Intended for healthcare professionals


How should I deal with online abuse?

BMJ 2022; 377 doi: (Published 10 May 2022) Cite this as: BMJ 2022;377:o1110
  1. Adele Waters
  1. The BMJ

The covid-19 pandemic prompted a rise in online abuse of doctors. Adele Waters asks three experts what doctors should do if they find themselves targeted

Don’t be drawn into an online argument

Susan Michie, professor of health psychology and director of the Centre for Behaviour Change, University College London, says, “The first thing I would say is: it’s not about you. You are merely a hook for a variety of malcontents to hang their unpleasant coats on. So don’t pay attention to content that is misogynistic, racist, violent, or nasty—unless there are direct threats of harm.

“I categorise responses into groups—it helps to take the emotion out of it. Many are bots, for example, others are organised ‘pile ons,’ following a tweet or media appearance. Others are from contributors who may have mental health problems or uncontrollable rage about the world in general. For them I feel sorry, and pleased I don’t live inside their heads.

“So, what to do about it? Twitter doesn’t block the accounts of people who send abusive messages, so it’s not worth reporting them unless there is a direct threat of violence. I routinely block followers who are abusive or unpleasant to me or others. Every couple of days or after a media appearance, I search for my name, go to ‘latest,’ and routinely block. You can use a mass block strategy if things become particularly bad.

“Abusive emails are rarer. Again, I don’t engage.

“I am in a couple of covid-19 WhatsApp groups where we mainly discuss scientific matters—but occasionally colleagues talk about the online abuse they’ve had. Everyone is incredibly supportive and it makes a huge difference knowing that hundreds, probably thousands, are receiving similar and are refusing to engage.”

Report harassment, alarm, or distress

Sam Nicholls, director of support4rs, an organisation that equips people and organisations to deal with negative protests and radical factions, says, “There is no rule requiring you to participate in social media so consider if you really want or need to.

“If you do, assess the impact it may have and participate accordingly, actively garnering support.

“Remember, posts may be read for many years, with changing perspectives and context —the amount you post will correlate with your potential for being targeted by trolls. Not only can that feel disturbing and unsafe, it can be extremely time consuming to manage, exposing you to a churn of invectives through simply defending your position.

“Of course, personal attacks and threats can be difficult to take, but most trolls have neither the intention nor capability to carry out their threats—I have investigated a significant number and, for many, the cyber world is the only arena where they can socially engage, let alone participate in face-to-face debate.

“If the abuse endures, depersonalise it. Don’t pay attention to words, pay attention to the construct of comments—this may identify one person behind multiple accounts. Block them and reach out to your supporters and ask influential social media users to proactively campaign for you.

“From a safety point of view, if you sense something is not right, trust that and employ situational awareness techniques.1

“If experiencing harassment, alarm, or distress, report it to the police, referencing these specific words. You’ll get a reference number which you can use in any subsequent attacks and will allow the police to track and monitor any escalation.”

Have a thick skin

Will Marsh, deputy director of communications, University of Bristol, says, “Harassment of any kind is wrong and can be hurtful, but the often murky world of social media can make it much easier for someone to fling muck at another anonymously and not think about the harm it is causing or fear any repercussions.

“At Bristol we encourage our academics to speak about their research and to provide their professional academic opinion on the news agenda of the day. But that can often provoke a strong reaction from individuals or groups with opposing opinions.

“When talking about potentially controversial science or research we advocate the following steps:

  • ● Be proactive—ensure the facts about the research are out there and the public hear them first hand, rather than through a third party with a potential agenda

  • ● Use support networks—the support of your employer, your peers, and other interested and informed parties

  • ● Be united—the university has a webpage outlining its institutional commitment to research integrity, including its support for academics who may have faced harassment

  • ● Have a thick skin—social media is not always respectful or a friendly place to be so it’s important to be able to ignore or take specific action as and when required.

Beware, there is no magic bullet—the fact is, harassment does happen. We can front up to it and stand for what we believe is fair and right but ultimately we need to look after our own and our colleagues’ wellbeing.


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