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‘No comment’: now the Medical Board tests social media landscape with advertising guidelines

The release in 2012 of a preliminary consultation paper on a social media policy for health professionals by the Australian Health Practitioner Regulation Agency (AHPRA) prompted a fast and fierce social media storm.

As Croakey reported at the time, the document – which was later revised – took a fairly dim view of social media, focusing mainly on its potential to breach laws and guidelines relating to the advertising of regulated health services.

Active tweep and Victorian surgeon Jill Tomlinson says she is now dismayed that the “lack of understanding of social media communication” shown by the AHPRA then has now “spilled over” into the Medical Board  of Australia’s proposed guidelines for advertising regulated health services that will take effect next month.

Of particular concern, she says, is the requirement 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 – despite the regular flouting to be seen of existing AHPRA advertising guidelines.

Dr Tomlinson has written an open letter to the Medical Board of Australia, saying the new guidelines demonstrate a lack of understanding of Web 2.0 technologies and communication , threaten to censor patient feedback, and risk changing the landscape of Australian healthcare social media. She asks, perhaps only a little rhetorically:

“When practitioners follow the new Guidelines, how far should they go with their “reasonable attempts” to have the offending posts removed?  If Google or a major forum fails to act according to my request, should I hire a forensic computer scientist, obtain a Supreme Court search warrant, and sue?”

***

Dr Tomlinson writes:

“Dear Medical Board Members,

RE: Proposed “Guidelines for advertising regulated health services

In 2012 the Australian Health Practitioner Regulation Agency (AHPRA) released a consultation paper on its proposed social media policy. Feedback from the Australian healthcare social media community was swift and negative. I am relieved that AHPRA has subsequently revised its proposed policy, but I am dismayed that AHPRA’s lack of understanding of social media communication has spilled over into the Medical Board’s proposed “Guidelines for advertising regulated health services” that will take effect on March 17, 2014.

According to Section 6.2.3 of the proposed Medical Board advertising Guidelines, from next month 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.

The existing AHPRA advertising guidelines are regularly flouted online. I frequently see examples of advertising that AHPRA has deemed “unacceptable”. For example, a competition where liking a Facebook Page gives you a chance to win $2,000 of cosmetic injectables. Facebook Pages with hundreds of testimonials. Online advertising of a competition where buying $50 of alcoholic drinks at a bar gives you a chance to win an overseas breast augmentation holiday. Facebook posts featuring solicited glamour photographs of women who have allegedly had breast augmentation performed by the surgeon behind the Page. Articles and social media posts that do not contain the “necessary warning statement” for surgical or invasive procedures. Claims that a practitioner provides superior services to other practitioners (An example: “Dr XXX is the best surgeon in Australia without a doubt! What an amazing experience…absolutely life changing …the best surgery I’ve ever had. No bruises…and very minimal pain. Best treatment and the best staff…thank you from the bottom of my heart”). A doctor’s website that says that testimonials are not permitted but provides a direct link to a website containing 22 patient reviews on his profile page. All of these examples breach s.133 of the National Law.

Advice that I have received from AHPRA about how to apply the existing guidelines suggests that there is confusion about how and when they should be applied. In 2012 I telephoned AHPRA asking if I needed to provide a warning statement on educational articles on my business website that describe hand fracture treatment. I felt it was unnecessary to advise individuals who were reading about hand fracture treatment that “Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.” The AHPRA representative checked with the “medical team”, then informed me that the guidelines did not apply to this situation. I was advised that it was not possible for AHPRA to provide this advice in writing. I received no response to two website enquiries I submitted to AHPRA regarding this matter.

I have two medical practice Facebook Pages that I keep free of testimonials, as required by the existing guidelines. I have specifically selected a type of Facebook Page that does not offer people the opportunity to rate my business out of 5 and provide a review. I have deleted positive feedback that my patients have placed on the Pages. I feel uncomfortable about deleting unsolicited and heartfelt feedback posted by my patients, as it seems rude and unappreciative. However, I must do so to remain compliant with s.133 of the National Law. The lack of common sense in section 6.2.3 of the proposed Guidelines has me questioning whether I should instead apply the Guidelines selectively according to my own logic and whims.

When practitioners follow the new Guidelines, how far should they go with their “reasonable attempts” to have the offending posts removed?  If Google or a major forum fails to act according to my request, should I hire a forensic computer scientist, obtain a Supreme Court search warrant, and sue? I think that’s probably above and beyond the call, but I also recognise that my logic is not concordant with that of the Board’s. Will reporting a patient’s positive Facebook status update as “harassment” suffice if I keep a screenshot of the Support Dashboard as evidence? And what do I do if my doctor-patient relationship is adversely affected by these attempts at patient censorship?

Online feedback offers doctors an opportunity to reflect and to change their practice where indicated to improve the care provided to future patients. What is the purpose of asking all patients and websites to remove online patient feedback? Do you wish to censor patients? Are you trying to keep the medical profession shrouded in secrecy? Has a recent internal review suggested that the Medical Board needs to create additional compliance and administrative work for doctors? No other Medical Board in the world has seen fit to propose such a requirement.

Research shows[1] that the main reason Australian health professionals choose not to engage in social media for healthcare and practice promotion is a lack of understanding of Web 2.0 technologies and communication. I suspect the proposed Guidelines reflect the Board’s lack of expertise in this area. You wouldn’t implement clinical practice guidelines that were developed by individuals who have no experience or expertise in the field. So why would you again propose to implement Guidelines pertaining to Web 2.0 communications that have been developed by individuals who have no experience or expertise in this field?

