Earlier this week Croakey published an open letter from Victorian surgeon Jill Tomlinson to the Medical Board of Australia expressing concern about a “lack of understanding of social media communication” shown in its proposed guidelines for advertising regulated health services that will take effect next month.
Of particular concern, she said, was that medical practitioners will need to ask any individual who writes online about their clinical care, or any website that hosts the online comments, to remove the comments.
Chair of the Medical Board of Australia Dr Joanna Flynn responds to the letter below.
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Dr Joanna Flynn writes:
While the Medical Board of Australia’s new social media policy has prompted some lively debate, the reality is that it doesn’t set new requirements.
Social media changes the means of communication, not the Board’s expectations of medical practitioners.
In other words, the social media policy clarifies that practitioners’ existing regulatory responsibilities apply to social media as they do to traditional forms of communication. They are not new expectations. They are existing expectations that apply to new media.
The ban on testimonials has triggered a lot of social media debate. In fact, the ban comes from the Health Practitioner Regulation National Law (section 133), which specifically rules out testimonials. The Board didn’t make this up. It developed guidance (through the Advertising guidelines) to help make practitioners’ legal responsibilities clear. The social media policy applies these same responsibilities to new media.
Our legislators shaped the National Law, including the ban on testimonials, based on history, traditional forms of media and past trends in complaints. Whether it is still appropriate in the 21st century, when there are a whole series of conversations taking place online, with different levels of control over who says what about who, is another question altogether. If there is appetite for change, this debate should be channeled into the forthcoming three year review of the National Registration and Accreditation Scheme, which we expect will include opportunities for feedback about aspects of the Law. Practitioners active in social media, who are concerned about the current legal framework, should seek out opportunities to have their say.
In the meantime, as a regulator, the core role of the board is to protect the public. Our focus is squarely on managing risk to patients.
Through the social media policy, the Board requires practitioners who are involved in social media to make sure they meet their regulatory responsibilities. These already exist in the Board’s code of conduct (Good medical practice), the advertising guidelines and now the social media policy.
Also, the policy doesn’t change the threshold for investigating concerns about a doctor’s conduct. It simply aims to make it clear what that threshold is.
The Board received nearly 5,000 complaints about medical practitioners last year. As a regulator, it will continue to focus on public safety and managing risk to patients. Part of the Board’s job is to make sure the standards it expects practitioners to meet are clear. In turn, the Board expects practitioners to take reasonable steps to meet them.
Social media will continue to evolve. The Board will keep thinking about both the opportunities and challenges of social media. We will continue to consult with the profession and the community as we grapple with these issues and look to international experience. The challenges of social media for regulation of health practitioners are not unique to Australia.
Dr Flynn’s response unfortunately fails to acknowledge or address the issues that I raised in my letter to the Medical Board. Dr Flynn’s response refers to the AHPRA social media policy. My letter refers to the AHPRA advertising guidelines. These are two separate documents.
The proposed AHPRA advertising guidelines do set new requirements and do change Board expectations of medical practitioners. From March 17, for the first time anywhere in the world, AHPRA and the Australian Medical Board will hold health practitioners responsible for comments that are posted by an independent individual on a platform that the health practitioner has no control over.
If the Board’s core role and focus is to protect the public and manage risk to patients, then why attempt to censor patient communication?
Dr Flynn states that the social media policy prompted lively debate. Indeed it did in 2012, when AHPRA proposed a draft policy that appeared to suggest that even a Facebook Like would be considered a testimonial. This draft was completely reworked following highly negative community feedback and thankfully the new 2014 social media policy looks nothing like the 2012 version.
In 2014 it is the proposed AHPRA advertising guidelines that do not make sense, and which have received highly negative feedback from health practitioners. My open letter appears to have been misunderstood and dismissed, but I am certainly not alone in expressing that the proposed advertising guidelines need to be reconsidered – as the Australian Doctor comments that I reproduce below demonstrate.
Sincerely,
Dr Jill Tomlinson
MBBS(Hons), PG Dip Surg Anat, FRACS(Plast), GAICD
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The comments reproduced below were made by health practitioners this week on the Australian Doctor website regarding the new AHPRA guidelines. The comments can be viewed by registered users at http://www.australiandoctor.com.au/news/latest-news/doctors-face-fines-over-patients-social-media-pos#comments
“AHPRA has no clue about the reality of social media. Time for AHPRA to be accredited on its knowledge of the 21st century.”
“I’m concerned that in obeying APHRA I might be trampling on the human right ICCPR Article 19.”
“I know, come March, let’s get all our friends to post awesome things about all the Doctors on the board of AHPRA.”
“In my view AHPRA is restricting valuable information available to patients to make informed decisions about their care. In my opinion that is not protecting the public, that is hindering the public.”
“Does AHPRA really think they can tell the tech savvy generations that they’re not allowed to share such info in the format easiest and most comfortable for them?”
“AHPRA are not just a hugely overpriced monopoly, they are off with the fairies. “
“Previously, it only related to what a Doctor posted themselves or made available to their patients or the public. Now it relates to what other people say on their own media platform external and independent to the practitioner. This is where AHPRA have lost the plot.”
“There is an implied freedom of speech in Australia, and we as practitioners have no power over the operation of websites. Unsolicited testimonials should be removed by APHRA not the practitioner, cos what’s it got to do with moi?”
“There is some logic to the ruling in that on Faecesbook it is quite possible for a doctor to create a bogus account and write glowing testimonials to themselves, however the rather clumsy response by AHPRA is also a serious blunder into the terrain of free speech.”
“I received this response from Doctoralia (who clearly do not care a bit!): Thank you for contacting us. We are aware of the law. Many other countries where we are present have a similar rule. We do not consider our reviews as testimonials, as they are not under the Professionals control. Patients are free to leave a review if they want. Besides this, any professional or centre has the right to switch off the review service from the profile, anytime. Best regards,”
“The plot has officially been lost ladies and gentlemen….”