What is social media?

Nearly 80% of Australians use some form of social media, and a quarter of Australians follow businesses or brands on social media.² 

The widespread use and low cost of social media makes it a convenient tool for general practices to connect with patients and health professionals, and vice versa. Using the internet to transcend geographic boundaries, social media is an effective way to engage the public and reach people in rural and remote communities. It can also be used as a community engagement tool – for example, to share practice social celebrations and acknowledgement of achievements by practice staff. 

Social media can also serve as a tool to facilitate expansion of professional networks (local, regional, national, international), information exchange, collaboration, curriculum development and e-learning, among many other professional activities. It is an easy way to network, keep up to date, learn, engage and connect directly with decision-makers. The RACGP’s member platform, shareGP, is a good example of how social media can be an important professional resource for GPs. A closed online space, it lets GPs connect and collaborate with their peers to share ideas, opinions, research and support. 

Multiple social media accounts can be used to cross-promote content, broaden your reach and engage across platforms (eg ‘tweet’ a link to your latest blog post, post a link to your Facebook page or your general practice LinkedIn profile). 

Social media can be a source of news, and it also gives GPs a platform to express their views about the health system, which helps generate and inform health policy and public debate. 

Social media provides a platform for health professionals to educate the community about health conditions, disease prevention and treatment. If done well, your social media platforms can be a source of evidence-based information that people use and trust.

Social media has opened up valuable new lines of communication between health practitioners and patients; however, it does pose some risks regarding security, confidentiality and professional reputation. It is crucial that GPs and general practice staff recognise and understand the difference between information appropriate for public consumption on social media and information that should  be kept confidential. 

All information published on the internet is nearly impossible to permanently delete or modify. Once content is seen by one person, it can be shared and distributed. It is important to carefully consider information before you share it online. Security and privacy settings of all social media platforms should be set to ensure that, where possible, users have control over who is part of their networks and who can view the information they post. 

Social media use can be time consuming. A general practice that actively engages in social media is likely to require a dedicated staff member with a good understanding of the social media platform being used to monitor and approve all content that is published. 

Practices also need to consider the impact of staff using social media for personal use during work hours. Although permission to use social media within a practice may be sought and granted, this may result in illegitimate use at times. Terms of usage, authorisation (and scope of these authorisations) should be reflected in your practice’s social media policy.

The Medical Board of Australia’s (MBA’s) Good medical practice: A code of conduct for doctors  in Australia, section 4.2.3, advises that  ‘Behaving professionally and courteously to colleagues and other practitioners including when using social media’³ is essential.

If you cannot or would not say something in public, then it is unlikely to be appropriate for online publication. The ‘elevator test’ is a good gauge for what is appropriate to say online and what is not. If your comment would be considered inappropriate by a crowd of strangers in an elevator, it is probably unwise to publish it on the internet. Avoid engaging in online arguments and providing negative responses to comments  or feedback. 

The Mayo Clinic’s simple yet effective ‘12-word social media policy’ sums up appropriate online behaviour for healthcare professionals as follows: don’t lie, don’t pry; don’t cheat, can’t delete; don’t steal, don’t reveal.⁴ 

If the views displayed on your personal social media page do not directly reflect those of the general practice, boards or committees that you are a part of, insert a disclaimer that explains this. For example, ‘This account reflects my personal views and not the views of my employer, or any businesses, committees or boards with which I am involved.’ However, you should be aware that disclaimers may be of little practical use in the absence of supporting or reinforcing activities.

The use of social media by GPs and general practice staff can be regarded as a form of advertising of a health service and is subject to the Australian Health Practitioner Regulation Agency’s (AHPRA’s) Guidelines for advertising regulated health services. If anyone leaves a testimonial on your social media profile, it could breach the national law that imposes limits on advertising of health services delivered by registered health practitioners. APRHA requires practitioners to take reasonable steps to remove testimonials that advertise their health services (this may include comments about the practitioners themselves). However, ‘practitioners are not responsible for removing (or trying to have removed) unsolicited testimonials published on a website or in social media over which they do not have control’.⁵ 

It is up to your practice to ensure that the settings of your social media websites adhere to AHPRA and MBA guidelines (eg disable reviews or comments functions). For all related codes and guidelines, refer to the codes, guidelines and policies outlined by the MBA.

AHPRA and the National Boards have published a self-assessment advertising tool and a testimonial tool to help health practitioners comply with the national law. 

The RACGP has also developed a factsheet, ‘Responding to online reviews’, that provides further information about using testimonials. 

