Social slip-ups

You may be familiar with the unfortunate faux pas made by health secretary Jeremy Hunt, when he tweeted a picture of himself and a number of doctors during a visit to University College Hospital in July 2015. In the background of the picture was a board clearly identifying the names of patients on the ward at the time.

There is obviously a degree of common sense to be applied when posting pictures at work, but as mentioned above the problem can be more subtle. Imagine a scenario where doctors are posting about a particularly interesting case. One doctor may post a description, another the name of the hospital and a third doctor could post a picture. It's quite possible that while the patient may not be identifiable from any of the individual posts, they become so when taken as a whole during the course of the discussion.

Out of your hands

It is also essential to bear in mind that once something is posted it becomes very difficult to control how it is used or disseminated afterwards. This is of particular importance when making off the cuff comments about particular patients on social media (or indeed colleagues) which may return to haunt you later.

A number of doctors have contacted the MDU asking for advice about what to do when patients send them friend requests on platforms like Facebook and LinkedIn. Our advice is invariably to decline such requests, as even with very careful security and privacy settings doctors must be very careful about blurring the lines between their personal and professional lives - something which is becoming ever more difficult with increasing technological integration.

In summary

• Assume anything you post can and will be seen by anyone for the foreseeable future, regardless of your privacy settings.
• Remember your duty of confidentiality to patients. If you do discuss cases in online forums, make sure that patients can't be identified, particularly by piecing isolated bits of information together.
• Consider the GMC's guidance on the subject (see link above).

In the last issue of Notes, we looked at the many pitfalls that social media has in store for the unwary user. But it's not just yourself you have to look out for. Here we'll examine how an unwittingly irresponsible post can have unforeseen repercussions for colleagues, patients and their families, with a particular focus on patient privacy and confidentiality.

The GMC's Good medical practice guidelines are clear that patients have a right to expect that any information held by their doctors will be kept confidential.  In addition, the GMC has published further specific guidance about confidentiality, detailing doctors' use of social media. 

The key takeaway point is that the principles of confidentiality apply equally to social media as they do in face-to-face situations. The difficulty is that whilst you may not breach patient confidentiality when posting to social media, it may well be possible (through other posts) to decipher otherwise confidential information.