Doctors and the Social Media

The buzzword on the Internet these days is the Social Media and this underlines the fact that we live inter-connected lives and we are very much social creatures. We like to share things and have that built-in curiosity to see what our friends, family and colleagues are up to as well. Of course all that may not matter to the rare individual who is a hermit but it makes our lives more interesting that the Internet via Social Networks has made the ability to connect with one another just that much easier. I’d like to touch on these social networks from a medical perspective and discuss the potential advantages and also pitfalls on using social networks as doctors. I hope colleagues who are using the social network will pay heed.

First we look at the GMC Guidance on Doctors’ use of the Social Media:

The GMC states the medical advantages of using the social media are

a. engaging people in public health and policy discussions
b. establishing national and international professional networks
c. facilitating patients’ access to information about health and services.

I agree very much with these points and used in this manner, the social media can get the message across effectively.

However the GMC also warns doctors on Privacy issues

Using social media has blurred the boundaries between public and private life, and online information can be easily accessed by others. You should be aware of the limitations of privacy online and you should regularly review the privacy settings for each of your social media profiles.§ This is for the following reasons.
a. Social media sites cannot guarantee confidentiality whatever privacy settings are in place.
b. Patients, your employer and potential employers, or any other organisation that you have a relationship with, may be able to access your personal information.
c. Information about your location¶ may be embedded within photographs and other content and available for others to see.
d. Once information is published online it can be difficult to remove as other users may distribute it further or comment on it.

The GMC also warns doctors about maintaining a professional boundary between yourself and patients:

Using social media also creates risks, particularly where social and professional boundaries become unclear. You must follow the guidance in Maintaining a professional boundary between you and your patient
If a patient contacts you about their care or other professional matters through your private profile, you should indicate that you cannot mix social and professional relationships and, where appropriate, direct them to your professional profile.

In the context of the physician-patient relationship, the GMC warns:

You must consider the potential risks involved in using social media and the impact that inappropriate use could have on your patients’ trust in you and society’s trust in the medical profession. Social media can blur the boundaries between a doctor’s personal and professional lives and may change the nature of the relationship between a doctor and a patient. You must follow our guidance on the use of social media.

Let’s examine some of the popular Social Network sites and see how the above may affect us:

Facebook
Currently the leader of the pack of the social media sites with the most users. Many Malaysians including doctors are using it. In the life cycle of things on the Internet, Facebook is seeing some maturity now that the user demographics seem to be older as there are reports of Facebook losing it’s appeal to younger users (who are running to engage each other on mobile apps like WeChat and Line) so the future may not be as bright, but for now it still is the king.
In view of the large user base it’s still a smart move to make use of Facebook to engage others particularly to promote educational information and news amongst colleagues and the public. You can do this by easily creating a Facebook page which may be about your speciality interest for instance. Even the DG of Health is in particular an avid Facebook user and has his own Facebook Page which is used in an admirable manner to engage the public.
Engaging others on the Social media is a two edged sword. You can cut through media red tape to reach out to others but on the other hand your critics can also easily respond to you on your page. Creating and maintaining a Facebook page means you have to be prepared to engage everyone and not everyone is nice out there.
I am rather concerned about the way some Malaysian doctors are using Facebook pages about their Clinics. What is being posted on some of these pages could be construed as advertising in breach of MMC guidelines so make sure your content is ethical and any “advertising” has the appropriate official approval.
Facebook pages are in contrast to your personal Facebook Profile. This is where many users get confused as far as privacy goes and where the clear and present danger lies for doctors. Facebook privacy settings are confusing for many and I have seen inappropriate things posted on personal profiles which ended up being publicly accessible. Even if you think you have the privacy settings correct you never know if a “friend of a friend” can view what you posted. Unless you are confident about privacy settings, you should probably NOT befriend patients or simply anyone on Facebook otherwise you might be in danger of breaching that Professional boundary which the GMC mentions.
There are also lots of Facebook groups for doctors which function as Chat rooms or educational sites. While some of these groups are “closed” or “secret” you never know if someone might accidentally share or leak out whatever is posted there. This goes for patient information in case discussions and sharing patient pictures in particular which may expose doctors to the risk of legal action. For your information, the MDU has posted an article Doctors must Follow Medical Guidelines on Sharing Photos of Patients which also has a link to GMC guidance on this issue. If you do engage in these activities, do be extra cautious and when it comes to posting patient information or pictures as you never know for sure (nearly 10% of Facebook accounts are fake) who is really who in that Facebook group or who has access to what you posted. Think 100x before posting.

Twitter
Using Twitter is also a popular activity and useful for getting news and sharing links out on this micro-blogging site. Others like it for expressing their opinions and thoughts. Like Facebook it’s fine but be careful what you Tweet is instantly noticeable and not easily retractable. You should be mindful of the same GMC guidelines in using this social media platform.

Linkedin
Linkedin tries to be that Professional network and that may be useful for doctors who are trying to connect with others on a Professional basis. There seems to be less sharing of personal things on Linkedin than Facebook but nevertheless one should be cautious about what you share on your Linkedin profile. Keep it professional and you should be fine on Linkedin.

There are plenty of other social network sites e.g. Google+, Pinterest, Instagram, Foursquare etc. where you can interact with others in interesting ways but if you keep medical matters out, it generally won’t matter but bear in mind these are public domain and again if patients stumble on your online activities, that might blur the Professional boundary the GMC alludes to.

What about specific social network sites for doctors? In the US, there is Doximity which is a social network dedicated to US doctors. For sharing of medical photos and Xrays, I have also come across Fig. 1 which uses apps on mobile devices for users to easily share medical images with other users. The apps for Fig. 1 are for the moment only available in the US iTunes store.

For Malaysian doctors, we have of course maintained DOBBS, a dedicated site for networking and discussion for Malaysian doctors. It has been in existence since 2000 and now has over 2000 users on board. Besides forums, Dobbs users have access to a private Activity timeline for sharing pictures, videos and links, a private messaging system (with attachments), medical news, CME activity and also a Job Board. You don’t have to worry about accidentally sharing things to the public unlike Facebook so if you are a Malaysian doctor, do come aboard Dobbs. Registration is free for all Malaysian doctors. Click here to register today.