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.

03 March 2013

My political foray

It's gradually been dawning on me that we all need to seize control. I know some of you think I'm wasting my time and money supporting the National Health Action Party. But I don't think I am. I've never been a member of a political party before and, until Eastleigh, I had never been canvassing. It's never too late to learn.

And I have learnt a lot. The hostility shown on the doorstep was an eye-opener. The people of Eastleigh came over as utterly disenchanted with the political process. Who can blame them? I feel the same way. We are in the era of disenchantment. We don't feel we have any control. The politicians just plough on regardless. And their direction of travel is wrong.

The other thing that dismayed me was how the propaganda originating from our masters and spewed out by our complacent and compliant press is actually believed. The badmouthing of the NHS has been so widespread and sustained that the public now think that the good care they themselves may have received has been the exception rather than the rule. You can't overturn entrenched views. Evidence cuts no ice on the doorstep. Politics is about belief.

A comment on my previous post mocks the efforts of the NHA Party in Eastleigh. Mocking is easy. Doing nothing is easy. But trying to do something to improve matters is difficult - especially if you make no progress and are ridiculed.  But today I feel that there are signs that the tide is turning. I awoke this morning to news that the prime minister himself is claiming that his is the party of the NHS.  Later came a tweet from the Labour Chief Whip in the Lords telling me that "doctors have rumbled the Govts Trojan horse, sneaky regulations that marketise & privatise health care in the NHSby forcing CCT". I'm not sure which planet the Chief Whip's been on over the past year but it's better late than never.

So on a day when five Sunday papers have an NHS story on the front page, two about privatisation, I am heartened that the views of those with genuine concerns are at last being heard. I think the National Health Action Party is having an effect. Don't dismiss it. Maybe you should even consider given it your support.