Social media is one of the fastest rising sources of complaints, and breaches often stem from its instantaneous nature, says lawyer David Gardner, a former AHPRA investigator who now runs CPD courses on AHPRA compliance for health professionals.
“The way that you can go back and forth very quickly with someone can end up in situations where you’re not really thinking about what you’re saying, you’re just responding to a stimulus,” Mr Gardner explains.
“That can result in you saying things that don’t reflect what you truly think.”
This happens in a “staggering” number of cases where a person’s online conduct lands them in a tribunal, he says. “We really want to avoid having people sleepwalk into a tribunal.”
“It’s not just what you do at work, it’s not just when you’re posting about clinical matters, it’s everything that you do,” he emphasises.
Why do regulators care about personal posts health professionals share online?
Online posts are essentially permanent and can go viral “in a matter of hours or even minutes,” Mr Gardner notes.
“And what you say online can reflect poorly on the profession and it might even suggest that you pose a risk to patients.”
The first thing is to understand your obligations, which are spelt out in the Medical Board’s Code of Conduct and AHPRA’s social media guidance. And although this article won’t cover advertising, if you’re promoting your services online, you should also be aware of section 133 of the National Law, and AHPRA’s advertising guidance, especially because breaching this provision is a criminal offence. If you’re practising in the cosmetic space, additional advertising requirements may apply.
Your personal conduct should display the values that the Board expects—most notably, respect for others, including other cultures, countries, religions or people, Mr Gardner says.
Here are some important things to remember.
Assume anything you ever post or even send in a private message will exist forever, get copied, and might get seen by a regulator or employer.
“When people are sending messages or posting something online, they don’t necessarily think that one day this could be blown up in front of a judge on a giant screen in a tribunal,” Mr Gardner says, so some careful thought now could prevent you from having to explain yourself in future.
“Be aware anything that you post you could potentially need to explain in the future, so be thoughtful about it.”
Well-meaning practitioners sometimes respond to things people post online in an effort to help, but doing so often breaches professional boundaries.
“You are taking what is a social or non-clinical relationship with some random person on the internet … and turning it into a clinical one — but you haven’t conducted an assessment, you haven’t got information about this patient’s history, you don’t know a lot of information – so it’s really risky to be giving that person advice,” he points out.
Patients may find you online, comment on your posts or private message you, so it’s worth thinking through how you’ll respond when someone starts to overstep, he adds.
For example, you could send a polite reply explaining you can’t communicate on this platform and suggest they book an appointment.
It’s also important to consider your safety—and resist the temptation to overshare.
“We sometimes forget how much information we put out there … about ourselves, about our families, where we go, holidays, what we’re doing.”
He recommends keeping strong privacy settings on social media and avoiding non-clinical as well as clinical interactions with patients – both to protect yourself and to help maintain professional boundaries.
If it’s clear you’re responding to public comments from someone who is your patient, this also constitutes a breach of confidentiality, even if you believe there’s implied consent.
Clinical discussion groups and messaging platforms can be acceptable places to share cases and seek guidance, but they require proper de-identification and secure handling of health information, and it’s important to be careful.
Be aware that some platforms store information overseas, potentially breaching your obligations regarding the disclosure of health information outside Australia.
One of the best ways to avoid making a mistake that generates a complaint is to slow down, Mr Gardner says.
“Often when you step back and think about it, you will either think, okay, my voice isn’t needed or I’m not actually adding anything, or this is a risky topic, this is a controversial topic and I need to think about it and maybe I need to chat to someone about it. Or you’ll think, I’m just commenting on a cat photo. It’s fine.”
Either way, taking a step back will likely prevent you from posting 25 messages in 10 minutes, he adds.
As a defensive tactic, assume the people you’re engaging with online are coming from a position of good faith, Mr Gardner says.
“If you start from that position, you’re much less likely to misunderstand something and jump down someone’s throat and say something that you later regret.”
Before posting anything potentially controversial, run it by a respected colleague or mentor.
“Get someone who isn’t just going to say yes, isn’t just going to agree with you. Get someone who will respectfully push you, probe, ask questions,” he advises.
If you do decide to post and get a complaint, having a record of that discussion you can share with the regulators can help to show you proactively thought about the risk and tried to take appropriate steps to manage it, he notes.
On that note, Mr Gardner says it’s useful to keep a record of anything you do that shows you’ve thought about risk, carefully approached a situation, and put patients first.
“It helps you get a bit of a system going that is safer. And it’s the very best thing you can give to a board or a regulator to defend yourself against a complaint.”
When you’re posting something online, consider: How would I explain this to the medical board? How would I stand up and say, ‘this is an appropriate thing for me to send out into the world’?
“If you can, and you’ve thought about it, and maybe you’ve checked with an experienced colleague, then you can probably post it,” Mr Gardner says.
More information
David Gardner’s in-depth course | Social Media in Health: Perils and Pitfalls course
AMA NSW | Social media: Resources for doctors in training
AHPRA | Social media: How to meet your obligations under the National Law
You might also like this article on seven common pitfalls to avoid online.
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