28 March 2013

JG speaks up

Here is a comment written by an anonymous doctor in response to the GMC guidance on social media. I am grateful to Dr Anne-Marie Cunningham for drawing my attention to it. I have to say that I agree with everything this doctor, who calls himself JG, said:

There is no way I would ever write to the GMC about this but I'm happy enough (at the behest of Anne-Marie) to comment here - which, of course, shows the value of social media.
My first thought is that this advice comes much too late. A quick check shows I first blogged in 2006. That's when I needed this advice.

My second thought is that this advice doesn't really facilitate anything. I learnt the hard way that it was difficult to put clinical vignettes online without risking a breach of confidentiality. At first I started changing dates/times/sex and I kept myself anonymous but if the condition is rare that doesn't help much. As a result, I concluded that using a blog as a way of teaching on real clinical cases was unwise. Yet we have been publishing such cases for centuries. The GMC provides no solution – not with this guidance anway. My guess is that most patients would not mind and might even be pleased to have their case publicised but how do I get their permission reliably without falling foul of the regulator?

As for identifying oneself when acting in a professional capacity, I am not too comfortable with that. But what is meant by a “professional capacity”? Even if I did put my real name how would anybody know that I am really a doctor and really who I say I am? There are people on Twitter who claim to be well-known people who are imposters. None of this has been addressed. And what is a “professional capacity”. Is moaning about the GMC or Mr Lansley’s policies operating in a professional capacity or do they just mean things related to patient care? And if I used my real name wouldn’t that be inviting patients to contact me in my area of special expertise (which I hope I have kept largely under wraps)? That’s not something I want to do and, it would seem, nor should I.

The GMC tells us not to give medical advice so why do we need to identify ourselves? Requests for medical advice are, in any case, surprisingly rare. Patients as well as doctors seem to know where to draw the line. But only days ago somebody asked urgently whether an overdose of a particular drug was dangerous and whether he should take action. Thinking of the GMC advice that “you must not use social media to discuss an individual patient”, I held back. Fortunately others did not and promptly gave appropriate advice. I think if they hadn’t I would have done the same. It was the GMC that deterred me. As it happens the police were called and hopefully the patient was OK – though I don’t know.

What if somebody tweets: “I have severe crushing chest pain”? Do you tell them that you cannot discuss their problem and that they should call their doctor for advice? Or should you tell them to call an ambulance? Or do you pretend, as I did, that you hadn’t seen the tweet. These issues have always been around. I was taught as a medical student how to deal with requests for medical advice at a cocktail party. Twitter is not very different really. The advice I was given then holds good for Twitter now.

I don't welcome this advice at all because it won't be long before the GMC start prowling around the social media. Doctors won't be able to be people. They will have to be professionals. The only safe thing to do will be to stay away. Doctors will become social media lepers.


I think this JG chap makes some good points though not everybody agreed with him. You can read the views of others here.