Julian Walter clarifies what 21st century tech activities you ought to avoid to keep your medical career in optimum health.

1. Law and Order in Social Media
A new frontier or the wild west?
Dr Julian Walter
Medico-Legal Advisor (Solicitor)

2. Same problems,
different ways

3. COMMUNICATION
Same problems, different ways

4. = TROUBLE
Old problems
New medium
No time to think
Wide audience
Same problems, different ways

5. “Not quite the tablets I had
in mind”
Same problems, different ways

6. Same problems, different ways
Where are we now?

7. Same problems, different ways
• Widening use of social media by medical practitioners
September 2012

8. Same problems, different ways
• AHPRA speaks ........... And we wait
http://t.co/5h04G4Gk

9. Same problems, different ways
WHAT DID AHPRA SAY?
• Advertising
• Maintaining Professional Obligations
• Professional Boundaries
• Professional Behaviour
• Confidentiality & Privacy

10. Same problems, different ways
Is this the end of Social Media before it even began?

11. Same problems, different ways
We have to ask the right questions

12. What are the
‘rules’?

13. What are the ‘RULES’?
MEDICAL BOARD OF AUSTRALIA
CODE OF CONDUCT
http://www.medicalboard.gov.au/documents/default.aspx?record=WD1
0%2f1277&dbid=AP&chksum=eNjZ0Z%2fajN7oxjvHXDRQnQ%3d%3d

14. What are the ‘RULES’?
AMA
https://ama.com.au/social-media-and-medical-profession

15. What are the ‘RULES’?
American Medical Association
http://www.ama-assn.org/ama/pub/physician-resources/medical-
ethics/code-medical-ethics/opinion9124.page

16. What are the ‘RULES’?
British Medical
Association

17. Professional
Boundaries

18. Professional Boundaries
BOUNDARY VIOLATIONS

19. Professional Boundaries
“Professional boundaries are integral to a
good doctor–patient relationship. They
promote good care for patients and protect
both parties”

20. Professional Boundaries
“Never use your professional position to
establish or pursue a sexual, exploitative or
other inappropriate relationship with
anybody under your care”

21. Professional Boundaries
“Avoid expressing your personal beliefs to your
patients in ways that exploit their vulnerability
or that are likely to cause them distress”

22. Professional Boundaries

23. Professional Boundaries
MORAL PANIC ??

24. Professional
Behaviour

25. Professional Behaviour
www.foxnews.com

26. Professional Behaviour
“In professional life, doctors must display a
standard of behaviour that warrants the trust
and respect of the community. This includes
observing and practising the principles of ethical
conduct”

27. Respect for
colleagues

28. Respect For Colleagues

29. Respect For Colleagues
“Good patient care is enhanced when there is
mutual respect and clear communication between
all health care professionals involved in the care
of the patient - Communicating clearly, effectively,
respectfully and promptly”

30. Confidentiality

31. Confidentiality

32. Confidentiality
“Patients have a right to expect that doctors
and their staff will hold information about
them in confidence, unless release of
information is required by law or public
interest considerations”

33. Confidentiality

34. Photography

35. Photography
YOU
3rd
Party

36. Photography
IMPORTANT POINTS:
Disclosure only if purpose directly related to the primary
reason for data collection;
AND
Disclosure is within the reasonable expectation of the patient
National Privacy Principle 2.1(a) - Privacy Act 1988 (Cth)

37. Photography
To infinity ...... and beyond!

38. Photography
IMPORTANT POINTS:
"child abuse material“ = the private parts of a person who is,
appears to be or is implied to be, a child.
s91FB (1)(d) Crimes Act 1900 (NSW)

39. Photography
IMPORTANT POINTS:
- Informed consent, audience and purpose
-Maintain confidentiality & privacy
- Part of the record
- Secure storage
- Beware the Policy

40. Photography

41. Photography
Clinical images Explanation only
Research - Written Consent
Education - Written Consent
Publication - Written Consent
Branding - Written Consent
Advertising - Written Consent

42. Photography
Does a unique image identify the patient?
Obtain consent even for de-identified images

43. Online doctor
rating

44. Online doctor rating
Currently in the US, approximately 16% of doctors rated on this site
http://www.jmir.org/2013/2/e24/

45. Online Rating
Difficult area
Just ‘over the fence banter’
Or
Something more serious ?

46. Online Rating
Legal solution is not ideal

47. Online Rating
Legal solution is not ideal
Defamation action:
Who is the poster?
Opinion? Fact? Defamatory?
Risks: expensive
costly
no guarantee of success
publicises complaint

48. Online Rating
Social Media driving the profession?

49. Online Rating
Conclusion:
In a nationally representative sample, higher patient satisfaction
was associated with less emergency department use but with:
- greater inpatient use of healthcare
- higher overall healthcare and prescription drug expenditures
- increased mortality
http://archinte.jamanetwork.com/article.aspx?articleid=1108766
(26% more likely to die than those who had
the lowest satisfaction)
Social Media driving the profession?

50. QUESTIONS?
Dr Julian Walter
Medico-Legal Advisor (Solicitor)