INSIGHTS

The use of social media is increasing exponentially, and its use by medical practitioners is no exception. Platforms like Instagram, Facebook, TikTok, and YouTube, to mention a few, are now being used by healthcare professionals to share valuable information and engage with the general public. The greater the audience that follows or subscribes to shared content, the greater the influence.

However, with great influence comes great responsibility. Medical practitioners must navigate social media carefully lest they breach their ethical obligations or mislead the public. Here is a quick guide to help medical practitioners make the most of social media lives while maintaining their ethical obligations and avoiding medico-legal pitfalls

Advantages of Using Social Media for Medical Practitioners

1. Awareness: Social media can create public awareness about general health, medical conditions, and health risk factors.
2. Access: Many people lack access to quality healthcare. Social media can provide them with valuable health information, although it should not replace professional medical consultation.
3. Advertising: It offers a platform for advertising, provided that this adheres to the HPCSA guidelines.
4. Business/Income: you can make extra income through social media, depending on your audience size. This must however be done within the confines of the HPCSA guidelines on fees and financial interests.

Disadvantages of Using Social Media for Medical Practitioners

1. Unwanted Attention: It’s crucial to separate personal and professional media accounts to avoid unwanted attention affecting one’s personal life or profession.
2. Loss of Confidence: Patients might feel that their doctor’s significant online presence detracts from patient care, potentially raising concerns about the quality of such care.
3. Misunderstandings: The vast audience on social media may misinterpret shared information, leading to issues like self-diagnosis, misdiagnosis, or failure to seek proper treatment.
4. Confidentiality Risk: Maintaining patient confidentiality is paramount. There is a risk of unauthorized disclosure, even when discussing cases anonymously.

Here are some relevant principles to consider from the HPCSA’s Ethical Guidelines on Social Media (Booklet 16, 2019) 

Consent

• It is important to maintain patient confidentiality. Disclosure of patient information should only be with proper consent, by court order, or by law.
• Even when discussing a case anonymously, bear in mind the possibility that a patient or someone close to them can piece together the details and identify the patient.
• It is advisable to inform patients of your professional social media presence and obtain written consent in advance if there is even the slightest chance of the patient’s information being discussed online.

Doctor-Patient Relationship

• Maintain professional boundaries if and when interacting with patients online.
• Separate your personal and professional accounts to maintain healthy boundaries.
• Should you receive inappropriate communication from a patient via social media, you must politely re-establish boundaries.
• If the patient persists in such behaviour, you must document the communication and all your attempts to re-establish boundaries and then seek advice. 

Medical Advice Online

• Providing medical advice online is discouraged. Practitioners must be careful to avoid providing patient-specific medical advice on social media.
• Should patients seek medical advice on social media, you should politely request that they schedule an appointment for a consultation, except in cases of emergency or life-threatening situations.
• If furnishing medical advice online, make sure it is general/non-specific health advice that is evidence-based, scientifically sound and generic. Thereafter, it is advisable to give a disclaimer or advise the recipients to consult a medical practitioner for more specific information.
• Limit your discussions to issues within the limits of your knowledge, area of expertise and qualifications.

Health Professions Image

• Practitioners are urged to avoid online activity that may bring the medical profession into disrepute. This could be on their personal or professional media platforms, such as the following examples:

1. Using social media when tired, stressed, upset or intoxicated;
2. Gathering “content” (taking photos or videos) during surgery or while taking care of a patient;
3. Making derogatory comments about patients, colleagues or organisations;
4. Making unsubstantiated comments about individuals or organisations;
5. Making unsubstantiated health claims;
6. Engaging in disputes on social media;
7. Making comments that can be perceived as hate speech, racist, sexist, homophobic, or otherwise prejudiced.

• Practitioners are also urged to refrain from engaging in disputes publicly, making unsubstantiated claims or defamatory comments about other practitioners or organisations. If there is a dispute, it is advisable to handle it discreetly and consult legal advisers if and where necessary.

Conflicts of Interest

• One of the ways to make an income from social media is by endorsing or marketing products for brands and/or organisations.
• Practitioners must not endorse any medical institution, medical products or medical services falsely, unfairly, to the detriment of others or for financial gain.
• Where a medical practitioner has a financial interest in a product they have endorsed or a product used on their social media platform, they must declare such financial interest and ensure that such endorsement is not unfair to other medical institutions, medical products or medical services.
• The HPCSA rules are silent on endorsing non-medical/health-related products, or services. However, when in doubt, it is best to err on the side of caution and consult the HPCSA or obtain legal advice before entering into any endorsement arrangement or contract.

Unprofessional advertising

• The Ethical Rules of the HPCSA provide that advertising should not be unprofessional, untruthful, misleading, deceptive or cause consumers unwarranted anxiety that they may be suffering from a health condition.
• Practitioners must not engage in touting (offering guarantees or benefits that fall outside their scope of practice) and canvassing (boasting about personal qualities, superior knowledge, quality of service, professional guarantees, or best practice).
• You can click on the link below for a useful article on advertising as a medical practitioner https://www.macrobert.co.za/insights/posts/advertising-medical-professional-services  

Final Thoughts

Medical practitioners must use social media responsibly, bearing in mind that their conduct reflects on their profession. If unsure about a post or content, it is advisable to seek guidance from a fellow colleague, the HPCSA, or seek legal advice where necessary.