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Social media for doctors: keeping it professional

Jan 8, 2018

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 obligations.

General 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 social media.

The key issues to consider are:

  1. The different privacy settings and defaults of each platform you use.
  2. How your professional and legal obligations affect your use of social media.
  3. How posts, even those you think are private, could reflect on your professional reputation if seen by a patient, colleague or potential employer.
  4. Your rights and obligations in relation to comments made about you online.
  5. Your obligations to comply with policies covering your employment.

Privacy settings

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 all sites.

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 Australia’s “Good 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.

Privacy and confidentiality

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.

Professional behaviour

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 ‘friend’ patients.

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.

Advertising and online content

AHPRA’s 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.

Employment obligations

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.

Key tips

  • 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.  

Further resources:

AHPRA’s Guidelines for Advertising Regulated Health Services

Medical 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

Article: Promoting your practice (subscription)

AMA/MIIAA Guide: Clinical images and the use of personal mobile devices – a guide for medical students and doctors

Social 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: editor@avant.org.au