Medicolegal Adviser Dr Gordon McDavid answers some of the most common
social media queries we receive from practices.

How can a practice deal with abuse from patients on social media?

Abusive behaviour by patients must be handled in a robust yet considered manner, ensuring compliance with the practice’s obligations as a healthcare provider and as an employer. Unacceptable communication via social media may feel like a nightmare scenario for any practice. However, as with any challenging patient situation, a good starting point is to try to achieve open communication with that patient.

The approach to managing patient behaviour will depend upon the particular circumstances and it is important to try to aim for a mutually acceptable resolution of the patient’s concerns. For example, if the patient has made a complaint about the practice, it may be preferable for the practice to address this under their complaints procedure. Practices may wish to ensure that the patient understands that abuse (in any form) is unacceptable. Most social media providers will have a mechanism for reporting abusive comments and this should be considered.

What can staff do about patients taking photos in waiting areas and posting them on social media?

This tricky scenario is becoming all the more commonplace with the increasing use of camera phones. Practices should have a policy in place in relation to photographs being taken on-site. It might be to prohibit patients taking photographs, particularly in clinical areas or waiting rooms.

A photograph in which an unsuspecting patient is inadvertently pictured attending surgery, could be considered a breach of confidentiality – particularly if that photo then finds its way online and is published on social media. This could cause distress to patients and could invite a complaint.

Banning photographs can be a challenge. A practice would be expected to take reasonable steps to enforce their policies, for example, empowering staff to politely interject if a patient is observed taking photos, or displaying clear notices in public areas. These notices should make specific reference to the fact that no photographs should be published online.

What should a social media clause within a staff confidentiality statement include?

It is important to include a social media clause in the staff confidentiality statement. In relation to social media particularly, the following comments may be helpful:

• It is wholly inappropriate for a GP or member of staff to post derogatory comments about a patient on social media sites. The healthcare regulators, such as the GMC, would take an extremely strict line in this regard.
• It would be also inappropriate to discuss posts on social media in the context of a consultation.
• It is also not appropriate for staff to discuss the practice or staff members on these sites. A clause could be included in a staff member’s contract.
• We understand that such sites often have a quick means by which abusive comments can be reported.
• Medical Protection takes the view that GPs and practice staff should avoid accessing patients’ personal social media sites, or at least avoid adding patients as friends.

The social media clause should state that staff members should act, on social media, with the conduct that would be expected of a practice employee. It should state that patients, consultations or desk enquiries, even anonymously, should not be discussed on social media sites. Aspects of the day-to-day running of the practice or reference to colleagues should not be discussed.

Is it OK for a patient to take a selfie during minor surgery?

This sounds a bit unusual but at Medical Protection we’ve heard this is becoming an increasingly common request, especially in practices that deal with a high student population. If a patient were to ask to take a selfie photograph, it is worth discussing this with the patient to explore the reasons for the request. If the reason is innocent enough and you have no concerns about the patient taking such a photograph, there is no reason to refuse to allow this. However, if the picture could potentially capture something it shouldn’t, such as another patient in the background or confidential information, then it would be your duty to intervene. Practices may wish to consider a policy in this regard and may elect to have a blanket protocol to prohibit all forms of photographs.

My nurse has been criticised on our practice’s Facebook page – what should i do?

It is important to open the lines of communication with the person expressing unhappiness and to deal with such a situation as any complaint would be managed.

The optimum strategy would depend on the particular circumstances but contacting the patient directly and offering to look into their concerns is likely to be a helpful first step. Such action provides a means to look into the allegations and a forum to be able to respond to the criticisms, whilst also steering the patient away from voicing their negative views online.

You also need to keep in mind your obligations under the relevant complaints regulations for your area.