Is your organisation ready for social media?

Social media is here to stay. A lot of registrars and young doctors have one or more social media accounts, and I have yet to meet a medical student who is not on Facebook. Patients are already sharing online (health) information via Facebook, Twitter and other social media accounts – so sooner or later health professionals will need to decide whether or not to participate.

Potential benefits

Social media is increasingly used for medical education, and sharing knowledge and information such as tips, resources, literature and links. It’s also useful to build an online community. Clinics can share health information and other practical information.

Social media is more interactive than a website and you can reach a wider audience in real-time. Another benefit is the value of health promotion and lifting the profile of a medical practice or organisation. I’d like to mention the use of blogs, pictures and videos. I find they are a great way to communicate a message, and I use my social media accounts to let my followers know when I’ve posted something new.

Make the most of social media

Organisations need to be prepared to put aside time to manage their online presence, and there is no easy way out here. It takes time to post useful material and interact with others. Social media is a two-way street and not just another promotional channel. If you use social media for branding or promotional purposes only, you may lose followers.

Your online presence should have a consistent approach. Too many organisations set up a Facebook account without first developing a clearly defined strategy. It is recommended to take some time to plan and figure out the purpose of the social media campaign, which medium to focus on, and how to keep it sustainable and current. This usually requires a motivated person within the organisation.

Preparation is key, and implementing a social media policy should be part of the preparation. Some things to include in the policy are, for example, how to respond to negative feedback and/or complaints received via social media; and how to comply with AHPRA regulations.

The AMA has a useful document that outlines the risks. I also felt that the social media workshops organised by MDA National are an excellent way to become familiar with the common pitfalls.

Is social media for you?

Due to the time commitment, and the effort it takes to set up and maintain social media accounts, it may not be ideal for everyone.

For those who want to contribute to online health promotion or interact and share health information with their patients or other health professionals, social media is not without risks, but it can be an effective tool if used wisely.

This article appeared in MDA’s Defence Update in April 2014. Original title: ‘Social media in modern medicine’.

Blocking social media at work is not the answer

Restricting social media usage at work is sometimes done out of fear. “We don’t want our staff to be distracted.” And: “They shouldn’t waste their time on social media.” Other understandable reasons may include perceived cyber risks or the cost of excess data usage.

An organisation that blocks social media sites may send out one or more of the following messages:

  1. We don’t trust our staff
  2. We don’t really understand what social media is all about
  3. Even though consumers are using social media for health purposes, we’re not really interested

In most cases decision makers are probably unfamiliar with social media and may see it as a threat.

Why staff should have access

Here are five reasons why health care staff should have access to sites like LinkedIn, Twitter, YouTube, Blogs etc:

  1. Social networks are powerful learning tools for staff
  2. Social media are increasingly used as health promotion tools (such as embedded YouTube videos)
  3. Shared knowledge accessible via social media will assist staff in finding answers and making decisions
  4. Interactions with peers and thought leaders can increase work satisfaction (and will contribute to staff retention)
  5. Participating in social media and other new technologies will raise the (inter)national profile of an organisation

When it comes to cyber security, I believe there are alternatives that are more effective than blocking social media access including upgrading and updating operating systems, updating antivirus software, improving backup procedures, clever password management and online safety training for staff.

A simple social media staff policy also goes a long way.

AHPRA’s guidelines: Can someone tell me what just happened?

The Australian Health Practitioner Regulation Agency now says in its new guidelines that practitioners can be fined if patients post online testimonials praising the clinical care they received.

Last Friday, it seemed as if AHPRA had backed down on the harsh regulation. But is this really the case?

What does AHPRA say?

First of all, here’s a quote from the current guidelines:

a review (…) that states ‘Practitioner was quick to diagnose my illness and gave excellent treatment’, is a testimonial which references clinical care and is considered in breach of the National Law.

The guidelines also state that health practitioners must take steps to remove unsolicited testimonials appearing on any (social media) website not under their control. However, last Friday the medical board put out a media statement on the AHPRA website saying this:

The advertising guidelines apply to testimonials in the context of advertising (…) there is a clear difference between advertising – which requires an intent to promote the health services – and unsolicited online comment over which practitioners do not usually have control (…). The Board recognises that practitioners are unable to control what is written about them in a public forum.

