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Protecting your online reputation

The MDU's Dr Natalie Hayes offers golden rules to ensure GPs using social media stay out of trouble.

GPs using social networking sites should exercise caution and keep security settings as high as possible (Photograph: Istock)
GPs using social networking sites should exercise caution and keep security settings as high as possible (Photograph: Istock)

The massive expansion in the use of social media sites in recent years has presented great opportunities for GPs in terms of networking and keeping in touch with friends.

But there are also potential pitfalls, such as damage to a doctor's professional reputation and the blurring of the doctor/patient boundary.

Most of us use social media as a pleasant way to socialise online with friends and family. But there have been some well-publicised cases of doctors being accused of posting unprofessional comments on social networking sites, potentially damaging their reputation and career.

In one example that hit the national news in September 2011, a group of doctors were criticised when describing a maternity unit as a 'birthing shed' and an intensive care ward as a 'cabbage patch' during a Twitter discussion.

GMC draft guidance
In April 2012 the GMC published draft guidance on doctors' use of social media. This states that the same standards are expected of doctors communicating on social media as when they are face-to-face with patients.

However, the GMC's draft acknowledges that social and professional boundaries can become unclear when using social networks.

Below are some simple, common sense golden rules for social networking, which should help you to preserve your professional reputation.


1 Check your privacy settings
Keep your profile private – limit access to friends only. Be aware that anything you upload on to a social networking site may be distributed much more widely than you intended.

2 Watch out for unprofessional content
Be cautious about posting anything that might bring the profession into disrepute.

3 Do not discuss patients
Be professional in your comments, especially about patients or your colleagues.

4 Keep professional boundaries
If you receive an online friendship request from a patient, decline it and explain that it is inappropriate to mix social and professional relationships.

Privacy settings
People are cautious with their privacy in many aspects of their lives, but when it comes to social networking, many allow their information to be freely accessed by anyone when they forget to apply sufficiently stringent security settings.

You may be happy to share family photographs with your friends, but do you want your patients to see them as well?

The draft GMC guidance advises doctors to keep their privacy settings under review because social networking sites cannot guarantee confidentiality, whatever privacy settings are in place.

The guidance reminds doctors that their employer, or other organisations with which they have a professional relationship, may be able to access personal information and that once online, information can be distributed far more widely than you may have intended.

Unprofessional content
As the doctors who used Twitter to conduct a light-hearted conversation about maternity and intensive care units discovered to their cost, social networking sites contain a huge spiderweb of connections.

Comments that you share with friends may still be accessible to others outside your network. Although you may believe you have set your security settings as high as possible – and that only your contacts can see what you have written – it is still important to exercise caution when making posts. A good rule of thumb is to consider whether the information you publish online gives off the image you would like to portray if a patient or colleague came across it online.

The draft guidance states that doctors should treat colleagues fairly and with respect and should not bully, harass or make gratuitous, unsubstantiated or unsustainable comments about individuals online. They should usually identify themselves and be aware of the possibility that any information uploaded anonymously may be traced.

Do not discuss patients
It might seem obvious advice not to talk about patients online, but it is all too easy for discussions about the working day on forums and chatrooms to reveal more than intended.

It is worth bearing in mind that even seemingly innocuous details could be recognisable. For example, information as innocent as the appointment time, coupled with previous posts about your role or place of work, may be enough to make the patient identifiable. This could have serious consequences and may lead to a GMC complaint. The draft guidance states: 'You must not use social media to discuss individual patients or their care with those patients or anyone else.'

Professional boundaries
Social networking can feel as though it is one step removed from reality, with the result that people forget that the rules are the same, online and off.

There may appear to be an unwritten etiquette which suggests it is impolite to decline an online friendship request. However, the draft guidance is clear that if a patient contacts you through a private profile, you should explain that it is not appropriate to mix social and professional relationships and, where appropriate, direct them to your professional profile instead.

  • Dr Hayes is a medico-legal adviser at the MDU

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