Health practitioners and health organisations have a legal obligation to keep patient information confidential and protect the privacy of patients’ information. This obligation applies to the use of social media. The MBA’s Good medical practice: A code of conduct for doctors in Australia, section 3.4, states that good medical practice involves ‘Ensuring that your use of social media is consistent with your ethical and legal obligations to protect patient confidentiality and privacy.’³

This means that when using social media, staff must not discuss patients or post pictures of procedures, case studies, patients or sensitive material. Such material posted online may identify patients without their informed consent. 

For further guidance refer to the RACGP’s Privacy and managing health information  in general practice

Before participating in social media use, it is important for GPs and general practice staff to secure computers, digital technologies, and internet and Wi-Fi connections to ensure that your practice is protected against potential exposure to unauthorised access and theft or loss of personal information. 

For guidance and a framework to evaluate risks, and solutions to improve competency and capacity in computer and information security, refer to the RACGP’s Information security in general practice.

If your practice intends to use social media, you must ensure that you have a social media policy in place and that staff comply with the policy and its relevant content. You should consider developing a practice code of conduct for the use of social media that reflects the MBA’s Good medical practice: A code of conduct for doctors in Australia. The RACGP has put together a social media policy template that you can adapt to your practice. 

If you decide to use social media for your practice, it is recommended that you assign a staff member to manage the tasks of updating and maintaining your online information. You should document and clearly define this role in your practice’s social media policy. 

Further, it is recommended that you educate all members of the practice team about using social media. The topics covered in staff education would fall into two main categories: social media policy,  and how to use social media. 

Social media policy training should include:

• what your practice’s social media policy is
• why you have a policy
• who can set up new social media channels and what approvals need to be in place to do this
• who in the practice is authorised to post on social media
• what constitutes professional conduct when using social media
• information about the practice’s reputation and in what instances social media use, including personal use, may put the practice’s reputation at risk (refer below)
• legal obligations, including the importance of protecting confidential patient information
• the consequences of policy breaches (these should also be documented in the policy).

Training on how to use social media could include:

• the basics of social media – what it is, how it works, why use it
• protecting personal and professional information online (eg by adjusting security and privacy settings)
• how to craft messages to get the results you want – depending on whether you want to use social media for recruitment, marketing, information provision or other purposes
• social media etiquette – social media is about building relationships, so be mindful of what people like or dislike from the businesses they follow. For example, rather than constantly pushing messages out to people, engage with them – think conversation, not soap box
• expectations for posts made on behalf of the practice (eg what tone you should take, what are or aren’t appropriate topics, minimum response times to comments or queries made on the practice page)
• the practice’s brand and messaging on social media
• the importance of protecting confidential patient information
• the importance of checking facts before posting
• the importance of checking spelling and grammar before posting
• how to make posts interesting
• how to handle ‘bad’ posts (refer to the RACGP factsheet ‘Responding to online reviews’).

In addition, it is recommended that you educate GPs in the practice about the professional risks involved when using social media in a personal capacity. Private activity that could adversely affect their professional status and reputation includes:

• joining an online forum with extremist views
• posting abusive posts about a colleague or patient
• friending/following a patient
• finding and responding to a patient profile on dating websites.

It is also important to understand the possible legal implications of posting personal information online. This may cause defamation action or disciplinary complaint about unprofessional behaviour.

Consider the following when deciding whether to use social media in your practice.

• Do you have the staff resources to implement and manage your social media profiles?
• What policies and procedures will you need to create to use social media safely and efficiently?
• Will this be of benefit to your patients?
• Do you have the time to train staff?
• What social media platforms will allow you to collaborate with the most relevant groups or people?
• Who is your target audience? Will you be able to connect with your target audience to increase your business profile?

• Get started by setting up your accounts. Consider what email addresses and other contact details you will use for your account set-up.
• Take the time to set up your accounts properly by completing the ‘about’ sections for your business with consistent and accurate information.
• If you are using images of your business, they should be consistent across all your social media sites. Make sure you get consent from staff before posting photos or information about them.
• Determine your social media objectives and what content you want to provide. This will help you work out what resources you need to generate and how to manage your social media channels.
• Create a social media policy that protects your business, your staff and your patients.
• Keep it together – ideally, the different social media you use should complement and link with each other. For example, you might use Twitter to connect with people about health policy, but link from Twitter to your LinkedIn profile where you can upload more detailed posts about topics of interest.
• Don’t forget your website – even if you’re on five different social media platforms, your website will probably be where the most useful and comprehensive information about your practice is kept, so wherever you can, try to direct people from your social media to your website.