Doctors using social media – Fitness to practise implications and pitfalls

Social media can blur the boundaries between public and private life and doctors must be careful to maintain professional boundaries when using social media.

Good medical practice & other GMC guidance

It is important to note that the standards expected of doctors do not change because they are communicating through social media as opposed to face to face or through other traditional media.

Good medical practice

The Good medical practice states, amongst other things:

36 You must treat colleagues fairly and with respect.
65 You must make sure that your conduct justifies your patients’ trust in you and the public’s trust in the profession.
69 When communicating publicly, including speaking to or writing in the media, you must maintain patient confidentiality. You should remember when using social media that communications intended for friends or family may become more widely available.
70 When advertising your services, you must make sure the information you publish is factual and can be checked, and does not exploit patients’ vulnerability or lack of medical knowledge.

Doctors’ use of social media

The GMC has produced guidance for doctors on their use of social media. When using social media, doctors must be careful to ensure social and professional boundaries do not become unclear or blurred. Doctors must ensure they follow the GMC’s Maintaining a professional boundary between you and your patient when using social media. This guidance states, in relation to social media:

“You must consider the potential risks involved in using social media and the impact that inappropriate use could have on your patients’ trust in you and society’s trust in the medical profession. Social media can blur the boundaries between a doctor’s personal and professional lives and may change the nature of the relationship between a doctor and a patient. You must follow our guidance on the use of social media.”

Maintaining doctor-patient partnership, when using social media means that “Patients should be able to trust that their doctor will behave professionally towards them during consultations and not see them as a potential sexual partner.”

Use of social media and fitness to practise

The GMC makes clear that doctors must be prepared to explain and justify their decisions and actions including those that relate to their use of social media. Social media can blur the boundaries between public and private life in ways that would be more obvious in real life situations and this presents a heightened risk for doctors.

However, fundamentally the issues that may arise through the use of social media does not change; privacy and confidentiality, maintaining professional boundaries, respect for colleagues, anonymity and conflict of interest.

The GMC’s guidance goes on to say that “serious or persistent failure to follow our guidance that poses a risk to patient safety or public trust in doctors will put your registration at risk.”

Social media pitfalls – dos and don’ts

Maintaining boundaries

If a patient contacts you about their care or other professional matters through your private profile, you should indicate that you cannot mix social and professional relationships and, where appropriate, direct them to your professional profile.
If, as a result of the above, there is a professional breakdown, doctors should consider whether it is appropriate to end their professional relationship with a patient.
You must not use your professional relationship with a patient to pursue a relationship with someone close to them.

Respect for colleagues

Report sexualised, unprofessional and/or otherwise inappropriate online behaviour towards patients by colleagues.

Anonymity

GMC guidance makes clear that doctors who identify themselves as a doctor in publicly accessible social media, you should also identify themselves by name.

Conflict of interest

When you post material online, you should be open about any conflict of interest and declare any financial or commercial interests in healthcare organisations or pharmaceutical and biomedical companies.

Maintaining confidentiality

You must not use publicly accessible social media to discuss individual patients or their care with those patients or anyone else.
Doctors must also take care when discussing “individual pieces of information” because the sum of published information online could be enough to identify a patient or someone close to them.
The same laws of copyright and defamation as written or verbal communications, whether they are made in a personal or professional capacity.
You should be aware of the limitations of privacy online and you should regularly review the privacy settings. Remember, social media sites cannot guarantee confidentiality.
People, colleagues and organisations you are friends with or follow can see your posts and information. You should regularly review these.
Take extra care when posting photos online, you may inadvertently be sharing information such as location, identity of other people or other personal information in the background.
When using professional social media sites that are not accessible to the public, be careful not to share identifiable information about patients and/or colleagues.

Worth going it alone before the GMC?

MPTS Legal Representation – Does it Pay?

Our GMC & MPTS Case Success

In upholding the appeal, Alan Bates, sitting as a Deputy Judge of the High Court, said:

Failure to assess witness credibility and reliability The panel did not sufficiently evaluate the general credibility and reliability of key witnesses, whose evidence was essential to the charges. It failed to consider factors such as contradictions between witnesses' accounts and whether their testimonies should be approached with caution. This omission undermined the panel's ability to justify its conclusions.
Lack of explanation for preferred evidence The panel failed to provide adequate reasons for preferring the complainants' evidence over the appellant nurse's and the paramedic's. Simply stating a preference for certain witnesses' accounts without detailed justification left the appellant without a clear understanding of why her evidence was rejected.
Errors in evidence evaluation The panel assessed each charge in isolation without considering broader patterns or contextual evidence. It failed to recognize that inaccuracies in one allegation (contradicted by CCTV) could cast doubt on the reliability of witnesses' accounts in other allegations, leading to flawed conclusions.
Improper handling of contextual evidence The panel neglected to evaluate the behaviour of the complainant nurses during the investigation, which was relevant to determining their credibility. Additionally, it overlooked the appellant nurse's claims that the allegations were fabricated to remove her from her managerial position.
Insufficient reasoning for findings The panel provided inadequate reasoning for its findings of misconduct. It did not fully explain how the evidence supported its conclusions, including why the NMC had met the burden of proof for each disputed allegation. This failure left the appellant with unsubstantiated conclusions, undermining the credibility of the process.

Lessons

This case highlights several critical considerations for fitness to practise tribunals. One key lesson is the importance of thoroughly evaluating the credibility and reliability of witnesses, particularly when their testimony is central to the charges. Without such assessments, the accuracy and fairness of the tribunal’s findings can be compromised. Witness accounts must be examined not only in isolation but also in a broader context, taking into account patterns and inconsistencies to achieve a holistic evaluation.

Additionally, tribunals must provide clear and rational reasoning for their decisions. Merely preferring one witness’s account over another without detailed explanations can lead to procedural unfairness. Ensuring transparency in decision-making fosters trust in the process and supports robust outcomes. Tribunals must also maintain procedural fairness by upholding the burden of proof on the prosecuting body. Accused parties should never feel pressured to disprove allegations, as fairness is crucial to preserving the system’s integrity.

Finally, the impact of procedural delays cannot be underestimated. Prolonged proceedings can cause undue harm to the accused, affecting their career and reputation. Timely resolutions are essential to upholding justice while minimizing unnecessary stress on all parties involved. By focusing on these principles, fitness-to-practise tribunals can enhance the fairness and effectiveness of their proceedings.

Disclaimer: This article is for guidance purposes only. Kings View Chambers accepts no responsibility or liability whatsoever for any action taken, or not taken, in relation to this article. You should seek the appropriate legal advice having regard to your own particular circumstances.