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Social ups and downs

Cate Swannell
Med J Aust
Published online: 7 April 2014

Twitter, Facebook, Tumblr, Pinterest, Google+, 4Square, LinkedIn, Reddit, blog, vlog, Vine and Web 2.0 — these are terms which roll off the tongues of geeks and nerds, but for many doctors they are a foreign language

In an increasingly digital world, more health professionals are dipping their toes into the murky waters of social media and, for the novice, there can be hidden dangers.

Social media applications like Twitter and Facebook are fast-moving, addictive and informative, but they can also be deceptive and overwhelming, particularly in the early stages.

Can they be useful for doctors? Dr Jill Tomlinson, a hand surgeon, certainly thinks so. She has been “online” since 2003, actively so since 2005.

“I think it is increasingly important for doctors to be aware of, if not active on, social media”, Dr Tomlinson tells the MJA.

“Patients — consumers — are increasingly savvy. They’re always searching for information on the internet, particularly if they don’t feel their local resources are giving them what they need to know.”

Dr Tomlinson has a blog through which she engages with current issues in her field of medicine, and is active on Twitter.

“Doctors can use social media to connect with patients in terms of feedback, or if they need specialist advice. And it’s a very good news source for doctors.”

Word travels quickly and far more widely that it at first appears, and that is where dangers lurk, particularly for health professionals.

In a 2009 BMJ feature, Mr Godwin Busuttil, a London barrister specialising in media law, was quoted as saying that “people feel disinhibited when they go online”.1

“A doctor traditionally may have discussed things — such as the subject of the blog — with other doctors in the hospital canteen or on the phone but would not have dreamt of putting them on a message board where everyone could read them”, Mr Busuttil said.

“If a doctor is talking to a colleague, it’s done in a collegial way, in the spirit of professional inquiry. No harm is likely to be done, and there may actually be a benefit to the patient. But doing it online gives rise to all sorts of concerns about patients’ privacy.”

The short answer is, don’t disclose online what you wouldn’t disclose in the “real” world, don’t breach confidentiality and don’t perform illegal acts.

The issue of the real world struggling to catch up with the digital came to the fore in Australia recently, via an updated set of advertising guidelines from the Australian Health Practitioner Regulation Agency (AHPRA), which sparked a long-running online debate and, in the end, successful intervention by media-savvy doctors.2

Section 6.2.3 stated that: “A practitioner must take reasonable steps to have any testimonials associated with their health service or business removed when they become aware of them, even if they appear on a website that is not directly associated and/or under the direct control or administration of that health practitioner and/or their business or service. This includes unsolicited testimonials.”

“That’s an impossible task”, says Dr Tomlinson, who led the campaign – AHPRA Action.

She organised an online petition which she posted on her website on 17 March, asking AHPRA to remove Section 6.2.3.3

Following the outcry, AHPRA conceded that the advertising guidelines were continuing to cause confusion. Finally, in a statement from the Medical Board of Australia released on 26 March, AHPRA backflipped on web reviews.

“The Board has decided that the guidelines need to change to make it clearer that practitioners are not responsible for removing (or trying to have removed) unsolicited testimonials published on a website or in social media over which they do not have control”, the statement read.4

Dr Tomlinson told the media that she was happy that “common sense” had prevailed in the end.

She has no doubts about the future of medicine online.

“Even if you’re not actively engaging, you can still see the conversations, and be kept aware of advocacy issues, new research and guidelines, clinical practice and patient feedback”, she tells the MJA.

1. McCartney M. How much of a social media profile can doctors have? BMJ 2012; 341: e440. http://211.144.68.84:9998/91keshi/Public/File/38/344-7841/pdf/bmj.e440.full.pdf (accessed Mar 2014).

2. Australian Health Practitioner Regulation Agency. Guidelines for advertising regulated health services. Canberra: AHPRA, 2014. http://www.ahpra.gov.au/News/2014-02-13-revised-guidelines-code-and-policy.aspx (accessed Mar 2014).

3. Petition to remove section 6.2.3 from the advertising guidelines. http://www.change.org/en-AU/petitions/australian-health-practitioner-regulatory-agency-ahpra-remove-section-6-2-3-from-the-advertising-guidelines (accessed Mar 2014).

4. Bracey A. Doctors win: AHPRA backflips on web reviews. Medical Observer 2014; 26 Mar. http://www.medicalobserver.com.au/news/doctors-win-ahpra-backflips-on-web-reviews (accessed Mar 2014).

  • Cate Swannell


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