Social media

Question 1

You are the IMT1 working on the acute medical unit.

One of your FY1 colleagues has made a post on social media making fun of a patient’s behaviour following an on call shift.

The post did not contain any patient identifiable information but would clearly be offensive to the individual in question if they were able to see it.

How would you approach this situation?

Answer 1

Issues raised
* Patient confidentiality and professionalism and behaviour of the FY1 in question

Seek information
* Clarify the nature of the post and whether this is likely to result in a breach of** patient confidentiality** and any patient safety concerns. Even without full identifiable details, it may be that others knew details of the case and would be able to recognise those involved.

Initial measures & patient safety
* Ideally approach the FY1 and suggest that they take down the post if possible before any further harm to the patient and staff reputation is done.
* It could be that they did not realise the inappropriateness of their behaviour.
* If they are reluctant or lack understanding, it may be necessary to escalate this immediately.

Escalate
* Encourage the FY1 to self report this issue and debrief with their consultant supervisor. It may be that I might need to escalate this separately to their supervising consultant anyways.
* Be Empathetic to the FY1, most likely this is likely to be a genuine misjudgement rather than outright malice and provide educational input if possible.

Reflect

Do not forget reputation of the medical profession

Question 2

Please outline how you would explain your concerns to the FY1 colleague in question

Answer 2

• Approach in non-confrontational manner in an appropriate environment
• Using carefully selected language to explain why they needed to remove the post would be important as as well as avoiding threats or other dramatic consequences
• Important to state the clear issues with the post and that I feel that this is a professionalism issue
• Encourage the FY1 to discuss the matter with their senior.
• It may be that other staff members or even patients may require an apology.

Question 3

The FY1 in question becomes very distressed by their mistake and subsequently calls in sick for work each day for the rest of the week. How could you address and support your colleague?

Answer 3

• Acknowledge Distress: Recognize that the situation is particularly challenging for an FY1, who may feel fearful, ashamed, or embarrassed.
• Show Empathy: Approach the colleague with a nonjudgmental, understanding attitude if you have a good professional relationship.
• Offer Support: Provide a listening ear and be available for them to talk openly about their feelings.
• Signpost Resources: Sensitively direct them to appropriate support services (e.g., occupational health, counseling, peer support groups).
• Address Avoidance: Recognize that calling in sick is not a sustainable coping strategy.
• Team Involvement: Raise concerns with the team about the colleague’s wellbeing if appropriate, ensuring a compassionate approach.
• Facilitate Return: Consider if they need additional support (e.g., supervision, adjustments) or an empathetic meeting before returning to work.

Question 4

What are the issues surrounding the use of social media for doctors?

Answer 4

Social media when used well can be a powerful tool for education and support but also has the potential to generate several issues including:

• Patient confidentiality - discussing any individual cases should be avoided in a public space regardless of the use of identifiable information.
• Physician anonymity - identifying yourself as a doctor and including your name poses challenges to your privacy and being contacted by members of the public.
• Professional boundaries - the type of interactions facilitated by social media platforms could make it harder to establish clear social and professional boundaries with other users.
• Misinformation - any facts or sources of information posted could be subject to bias or errors. It is particularly important to be sure of the validity of any resources shared under your name as a healthcare professional.
• Giving medical advice is best avoided entirely due to the potential legal and ethical ramifications of unofficial interactions and potential consequences.

Question 5

Are you aware of any guidance available for social media use by medical professionals?

Answer 5

GMC, MDU, BMA