Risk: What's up with WhatsApp?

EXCHANGING information quickly and easily has always been a key goal for doctors. As healthcare is increasingly delivered via digital platforms, it’s no surprise that messaging apps such as WhatsApp and Snapchat have become popular amongst clinicians as a way to easily communicate with colleagues.

One message can be sent into the pockets of an entire team instantly. You can attach guidelines, policies and share good practice with the click of a button. This has been enormously helpful and beneficial to all healthcare professionals, especially during the pandemic. Former health and social care secretary Matt Hancock even suggested that doctors could use WhatsApp to send patients test results and medical advice.

But while this all seems like the answer to our digital prayers, it is essential to remember that the standards expected from us do not dilute simply because we are behind a keyboard or phone.

MDDUS receives frequent enquiries about the use of messaging apps by healthcare professionals. Queries vary from what information can be shared to concerns about the content of a colleague’s advice or message, which has been captured in a screenshot for evidence.

Patient boundaries

When it comes to patients, the message from the General Medical Council (GMC) is clear - you must maintain a professional boundary between you and your patient and ensure that the use of social media does not allow this professional boundary to become blurred.

• Don’t share your personal number with patients and send messages via services such as WhatsApp.
• Be clear and explain that you cannot mix social and professional relationships and, where appropriate, direct them to your professional profile or practice/trust webpage.

Confidentiality

Many doctors only use private or professional social media/messaging platforms and may wrongly assume that this gives them free rein as to what can be discussed or shared.

However, it is still important to remember that patient confidentiality remains the cornerstone of medical practice, and no identifiable information about patients should be disclosed on such platforms. If you are using WhatsApp to share information or discuss a patient with a colleague, you should not disclose any identifiable information about them at any time.

So please, exercise caution when sending messages, as you will be held accountable for your opinions, advice and posts and may be expected later to justify the content.

Pitfalls of “private” groups

Communicating with colleagues via social media/messaging services can be powerful and immensely helpful. Where else can you get the opinion of several thousand colleagues with the click of a button and within a few minutes?

Modern medicine should embrace the benefits of these digital platforms, but remember: any opinion, information or advice you share may remain online indefinitely and could easily be shared more widely beyond the private group. This could open you not only to criticism from colleagues but it could potentially catch the attention of your employer or the GMC.

It was recently reported that a group of doctors are facing investigation by Health Education England for allegedly sharing offensive messages and pictures on a private WhatsApp thread over a two-year period.

If you find yourself in a situation where you disagree with a colleague or are annoyed about a patient, it is important to remember that you must maintain the same high standard of professionalism that you would if you were having a discussion face to face.

Healthcare professionals who behave unprofessionally on social media are held accountable.

Professional duties

The GMC makes it clear in Good medical practice that doctors must:

• Treat colleagues fairly and with respect.
• Make sure that your conduct justifies your patients’ trust in you and the public’s trust in the profession.
• Maintain patient confidentiality when communicating publicly, including speaking to or writing in the media.You should remember when using social media that communications intended for friends or family may become more widely available.

At times, things can get stressful and become frustrating, and it may be tempting to share your thoughts and feelings about a colleague, patient, surgery or particular clinical practice. Wait, reflect and consider any comments before making them. Are they professional? Would you say the same things in person? If the answer is no, then you may wish to think of other ways to make your point or provide feedback.

The GMC has produced guidance for doctors, which makes it very clear that you should show respect for colleagues online too. Doctors’ use of social media states:

• You must not bully, harass or make gratuitous, unsubstantiated or unsustainable comments about individuals online.
• When interacting with or commenting about individuals or organisations online, you should be aware that postings online are subject to the same laws of copyright and defamation as written or verbal communications, whether they are made in a personal or professional capacity.

So, as we advance digitally and embrace the use of social media in medicine, we must not forget that what we say and how we say it is still important. Our colleagues and patients expect us to behave professionally at all times, whether we are communicating face to face or from behind our phones.

ACTION POINTS

• Be sure to comply with current guidance from the GMC and your trust/health board surrounding the use of social media/messaging services,
• Remember that any opinion, post or comment remains online and could be shared beyond private groups. If you wouldn’t say something in person, should you say it online?
• Always maintain patient confidentiality.
• Remain professional and do not act in a manner that discredits your position or your profession.