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Offline or online, you are still a healthcare practitioner

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Maintaining excellent professional conduct online

Regardless of our interactions with or stance on social media; from compulsive over sharers to social media ghosts, you will be hard pressed to find yourself leading an anonymous life online as we can all be somehow inter-connected via people we may know and even through our jobs. But whatever the case may be, we can’t allow ourselves to become complacent when it comes to our professional profiles and how we may be judged online.1 To help you navigate through what can be a minefield of cautionary tales and dos and don’ts, we have compiled this list which will help ensure you adhere to professional standards set out by the medical and dental boards when using digital platforms.

Legislative obligations and codes of ethics. Healthcare practitioners must comply with the healthcare practitioner National Law and their national board’s code of ethics and professional conduct (Code of Conduct) including for medical and dental practitioners. This involves all types of online activities, public or limited to a specific group of people (closed, invisible groups included).

Your employer’s social media policies. Before posting, always ask yourself: “Would this be in breach of my employer’s policies, my employment conditions and/or my obligations under the regulatory authority?” If in doubt, re-evaluate the suitability of your post. In some cases, even if you have a patient’s consent to share their clinical data, you may be restricted by your employer’s or hospital’s policies.

Reputational impact. Would you be comfortable with your post being viewed by your patients, colleagues or employer? Do not post content that might endorse activities or behaviour that could damage your professional reputation or be in breach of your professional obligations. Be mindful of joining groups or liking content that may be deemed divisive that is, racist, sexist or defamatory in nature

Maintaining confidentiality and using appropriate privacy settings

As in all healthcare settings, respecting the privacy and confidentiality of patients is paramount, but this is especially true online . Online breaches of patient confidentiality can have far reaching implications and permanency associated with a digital footprint. Accordingly, unless you have explicit consent from a patient, you must never use social platforms to discuss cases or share pictures of procedures, case studies, patients or sensitive material where patients may be easily identified.

The Australian Medical Association (AMA) recommends the following:

Ensure you have patient’s’ consent to share their clinical data. Obtain written and explicit consent before posting any information online.

De-identify the clinical data you post.Protect the patient’s’privacy by removing any easily identifiable information..

Be mindful of the subtle information contained in your posts. Remember that patients, staff members or your employer may still be identifiable through the subtleties in the content of your posts such as within the background of a photograph, the metadata of an image, and the timing of the post.

Be wary of the secondary use of data. Check the terms and conditions before signing up to online social platforms and applications. You may be inadvertently granting permission allowing access to your profile or other information on your device such as your online address book, which may expose confidential patient details.

Turn off 'auto-upload information' feature in settings. As a precaution, refrain from auto-uploading images, photos etc to social media platforms or to back-up sites.

Treat clinical images as health information. Images taken on your phone and shared in professional or closed online groups or chat forums for professional purposes, must be treated with the same privacy and confidentiality as any other health record or information. Never use a clinical image unless:

  1. you have the patient’s consent to do so,
  2. the patient would reasonably expect you to use the image in this way, or
  3. you are otherwise permitted by law to do so.

Seek prompt advice from your hospital management team, your employer or MIPS if you inadvertently send an image to the wrong recipient or if you post anything you later believe to breach patient confidentiality, or your professional or employment obligations.

Check your employer’s endorsed social media platforms. Familiarise yourself with your organisation’s policy on clinical images and social media. Some hospitals have created their own secure mobile messaging platforms to replace commonly used platforms such as WhatsApp.

Establishing trusted online friendships

Healthcare practitioners have a duty to their patients and the community to establish and maintain professional boundaries. These are critical to the integrity of the doctor-patient relationship and safeguards patients from exploitation.

By 'friending' or following patients, former patients or relatives of patients on social media, doctors may find it difficult to dictate a clear professional boundary once patients can connect on a personal level and this may lead to misunderstandings.

The AMA recommends creating an online profile that is maintained as a professional page to share information relevant to your role as a healthcare practitioner where patients can become fans or friends of your page rather than you as an individual. Alternatively, you may wish to join a professional social networking site.

Safeguarding your professional reputation online

Did you know that any information you share in a closed group can be copied and shared? And that any information you post anonymously can be tracked back to you? The AMA advises adhering to the following principles to protect your professional reputation online.

Refrain from posting any content that may be considered harmful to the reputation of colleagues or the profession. Exercise sound judgement when posting online to avoid making unsubstantiated comments about individuals or organisations. Material posted online by individuals or organisations that are false, untrue, misleading or deceptive can have significant legal and financial consequences. Be mindful of not breaching your professional obligations or the policies held by your employer or regulatory authority.

Avoid posting anonymously. The AMA advises you use your own name and ensure you always communicate respectfully. Posting personally as an individual is better avoided as it may impact on you professionally.

Openly identifying yourself can lend credibility and accountability to online communications. When posting professionally, consider listing your credentials. It is also advisable to announce if your views are representative of your employer, institution or your own.

Understand and review your privacy settings. Review the settings of your social media platforms regularly. Keep your passwords secure and consider user encryption in your communications.

Participate in closed groups mindfully. Closed professional groups allow peers to discuss issues in a private environment that is facilitated by an administrator. These can be used as platforms to advocate on relevant issues and to engage with colleagues with a common interest.

You should be mindful of your behaviour and vocabulary when participating in these groups, as non-medical professionals may subscribe to a group. Consider how the public may view your interactions even if they are intended for a medical audience only. Remember that anything you post in a closed group can be copied and shared. Therefore, the same professional standards apply to your engagement as part of a closed group.

References

(1) Chretien KC., Kind T.(2013) Social Media and Clinical Care Ethical. Professional, and Social Implications. Circulation.127:1413–1421

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The materials provided are for educational purposes only. Whilst all reasonable care has been taken in preparing these materials, including the accuracy of the information supplied, MIPS does not accept any liability whatsoever arising out of the use or reliance of the information provided. Contact MIPS 24/7 Clinico-Legal Support 1800 061 113 or education@mips.com.au for specific advice.