We shouldn’t fear social media
BMJ 2011; 343 doi: https://doi.org/10.1136/bmj.d4864 (Published 03 August 2011) Cite this as: BMJ 2011;343:d4864
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Facebook and Twitter are part of many, if not most, trainee doctor's
social lives. They are an easy and convenient way of keeping in touch with
far flown friends as many of us move more than once in our quest for the
right job in the right location. I joined Facebook a few years ago mainly
to reconnect with friends I had left behind but also to let loved ones
know what I was up to and allow them access to photo albums. It all sounds
very innocent and for the most part is. However, the GMC has recently
issued guidelines on Facebook and Twitter due to the concerns raised
regarding breeches of confidentiality and boundary violations with
patients. Anecdotally these guidelines appeared to be met with a slight
roll of the eyes; we have had confidentiality drummed into us and are very
used to handling confidential data as well as preserving professional
boundaries. I might well have been an eye roller if it had not been for
two Facebook experiences that gave me cause for concern.
The first relates to professional boundaries. A patient I met
regularly in my clinic was a keen Facebooker (as are most).
During the time I worked with them I started to notice they knew some
unusually personal facts about me. It eventually transpired that while I
was not connected with this person in any way on Facebook my photo albums,
in particular my profile pictures were not secure. My patient's curiosity
had led them to view what they could on a number of occasions, thus
learning family details and roughly where I lived. Although there was no
particular harm done it caused me alarm as to the possible repercussions
if this patient had a more malicious intent when looking me up. It is a
very easy problem to rectify and would therefore urge all those with
accounts to double check your security settings as well as carefully
considering what you put on your profile picture.
The next incident involved confidentiality. After a particularly
difficult set of nights I posted on Facebook that I had had an "Eventful
Night". This in itself does not present a confidentiality issue but I had
not considered the large number of colleagues on Facebook who would know
what I was referring to. The post generated a large number of comments
each one adding a bit of detail to the night in question. I realized that
the comments now could be combined to create quite an accurate description
of where and what had happened, so the post was deleted. Facebook,
probably more so than twitter can create a false sense of security
especially if one is selective in who one "friends". It sometimes feels a
bit like the doctors mess where you're able to release some of the
emotions built up during a shift. Unfortunately, as I found out, even the
most innocuous posting can snow ball into something that could be
considered inappropriate. This won't prevent me from using it, but these
experiences reminded me that you can never quite take off the doctor's
badge.
Competing interests: No competing interests
It is rather disheartening that the level of debate for the medical
profession around the use of social media is still focused on should or
shouldn't we get involved!
The conversation needs to move away from doctor to doctor chit-chat
to actively engaging with patients.
Competing interests: No competing interests
Can be found on: http://tinyurl.com/64lm38u
And yes, I discovered this article via Twitter!
Competing interests: No competing interests
Re:A few fears felt using Facebook
Thanks a lot Clare for a wonderful rapid response.
Recently in our Trust we had to discipline a few junior doctors for
some of their comments on social networking sites. Fortunately, we were able to deal
some of these issues informally with discussion and advice and one or two
had written warning and hopefully nothing more will happen to these young
and bright doctors and their future. But, beware of dangers of Facebook,
Twitter and social network and associated dangers for doctors.
1. Making comments about hospital and naming the hospital.
2. Criticising colleagues on Facebook, and even comments like 'My
Trust nurses are mad' can put you in difficulty and the Trust can take
action for undermining patient and public confidence in the organisation.
It is simply not professional behaviour.
3. Releasing patient confidential information (photos without
realising patients can be seen)
4. Chatting to a patient which can then be considered as
inappropriate physical and emotional relationship by the regulator.
5. Worst, internet sex chat line and if some of your patients
recognise you and it goes into the media!
Don't let one moment of madness cost the job, career and referral
to the regulator.
Competing interests: Trust Medical Director and had to decide what actions to take against these bright, young and hard working juniors.