How GPs should use social media

Viewpoints from GPs Dr Raj Thakkar and Dr Shoba Poduval

A First5 GP perspective:

Dr Shoba Poduval is a salaried GP in Islington, north London

I started using Facebook while I was a foundation doctor. My profile page is personal, containing information relating to my life outside work, which only my friends can access.

I have chosen not to enter any professional information and recently changed my security settings. My professional distance from patients is important and I would not accept a 'friend' request from a patient.

Guidance from the GMC suggests applying the principles of Good Medical Practice to your activity on social media sites and using the same standards expected in face-to-face exchanges with patients.

However, we are entitled to a personal life outside of medicine and social networking has become an integral part of that.

The question is whether personal conduct on social media sites should always be interpreted as a reflection of professional conduct. I would argue it should not, and we should not allow social media to make our personal lives less private.

Professionalism
Professionalism should only come into question when patients are directly referred to. At this point, not only does confidentiality become an issue, but also (and perhaps more importantly) patients' trust in us. We are privileged to receive this trust and it is not worth jeopardising that.

Some discussions can be justified, such as those on doctors' forums and peer groups. Here, access is strictly limited to professionals and a code of conduct is enforced by moderators. The purpose of such forums is to generate discussion and increase knowledge, to improve patient care.

Another suitable use of social media is GP surgeries having their own Facebook page and Twitter feed, allowing patients to access information about services.

Improved communication
My use of social media has changed over the years, just as the medical profession has found more innovative ways to connect.

Previously most interaction needed to be in person, now there are vast numbers of First5 and other groups of GPs interacting online.

Improved communication and wider distribution of information is a huge advantage to everyone. This brings new challenges to existing rules about professionalism and confidentiality and I would encourage everyone to read the guidance produced by bodies such as the GMC. With the right level of caution, I expect to see social media use becoming more widespread among GPs.

RCGP social media highway code
  • Be aware of the image you present online and manage this proactively
  • Recognise that the personal and the professional cannot always be separated
  • Engage with the public but be cautious about giving personal advice
  • Respect the privacy of all patients, especially those who are vulnerable
  • Show your human side, but maintain clear professional boundaries
  • Contribute your expertise, insights and experience
  • Always treat others with consideration, politeness and respect
  • Remember that other people may be watching you
  • Support your colleagues and intervene when necessary
  • Test innovative ideas, learn from mistakes - and have fun

Source: RCGP, www.rcgp.org.uk/social-media

A partner's perspective:

Dr Raj Thakkar is a GP partner in Wooburn Green, Buckinghamshire

For sceptics, medicine and social media are ugly bedfellows, while for optimists, this is the future of efficient communication.

GP partners require their staff to be computer literate and they often have to work in silos. This, in combination with the evolution of smartphones, arguably provides ample opportunity for staff to be distracted by social media and its temptations.

Perhaps a more serious problem is use of social media by clinical or non-clinical staff to make inappropriate public statements or communicate with or about patients.

The NHS promotes innovation. Putting a blanket ban on staff using social media is unrealistic and difficult to enforce. However, principles need to be developed to minimise the inherent risks. These risks have been recognised by the GMC and advice has been published by indemnity organisations.

This advice should not be ignored. I follow the basic principles of having appropriate and protective privacy settings, not befriending patients on any site, never commenting on specific cases (no matter how anonymous you try to be), never breaching confidentiality and never making offensive or inflammatory comments (including on doctors' forums and blogs).

In addition, posting seemingly innocent pictures or comments may or may not be considered by a fitness to practise panel as a significant case, but employers still have the right to initiate formal disciplinary proceedings, perhaps at the very least, for using sites while at work.

The consequences of crossing boundaries on social media sites can lead to serious action. If you are in any doubt, don't post or blog.

Communicate with patients
Social media can be used to our advantage. At my practice, we have recently starting using Facebook and Twitter. The trick is to reduce risk, by setting up the sites so the public cannot write anything inflammatory; their use could be more like a noticeboard.

The uses of social media are far-reaching, convenient and low cost. Obvious examples include advertising flu clinics and publicising local public health concerns, new services and QOF reminders.

The technology is here to stay and the NHS is moving with the times.

Used with caution, social media is a powerful tool to engage our patients.

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