The full statement can be found here.

3 unanswered questions

Indeed, this sounds a lot better than the official advertising guidelines – the medical press have used the words ‘backflip‘ and ‘backdown‘. However, the guidelines have not been updated, which leaves the following three questions unanswered:

1. If a patient posts a comment on my Facebook page stating that I gave excellent treatment, this is still considered in breach of the National Law according to AHPRA’s guidelines and I may be up for a fine if I don’t delete this friendly post. Will I be able to defend myself by referring to the media statement posted on the AHPRA website on 7 March 2014? If AHPRA is serious, the guidelines should be changed in accordance to their statement.

2. Health professionals need to know why our feedback about exactly this issue has not been taken on board in an earlier stage. The first draft guidelines appeared in 2012 and health practitioners were not impressed. The rules were already clear: we knew that testimonials in advertising are a no-go (and I don’t mean unsolicited Facebook comments from patients) – and of course this applies to websites, social media, the classroom, the elevator and anywhere else.

In AHPRA’s udated draft guidelines (2013) the issue of patient feedback vs testimonials had not been addressed, which again led to a storm of online comments as well as another lot of official submissions. See also this post (April 2013). As we know, the final version was published last month and positive patient feedback is not allowed, but then again on Friday the board seemed to think that patient comments are not advertising.

3. As the advertising guidelines are common to all national boards (e.g. dental, nursing & midwifery, psychology etc) we need to know if and how the statement by the medical board will be applied to the other 13 disciplines.

I’m happy with the clarification by medical board chair, Dr Joanna Flynn, and I agree it is a step in the right direction. But it still seems unnecessary government interference, and, after three revisions, the guidelines leave important questions unanswered.

AHPRA’s draft social media policy

The 2012 draft social media policy by the Australian Health Practitioner Regulation Agency (AHPRA) caused a lot of upheaval. Health professionals expressed concerns it was too prescriptive. Now there’s a new version and the organisation is requesting feedback.

A 76-page consultation paper has been posted on the AHPRA website and it includes drafts of the social media policy, revised Code of conduct, revised Guidelines for advertising and revised Guidelines for mandatory notifications.

It looks like AHPRA has taken the feedback on the earlier version on board. The new draft Social media policy is less prescriptive. Health professionals have to follow strict professional values, no matter if they’re in the elevator at work, the pub, or on Twitter or Facebook.

What does it say?

Most of it is common sense, but I thought these two changes were worth mentioning:

  • Health practitioners are expected to behave professionally and courteously to colleagues and other practitioners, including when using social media (Code of conduct 4.2c).
  • Testimonials on Facebook and other social media networks have to be removed by health practitioners (Guidelines for advertising 7.2.3).

I’ve read all 76 pages but it’s not entirely clear to me what exactly a testimonial is and whether I’m now required to remove my LinkedIn testimonials and endorsements by colleagues from around the world.

Also, it will require some explaining when removing or refusing friendly, unintended testimonials from our patients on e.g. Facebook, and worse, it may even put health practitioners off social media. I won’t mention Google testimonials – they are impossible to remove. It would be great if AHPRA can provide some clarification and reassurance here.

Interestingly, an issue that causes heated debates has not been mentioned, namely anonymous posting on social media networks by health practitioners who are identifying themselves as such, but are using a pseudonym instead of their real name. Some say it’s important for e.g. whistleblowers to be anonymous, others say health professionals always have to be identifiable. But perhaps it’s a wise decision by AHPRA not to open this can of worms.

Good or bad?

The problem with regulations like this is that it increases liability for health professionals and practices already operating in a highly regulated industry – especially against a backdrop of the recent national eHealth developments and the legal issues that health providers are facing when signing up for the PCEHR. Some of the risks are: less innovation and progress, a defensive attitude by practitioners, higher legal and insurance costs, increased AHPRA fees and eventually more costs for patients.

That brings me to the risk management paragraph in AHPRA’s draft Code of conduct, which states that it’s good practice “to be aware of the principles of open disclosure and a non-punitive approach to incident management”. I wonder if AHPRA is going to follow this advice when a practitioner breaches a social media clause. Something tells me that the regulator will follow a punitive approach if we forget to delete Mrs Jones’ friendly Facebook recommendation.