Being a Doctor on Social Media

In our community, doctors are in a group of people that are held up to a different standard than the rest of the community. I realised that a few years ago when I posted to Facebook a picture of myself holding up a dead feral cat that I had dispatched with an arrow. Someone commented “Doctors should not be killing animals” And I thought I was doing the environment a favour by taking a predator of native animals out of the picture. I wont republish that here!

from https://www.reddit.com/r/midjourney/comments/1781e03/visions_of_peace/

In Australia, Australian Health Practitioner Regulation Agency (AHPRA) works in partnership with the National Boards to ensure that Australia’s registered health practitioners are suitably trained, qualified and safe to practice. It also polices the standard of health practitioners and deals with complaints against medical practitioners for a variety of reason.

Recently, I gave up being a moderator of a group I had been a member of for almost 10 years because I felt posts which were related to the current conflict between Israel and Palestine were being removed without explanation to the members. I posted about censorship in the group which resulted in a a flurry of likes and conversation about censorship with support for my views. I never thought I was a whisteblower until someone thanked me for being so. The post received support from a variety of GPs, but then it was limited, the it was closed and then it was gone. I explained to the administrators of the group what I thought of this and got told off.

I think the rationale was a fear that any posts about Israel and Palestine may incur the wrath of AHPRA but this was never full explained to members of the groups at the time I resigned. As a moderator there had been an incomplete discussion of what to do. A group of over 10,000 Australian & New Zealand doctors will contain a broad representatives from our multicultural society and a comment may not always be taken as intended.

In the censored post there had been conversation between Australian who supported Palestine, those that supported Israel. those that explained being Jewish or Muslim in Australia they felt a threat. One GP explained how she was now feeling anxious about leaving her children in daycare. This saddens me immensely because generally Australia is a mostly tolerant society. Although, yes we have a small number of extremists on both side who cowardly express their hatred in graffiti and social media. I have never felt threatened by the colour of my skin or the shape of my nose, or whatever someone uses to highlight racial difference. I have however recall feel threatened because of my spectacles, my favoured mode of transport, a bicycle, but that’s about it.

AHPRA enforce a social media policy on all doctors in which we are told we should

• complying with confidentiality and privacy obligations 
• complying with your professional obligations as defined in your Board’s Code of conduct
• maintaining professional boundaries 
• communicating professionally and respectfully with or about patients, colleagues and employers, and 
• not presenting information that is false, misleading or deceptive, including advertising only claims that are supported by acceptable evidence.

There have been several articles warning about the perils of social media the medical media.

The Medical Board code of conduct, which sets out the expected professional standard of practice, acknowledges that doctors have a right to express their personal views but notes that the boundary between a doctor’s personal and public profile can be “blurred”.  

Recently, AHPRA sanctioned a doctor following a complaint that her social media post questioned some of the appalling actions of Hamas in Israel on October 7. The medial defense company I subscribe to warns to take care. From the AusDoc article

An Avant spokesperson said the Medical Board of Australia’s code of conduct recognised doctors’ right to express personal views but warned “the boundary between a doctor’s personal and public profile can be blurred”.  The medical defence organisation (MDO) pointed to sections of the code that urged doctors to recognise that “cultural differences may impact on the doctor–patient relationship and the delivery of health services”. It also specifically warned doctors against expressing “personal beliefs to your patients in ways that exploit their vulnerability or are likely to cause them distress”.

AHPRA is a potential weapon that can be used to threaten doctors, whether that was AHPRA’s intention or not. The fear of a vexatious complaint is real. Possibly, as much as the fear of sued for a medical mishap. As defined by AHPRA, “a vexatious notification (concern) is one without substance, made with an intent to cause distress, detriment or harassment to a practitioner named in the notification. Vexatious notifications can come from anyone including patients, members of the public and other practitioners”.
There are several examples of this type of complain having an impact on doctors. Here is one reported in the RACGP media.

The fear of an AHPRA sanction leads social media posts being censored and lead to my post on censorship being sanctioned. This is just one of the implications of the standards that we, as health professional are held to, different to plumbers, bricklayers and used care salesmen in Australia.

Maybe before considering to be a doctor, a young person should undergo a process of informed consent to understand they will be beholden to different rules in society?