How should GPs best use social media?

Saturday 30 June marked World Social Media Day.
 
You would be forgiven, however, for thinking every day is social media day, given the ubiquity of the platforms.
 
For GPs, social media brings a world of opportunity – and potential danger.
 
Dr Nathan Pinskier, Chair of the RACGP Expert Committee – eHealth and Practice Systems (REC–eHPS), told newsGP that social media is a complex space for people in any field.
 
‘Look at how the US president uses Twitter – when it’s out there, it’s out there. What you mean to say is not always how it’s perceived,’ he said.
 
On the positive side, Dr Pinskier has observed more and more practices using social media as a way to promote their services.
 
‘We’re seeing practises using it as promotion, which is legitimate,’ he said. 
 
But there are many traps for the unwary.
 
‘Once a post is out there, it’s out there. GPs should be very careful about what they post, and ensure it complies with legislation,’ Dr Pinskier said.
 
One emerging area of concern is patient reviews of clinics or individual GPs. The issue recently came to prominence with the news that Australia’s largest online GP booking service, HealthEngine, had been editing reviews to make them more positive.
 
‘If a patient reviews your services [negatively], make sure your response is measured, non-emotive, factual, accurate and not likely to inflame the situation,’ Dr Pinskier said.
 
‘It’s a real challenge, assessing quality in healthcare.
 
‘What consumers tend to judge is the behaviour of their healthcare provider, the appearance of the practice, and waiting times. What practitioners focus on is the quality of the actual service – “Did I actually address their problem?” – so feedback can be skewed.’
 
Dr Pinskier said that even positive reviews can be risky, as they could potentially breach national law about advertising of health services. He advocates turning off the reviews function on any practice’s Facebook page.
 
Dr Sara Bird, Medico-legal Manager at medical defence organisation MDA National, has seen social media cause problems for many doctors.
 
She said there are three key issues – patient confidentiality and privacy, maintaining professionalism on social media, and observing doctor–patient boundaries – which have led to complaints to the Medical Board of Australia.
 
Dr Bird has found that posting anything about patients – even when the information is de-identified – can be a problem. She has seen examples where doctors have posted de-identified images of a patient’s body, only to have someone recognise the patient from a tattoo, or even a memorable piece of jewellery or clothing.
 
‘In terms of professionalism, we’re sometimes lulled into a false sense of security, and might say unprofessional comments,’ she told newsGP. ‘You might say them in the tea room, but not on social media.
 
‘If it’s not something you’d say in a crowded elevator, don’t post it.
 
‘You think you’re just talking to your group of friends and let down your guard, but you’re putting it out to a whole lot of people you don’t know.
 
‘Another issue is that social media can blur boundaries between doctors and patients. But the standards expected of doctors don’t change between the clinic and on social media.
 
‘If a complaint is made, [social media] makes it very easy for a patient or complainant to print out a whole lot of Facebook entries and send them to the Medical Board.’
 
Dr Bird stressed the importance of ensuring any information posted on social media is accurate.
 
‘“Think before you post” is a good rule,’ she said. ‘There is potentially widespread dissemination of information on social media, and you don’t have any control. So exercise a certain level of caution.’
 
Patient testimonials represent another emerging area to watch. Legislation prohibits the use of patient testimonials in a practice’s advertising, but the law does not restrict negative feedback.
 
‘It’s a great irony that you can’t use any positive feedback on a site under your control, and yet negative comments can remain,’ Dr Bird said.
 
She said that negative patient reviews have caused many doctors significant grief.
 
‘I’ve had some becoming quite unwell, getting up at 2.00 am and Googling their name, re-reading the comments,’ Dr Bird said. ‘It’s like a public shaming, with a sense of powerlessness, too.
 
‘There’s very little you can do to remove posts from doctor-rating websites.’
 
Dr Bird said often the best option is to do nothing; however, if a patient identifies themselves it may occasionally be worthwhile to discuss the concerns directly with the patient and see if they will remove the post. Sometimes there is valid criticism and an opportunity to see if you can improve the practice.
 
‘As for responding online, I would not recommend that unless you’ve taken medico-legal advice or advice from a trusted colleague,’ Dr Bird said. ‘And never post when you’re angry.
 
‘Websites do also have policies for the removal of reviews, so you can use those. But in my experience, doing nothing is generally the best option.’  
 
GP resource
The RACGP’s Guide for the use of social media in general practice provides advice on safe and professional social media usage for GPs and other general practice staff, including the risks and benefits and legal requirements for advertising and testimonials.

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