ‘publicly available’ and cannot be protected by privacy settings on
Be aware that even if you remove content from some platforms,
copies of that information may remain viewable elsewhere if it has been shared
with others. Assume that if you post something online it could become public
and you may be unable to delete it. If ever in doubt, don’t post it.
It is becoming increasingly common to be able to use your
details for one platform to log in to other platforms, applications or
websites. This means that information held by the one platform may be shared
between platforms and may become more widely available. It would be wise to
create individual profiles for each different platform or application so you do
not unwittingly give access to your information.
Professional and legal obligations
Doctors are required to meet particular standards of
professional behaviour, which are primarily contained in the Medical Board of
Medical Practice: a code of conduct for doctors in Australia”.The
Social Media Policy released by AHPRA and the National Boards in March 2014
confirms that the professional obligations in the Code of Conduct apply when
using social media.
Confidentiality remains a fundamental requirement of the
doctor-patient relationship. In addition, privacy legislation imposes further
obligations on practitioners and practices in relation to health information.
Sharing information, particularly with international
colleagues, can be helpful in allowing a ‘virtual corridor consultation’ with
an expert or as a second opinion to aid in diagnosis.
All patient information should be de-identified unless you
have the specific consent of the patient. If you do have consent, make sure
this is clearly documented. With images, it is best to always seek and document
permission, even if you believe the image has been de-identified.
If you are planning to post de-identified information, you
should carefully consider whether it can be sufficiently de-identified. For
example, if it concerned a particularly rare condition, the image itself, or
basic demographic information may enable the patient to be identified. There
have been instances of patients identifying themselves, or being identified by
friends or family, from the information or image posted about them. If
re-identification does occur, and appropriate consent had not been obtained,
de-identification does not cure the breach.
Inadvertent breaches of privacy and confidentiality can also
occur if personal information about a patient, or staff, is accidentally
disclosed, for example, in the background of a photograph. Some real life
examples include patient records being open on a computer screen, a patient’s
name being shown on imaging and a patient’s face being seen in the background
of an employee’s selfie.
Your social media profile will often connect your
professional and private personas. Your private actions may be seen as a
reflection on your public persona. It is therefore safest to assume that at
some stage a patient or colleague may be able to see your social media activity
- consider whether you are comfortable with that before posting.
Consider who you ‘friend’ or share information with on
social channels. Always be sure of the identity of people whose friend requests
you accept. Do not accept friend requests from patients and do not seek to
Bear in mind that the code of conduct also includes
professional obligations such as your responsibility to promote the health of
the community through health education, disease prevention and health promotion
(clause 5.4). Arguably, posting images or comments that could be seen to
endorse activities and behaviour as excessive alcohol consumption, drug use,
violence or anti-social behaviours, could not only damage your professional
reputation, but could be in breach of your professional obligations.
Guidelines for advertising regulated
health services (the Guidelines) includes social media in the definition
of advertising. When using social media to promote your practice, you need to
be particularly aware of restrictions on patient testimonials, use of images
including photographs, and discounts and incentives.
The Guidelines prohibit testimonials in advertising
regulated health services including on doctors’ own social media pages. Doctors
are not responsible for controlling the content on pages outside their control,
and patients can still share views through consumer and patient information
sharing websites that invite public feedback or reviews about experience of a
practitioner or practice.
Importantly, you should not re-post any testimonials from
third party websites on your own social media pages and if someone posts an
inappropriate comment or image you are responsible for removing it from your
page. It is generally advisable to disable the comments function on pages you
control and you should regularly review the content on your accounts to ensure
it is all appropriate.
Many workplaces, such as hospitals, have policies in place
regarding use of social media. It is important you familiarise yourself with
and follow any such policies, particularly in relation to the use of patient
information. Policies will generally prohibit using social media in a way that
would breach any law (for example privacy, defamation, confidentiality,
discrimination or harassment, intellectual property, competition and consumer
laws), or that would bring your employer into disrepute, and may prevent you
commenting on workplace matters.
If you are intending to use any patient information, even
de-identified, you should be aware that such patient information may be the
property of the practice or hospital where you work and should not be used
without the entity’s consent, as well as any relevant patient consent.
If you own the practice where you work, consider your online
presence in the context of what you would be willing to accept from any
employed or contracted doctors working in your practice.
Contact arising from
any online presence
You may be contacted by people who wish to seek further
information or advice from you in response to your social media presence. Develop
a strategy for responding to this - for example, referring them to their own
treating doctor for any clinical advice in the first instance. If they wish to
commence seeing you as their treating doctor, you should ensure that a formal
doctor/patient relationship is established in the normal course.
- Understand the privacy settings of all your
social media accounts and review these regularly
- Obtain and document patient consent to use any
patient information, even if apparently de-identified
- Be aware of your professional, legal and
employment obligations when using social media
- If in doubt, don’t post.
This article was originally published in RANZCO’s Eye2Eye magazine.
AHPRA’s Guidelines for Advertising Regulated
Board of Australia Social Media Policy
Avant factsheets: Social
media for doctors: keeping it professional and Reacting
to unwanted online feedback
Avant articles: First prosecution of a healthcare
corporation for unlawful advertising and Get smart:
clinical images and smartphones
your practice (subscription)
AMA/MIIAA Guide: Clinical
images and the use of personal mobile devices – a guide for medical students
media and the medical profession: a guide to online professionalism for medical
practitioners and medical students – although this was published in
November 2010, the practical examples remain useful.
Share your view
We welcome your feedback on this article – email the Editor at: firstname.lastname@example.org