The human drama of medicine is very popular with the media. But while journalists often approach doctors to help them cover healthcare stories, most GPs are understandably uncertain how to respond in view of their duty of patient confidentiality. So, bearing in mind the GMC’s new confidentiality guidance, how you can best manage the situation and meet your professional obligations in the following typical scenarios.
A journalist contacts your practice for a comment after a former patient alleges that you were rude and refused to make a home visit although she was bedridden. What can you say?
The GMC acknowledges that it can be frustrating and distressing to be criticised in the media, particularly when it includes inaccurate or misleading information but this does not relieve you of your duty to respect the confidentiality of patients and former patients.
It stresses that you ‘must not put information you have learned in confidence about a patient in the public domain without that patient’s explicit consent. You should usually limit your public response to an explanation of your legal and professional duty of confidentiality.’
MDU advice: Contact the journalist and explain that you cannot comment because of your duty of confidentiality. Be polite but firm and don’t allow yourself to be provoked. Don’t be tempted to brief him ‘off the record’: he may still use your comments in his story or ask the patient for a response.
A patient wants to raise awareness of her condition and has asked if you could talk about her diagnosis and treatment with a journalist who is making a radio programme about her campaign. Should you go ahead?
In its confidentiality guidance, the GMC recognises that ‘there are also important uses of patient information that are not connected to the delivery of health or social care but which serve wider purposes’, such as the public interest or education and training. However, ‘you should ask for consent to disclose personal information for purposes other than direct care or local clinical audit unless the information is required by law or it is not appropriate or practicable...’
When seeking explicit consent for disclosures for educational purposes, the GMC says ‘you must give the patient enough information about the nature and purpose of the disclosure to enable them to make an informed decision. This should include a description of the information to be disclosed and an indication of who will have access to it and how it will be used.’
MDU advice: You shouldn’t feel pressurised to take part in this opportunity. However, if you are happy to go ahead, discuss with the patient what information she is happy and not happy to be disclosed and document this, otherwise there is a risk that you might inadvertently say something that she doesn’t want in the public domain. To pre-empt difficulties, you could also ask to see the journalist’s questions in advance so the patient has the opportunity to agree your responses ahead of the interview.
One of your patients has been making derogatory comments about your practice online. His allegations are defamatory but can you respond?
It will be very difficult to respond to the patient’s allegations without breaching your ethical duty of confidentiality. In its guidance on the use of social media, the GMC says: ‘You must not use publicly accessible social media to discuss individual patients or their care with those patients or anyone else’.
Even if you are concerned that a social media thread is damaging public confidence in your practice, it would only be appropriate to give general information about your usual practice and not reveal any specific information about the patient or their care. The GMC's confidentiality guidance says: 'If you deny allegations that appear in public media you must be careful not to reveal, directly or by omission or inference, any more personal information about the patient than a simple denial demands.'
Ultimately, the GMC warns that a public dispute with the patient will be counterproductive. Such disputes 'often serve no practical purpose; they can prolong or intensify conflict and may undermine public confidence in the profession.'
MDU advice: You have to weigh up whether it is worth the trouble as the patient could still re-post their comments on another site where they could be seen by more people. Depending on where the allegations appear, you could invite the patient to get directly in touch to discuss their concerns but it’s always a good idea to seek advice from your medical defence organisation before responding.