• OMSG Editor

Should Doctors Be On Social Media?

Updated: Mar 16

Zara Small, St Catherine's College

The COVID-19 pandemic has catalysed public social media engagement with an estimated 40% increase in social media consumption across the UK as of March 2020 (Statista 2020). In an unprecedented time flooded with shocking media reports and false information it is unsurprising that along with this rise in social media use, public attention has shifted to medics’ social media accounts to observe a unique perspective of the pandemic on the front line. Therefore, with this increased public responsibility and a personal desire to interact with friends and family online, how can medics appropriately navigate the field of social media?

The answer does at first seem straightforward; most social media accounts offer privacy settings that whilst limit publicly viewable content, are rarely bulletproof and are under discretion of a user’s followers. Use of privacy settings is endorsed by both BMA and GMC guidelines for appropriate social media use, as well as maintenance of patient and colleague professionalism. And whilst the importance of a professional online appearance is likely to be universally agreeable amongst medics, the question of what a professional appearance actually is entails an increasingly complex discussion.


Medical professionalism seems to encompass a matrix of commitments required be upheld to patients’ needs, medical science, practice regulations, and personal boundaries, just to name a few. Undoubtably, the responsibility to act professionally online is not limited to the medical profession, but in an occupation increasingly under online observation, it seems important to act to define these boundaries. This topic has also received increased attention since the publishing of a now retracted paper in the Journal of Vascular Surgery this past July. The study selected 480 vascular surgeons and attempted to identify which proportion had social media content regarded as unprofessional. This paper was not the first of its kind, and alike similar studies conducted, it concluded by reiterating the dangers of unprofessional content on social media. However, unlike formerly published papers, the problems and controversy that resulted in its retraction are considerably more unique.


Firstly, the authors screened surgeons’ social media using a directory of names not in the public domain without explicit permission for use, thereby effectively stalking privately listed social media accounts. In addition, the rubric for identifying unprofessional content was at the discretion of researchers’ personal viewpoints, and so was partial to considerable biases as well as potential discrimination. For instance, unprofessional content included holding alcohol, political comments, and sharing religious views. The paper also deemed certain attire as unprofessional, including women wearing bikinis, describing it as “provocative posing”.

Concerningly, despite having been written and researched by a multi person team with multiple peer reviewers, the paper was still significantly discriminatory, and coupled with the condemnation of bikini photos, also blatantly sexist. Furthermore, the social media profiles were screened by three male medical professionals, so whilst this male viewpoint bias cannot be said to be representative of the wider public, it does highlight the gender inequalities of medicine itself. With only 13.2% of UK consultant surgeons identifying as female in 2020(RCS, 2020), it is shocking yet unsurprising that these inequalities could extend to social media. This was also retrospectively recognised by the authors who acknowledged the definition of medical professionalism adhered to was set out by “white, heterosexual men”.


In response to the publication thousands of female doctors shared photos of themselves in the ‘inappropriately’ classed swimwear to social media, tagged with #medbikini. Many of these posts’ captions discuss the sexism women-identifying doctors have experienced at work and encourage greater representation of women in medicine, whilst others simply used the hashtag to share old holiday photos. The diversity of the hashtag’s use is reflective of the normality that should be held to photo of a woman’s body, and a rejection of the paper’s sexualisation of these images. #medbikini also takes direct aim at the authors’ definition of professionalism, since it is objective that swimwear would not be professional for a doctor in clinic, but that it should be professional to be a doctor who is also a bikini-wearing, and social media using, woman.


Whilst #medbikini opens up a conversation of gender discrimination in healthcare, the hashtag also introduces the idea of online authenticity as a key advantage of responsible social media use. Medical professionals from underrepresented groups are able to use social media as an opportunity to advance public understanding and highlight their career, especially in male dominated fields such as surgery, or in specialties such as dermatology where images of white skin still dominate examples in textbooks. Therefore, choosing to share these personal stories, inclusive photos, and bikini snaps is perhaps less a debate of professionalism, but one of representation. Social media, despite its many problems and undoubtable risks, does in some respect represent a level playing field for medical representation.


So whilst it is distinctly clear there are important guidelines on safe social media use, these guidelines are also strictly present for in person practice too, so perhaps a more systemic approach is needed to balance the demands of a medic posting online. And with growing social media use among doctors, both catalysed and encompassed by COVID-19, if medics do choose to have public social media accounts, the question is potentially not how to protect medical professionalism, but how it can be utilised for their own representation, public health, and patient wellbeing.

References:


Hardouin S, Cheng TW, Mitchell EL, Raulli SJ, Jones DW, Siracuse JJ, Farber A. RETRACTED: Prevalence of unprofessional social media content among young vascular surgeons. J Vasc Surg. 2020 Aug;72(2):667-671. doi: 10.1016/j.jvs.2019.10.069. Epub 2019 Dec 25. Retraction in: J Vasc Surg. 2020 Oct;72(4):1514. PMID: 31882313


Edition: 69 (2020-2021)

Correspondence to: editors@omsg-online.com


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