This General Medical Council advisory document for Doctors comes into effect from the 22 April 2013.
My thoughts:
Anonymity
I think that the advice should’ve been much clearer as if you follow the guidelines to the letter (any material written by a Doctor could “reasonably be taken to represent the views of the profession more widely” and it is appreciated that “content uploaded anonymously can, in many cases, be traced back to its point of origin“) there really should be no GMC registered Doctor posting content online anonymously.
I think this isn’t very well thought through. Some of the very best contributors to social media discussions (not just about healthcare) are Doctors who wish to remain anonymous or just want to be allowed to share their opinions as a member of society when they’re not working. The workload of Doctors is tough enough that there should be some capacity in this guidance for them to be able to use social media when taking time out from work.
I can also see a multitude of ways that this could impact on Patient safety as it’s quite clear that whistle blowing Doctors don’t have an easy time. It’s possible that this guidance document itself could make any Doctor who leaks a Patient safety issue anonymously liable to not meeting their duties as a Doctor (because they will have run foul of guidance by trying to do it anonymously in the first place).
Need for every Doctor to have a Professional Profile
Im surprised the GMC isn’t doing something to provide this for registered Doctors on the Medical Register or at least suggesting to Doctors what would be considered to be an appropriate professional profile eg. is a Linkedin profile or About.me page enough or should they have a dedicated page on their clinics secure website?
Long and short of it is that every Doctor who is active today on Twitter, Facebook or even posting a comment on a news website is now advised to have a professional profile where they openly list all their “financial or commercial interests in healthcare organisations or pharmaceutical and biomedical companies” and any possible “conflicts of interest” they may have.
What I think is missing
I think the GMC has missed out on several key opportunities it has to take the lead here. Here are a few things I would’ve implemented if I was involved with this initiative at the GMC:
> Expand the GMC Doctor register to include an About.me style professional profile page (or at least a link to the Doctor’s own page).
> Social Media tracking: I’m surprised there isn’t a section of advice on this as it’s obviously a very challenging area for Healthcare Professionals to understand eg. GP Surgery bans Patient over offensive Twitter post
> The educational opportunity that the GMC has could’ve been complemented by sharing regular (CPD approved) videos to help Doctors understand and keep abreast of the changing social media landscape.
> More focus on the opportunities that social media and social media tools can provide to Doctors eg. how you can manage/respond to online reviews, why you might want to blog, the advantages of Professional networking, how RSS feeds can help you learn, the Patient educational opportunities that social media provides, etc.
> Just as social media is itself a moving target I think there was a missed opportunity to make the guidance document itself more interactive and wiki styled rather than as a PDF as there is a still no right/wrong approach to how a Doctor should use social media.
What did you think of the guidance document? What would you have added?
I agree that the guidance isn’t well thought through. I think it almost certainly fails to comply with the ECHR – and is thus theotetically unenforceable; but that it will be used to blackmail doctors that managers want to suppress (behave/keep quite or we’ll report you to the GMC, and even if they decide you did nothing wrong, you’ll suffer the stigma and your career will be on hold for years…”).
I think that there are lots of good reasons why doctors might want to comment anonymously; and even if the only reason for doing so were that they preferred to, this guidance is disproportionate and an unjustifiable infringement on doctors rights as citizens.
I have blogged at greater length at http://peterenglish.blogspot.co.uk/2013/03/the-gmc-and-guidance-for-anonymous.html
Hi Peter,
Sadly you’re probably right.
I notice lots of Doctors are saying that this is the reason they are leaving social media but the point you make (that it will be used to suppress their capacity to speak out) is precisely the reason that they need strong networks.
As soon as they try to take out a vocal Doctor who has a strong network they’ll realise that the whole thing is a big mess and completely unworkable. Communities Dominate Brands is a great book that deals with this topic (it was one of the reasons why I initially decided to commit to writing this blog).
I didn’t expand on this in the original post as I didn’t want to be giving any ideas to readers who might have a criminal mind but this guidance to always be identifiable will also expose Doctors to a multitude of privacy issues that will make them very vulnerable to fraud which has quite obvious implications in a wide range of areas particularly with regard to specific permissions that only Doctors have eg. prescription fraud, prescription forgery, etc, etc.
PS. Love your blog post – a great collection of useful links there. Check out this video of Michael Seres talking about how he uses social media with his transplant team as there are some great lessons in that for any Doctors who are trying to get their head around the issues.
PS2. Had a fun dinner the other night and we drew up a list of things that show how nonsensical this guidance document is. The one I came up with that I found funniest was that now on an online dating site like Match.com if a member lists their Profession as “Doctor” they are now obliged to list their GMC number or at least their real name. Imagine a Patient in the waiting room finding that on when they Google their Doctor’s name!
Enjoyed reading your blogpost. You make an excellent point in that SoMe is a moving target – we could well have a totally different attitude and understanding in a few years time as a consequence. It is a difficult area for the GMC or any other body to grasp and I think that no matter what version was ultimately released, it would have been impossible to have universal agreement on whether they got it right or not – criticism would be inevitable due to the wide differences of opinions people have over the handling of social media issues. As things are at the moment, most will agree that it is an imperfect document but in my opinion it is a start in the right direction.
On the discussions about doctors leaving social media – this is being grossly overstated as an issue. Sadly, some good contributors will take their bat and ball and go home – no SoMe policy is going to make everybody happy. The huge majority of doctors on social media already use their real name. The numbers of doctors leaving social media is a drop in the ocean to the numbers of both anonymous (maybe soon not to be) and those doctors using real names. The numbers of doctors on social media will continue to grow and medical community interaction with each other and the public will continue to thrive. One only has to look at the interaction and participation in the 2013 Social Media and Acute Care Conference (SMACC) held recently – the substantial majority of doctor tweeters were using their real names and there were over 1200 participants.
It has also been interesting to observe quite a number of previously anonymous tweeters come out and say how liberating it has been to now use their real name.
Hi Henry,
Thanks for your comments.
Have you considered how this new position could make Doctors more vulnerable to fraud?
Hi David, I think that doctors are worrying excessively about being vulnerable to fraud. I don’t think that the GMC is going to be out on a witch hunt – they will neither be interested or adequately resourced to do so. I think that a number of objectors are unnecessarily creating fear amongst their colleagues. If doctors behave appropriately under their own name, they will have nothing to hide. If they choose to use a pseudonym but for good reason, the ‘should’ descriptor indicates that they are unlikely to have concerns. You might be interested to see my comments on http://blogs.crikey.com.au/croakey/2013/04/05/its-all-just-a-social-media-and-medicine-storm-in-a-teacup-says-one-surgical-tweeter/
which gives a more complete view on the matter from my perspective.
Best regards
Henry