Please reconsider the proposed Guidelines. Remove the requirement for doctors to attempt to censor patient feedback. And in the future, please consult with individuals who have expertise in the field before introducing guidelines that will change the landscape of Australian healthcare social media.

Sincerely,

Dr Jill Tomlinson
MBBS(Hons), PG Dip Surg Anat, FRACS(Plast), GAICD
Plastic, Reconstructive and Hand Surgeon

Dr Jill Tomlinson is a plastic, reconstructive and hand surgeon from Melbourne, Australia. Her volunteer positions include Specialty Editor for Social Media for the Australian and New Zealand Journal of Surgery, and the Secretary of the Australian Federation of Medical Women. This letter has been written to the Medical Board upon request following a phone conversation with AHPRA – reference VIC2107284.

Related Posts

Comments 4

  1. Brendan Jones says:

    What does this country have against free speech?

    For those who haven’t been following the debate, Australians do not have the same right to free speech Americans have. They have the first amendment. Their journalists are protected when they pursue public interest stories. Their public servants are allowed to criticise the government. We have none of those protections in Australia.

    Our family chose our doctors based on word of mouth and other patients comments online. We’re delighted with them. Yet AHPRA thinks I don’t have the right to hear that information?

    http://victimsofdsto.com/online/#freespeech
    http://victimsofdsto.com/psc/#fail_freespeech
    http://www.findlaw.com.au/articles/4529/do-we-have-the-right-to-freedom-of-speech-in-austr.aspx

  2. GP Rural says:

    I wonder where this leaves the fledgling Patient Opinion movement in Australia? https://www.patientopinion.org.au/

  3. Les Posen says:

    Let’s go one step further. I am already being approached by IT companies hoping to sell me their ability to make an app for my practice, say for appointment making. I’d rather an app for other more clinical purposes, but what happens when the reaches the App store, and begins to rated an commented upon. (Apps with no comments or rating I think are passed over for those that have, even of the former is a better app).

    Do the ratings and comments on the app store rank as testimonials: ” This is a great app. Dr. Smith has taken her 20 years experience and developed an app which will be a great tool for those who suffer with…” She is to be commended for making her app free/inexpensive.”

    Are registered practitioners expected to write to the App store (Apple or Google Play) and say no comments are allowed? You wouldn’t think it’s 2014 and most patients have smartphones in their pockets, would you?

  4. Philip Darbyshire says:

    This is emblematic of AHPRA and we should have expected nothing less (and certainly nothing more). I would love to know of the extent of this “consultation” that they mention. If it was anything like the consultation on their Social Media Policy, Daleks discuss things more openly.

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Federal Budget 2021-22
Global health and climate change
2019-20 climate bushfire emergency
asylum seeker and refugee health
Climate emergency
disasters
Ebola
extreme weather events
flooding 2011
global health
NHS
NZ Election 2017
WHO
health
Health workers
Healthcare and health reform
abortion
adverse events
aged care
allied health care
Australian Medical Association
cancer
cardiovascular disease
child health
Choosing Wisely
chronic diseases
co-payments
Cochrane Collaboration
complementary medicines
conflicts of interest
death and dying
diabetes
digital technology
disabilities
e-health
emergency departments and care
Equally Well
euthanasia
evidence-based issues
general practice
genetics
health & medical marketing
health and medical education
health and medical research
Health Care Homes
health ethics
health financing and costs
health reform
health regulation
health workforce
HIV/AIDS
hospitals
HRT
infectious diseases
influenza
international medical graduates
journal articles
LGBTIQ
medical marijuana
Medicare Locals
men's health
mental health
MyHospitals website
National Commission of Audit 2014
National Health Performance Authority
naturopathy
NDIS
NHMRC
non communicable diseases
nurses and nursing
oral health
organ transplants
out of pocket costs
pain
palliative care
paramedics
pathology
Pharmaceutical Benefits Scheme
pharmaceutical industry
pharmacy
Pregnancy and childbirth
primary health care
Primary Health Networks
private health insurance
quality and safety of health care
rural and remote health
screening
sexual health
social media and healthcare
suicide
surgery
swine flu
telehealth
tests
TGA
trauma
women's health
youth health
Indigenous health
#CTG10
#NTRC
Acknowledgement
cultural safety
Indigenous education
Lowitja Institute
NT Intervention
social and emotional wellbeing
Uluru Statement
WA community closures
News about Croakey
PIJ Commissions 2021
Public health and population health
#PreventiveHealthStrategy
#UnmetNeedsinPublicHealth
air pollution
alcohol
consumer health matters
COVIDwrap
environmental health
Fetal Alcohol Spectrum Disorders (FASD)
food and nutrition
gambling
Government 2.0
gun control
health communications
health impact assessment
Health in All Policies
health inequalities
health literacy
human rights
illicit drugs
injuries
legal issues
marriage equality
Media Doctor Australia
media-related issues
nanny state
National Preventive Health Agency
obesity
occupational health
physical activity
plain packaging
prevention
public health
public interest journalism
road safety
sport
sugar tax
tobacco control
transport
vaccination
violence
Web 2.0
weight loss products
Royal Commission
Social determinants of health
discrimination
education
housing
justice
Justice Reinvestment
NBN
Newstart
poverty
racism
social policy
Summer reading 2020-2021
Tasmanian election 2021
Testing Croakey News category 1
The Croakey Archives
#cripcroakey
#HealthEquity16
#HealthMatters
#IHMayDay (all years)
#IHMayDay 2014
#IHMayDay15
#IHMayday16
#IHMayDay17
#IHMayDay18