Tweet with care

Think carefully before making comments on social media sites like Twitter and Facebook.

Posting an off-colour remark via Twitter or on Facebook might not seem the worst thing - but for doctors and dentists there can be more at stake.

NO doubt one short-term winner emerging from the current debate over privacy and the use of ‘super-injunctions’ to kill unflattering media stories has got to be the social networking website Twitter. The Quixotic attempts of solicitors representing a well-known footballer to prevent online discussion in regard to an alleged affair have only boosted user numbers on the website.

Judges, politicians, journalists all realise that the genie is now well out the bottle and you can’t hope to regulate the free exchange of information – dubious or not – across an unfettered global network. And yet for doctors, dentists and other healthcare professionals there are obviously other factors at stake.

Research published in the Journal of the American Medical Association has found that over half of 78 US medical schools reported cases of students posting unprofessional content online. One in 10 contained frank violations of patient confidentiality. Most of the content resulted in only formal warnings but some were serious enough to lead to dismissal. Today’s students are of course tomorrow’s doctors so it is a phenomenon that is likely to grow.

“The two biggest mistakes doctors risk making when on social networking sites are breaching patient confidentiality and bringing the profession into disrepute,” says Dr Anthea Martin, senior medical adviser with MDDUS.

“Both could attract the attention of the GMC, which has the power to launch an investigation, suspend the doctor involved and – in the most extreme cases – remove them from the register.”

Tweeting or Facebooking about what happened at work – even to Facebook “Friends” or those on private Twitter lists – may seem innocent enough. But when it involves patients or colleagues who may recognise themselves in the description there is the potential for serious allegations.

“Doctors must be scrupulously careful with their internet postings as providing information about patients, even if you do not name them, can still breach confidentiality,” says Dr Martin.

“And making derogatory or discriminatory comments about colleagues will fall foul of GMC guidelines that doctors must not make malicious or unfounded criticisms that may undermine patients’ trust in the profession.”

No doubt doctors and dentists can sometimes find themselves in no-win situations such as when a patient publishes criticism in the press or online. This may include inaccurate or misleading details about diagnosis, treatment or behaviour but healthcare professionals must be careful in responding to such criticism. GMC guidance on the topic states:

“Although this can be frustrating or distressing, it does not relieve you of your duty to respect your patient’s confidentiality. Disclosures of patient information without consent can undermine the public’s trust in the profession as well as your patient’s trust in you. You must not put information you have learned in confidence about a patient in the public domain without that patient’s express consent…You should usually limit your public response to press reports to an explanation of your legal and professional duty of confidentiality.”

The guidance goes on to state: “You should seek advice from your professional or defence body, or from a solicitor, on how to respond to press criticism and, if appropriate, any legal redress available to you.”

MDDUS reminds members to be ever vigilant of how your personal interactions with friends or colleagues could potentially impact on your professional life. The JAMA study concluded that medical students should be taught about the risks associated with making postings on the internet as part of their training. They also recommended ensuring all students using social media are made aware of privacy settings on networking sites and the value of performing periodic web searches of their own name to vet listed online content.

Such advice could apply to all doctors. Activities such as Tweeting or posting comments on Facebook might seem fun and harmless but a patient or colleague and – subsequently – the GMC or GDC may see things differently.

ACTION Think before you Tweet or post comments online – will it in any way compromise patient confidentiality or your professionalism?