Why doctors should be allowed to post anonymously online

The General Medical Council in Britain released new guidelines on social media for medicine. Essentially, if you are a doctor in the United Kingdom the GMC does not believe that you should be able to tweet/blog/post anonymously if you self-identify as a physician. The exact wording is as follows:

“If you identify yourself as a doctor in publicly accessible social media, you should also identify yourself by name. Any material written by authors who represent themselves as doctors is likely to be taken on trust and may reasonably be taken to represent the views of the profession more widely.”

First of all, no one should believe any medical information on the Internet, whether anonymous or not, that isn’t sourced and dated. Without a source it’s opinion at best. Without a date, well, medicine is constantly evolving and if a post is more than 2 years old, look for something more recent. That’s why I tell my patients to go to .gov sites because they are curated and the post indicates when it was last updated. If a blog is written by an anonymous doctor, but everything is sourced to excellent sites, is that evil? Does it mislead the public? Not necessarily.

Good online data should also come from a source that has disclosed bias up front. If you are reading information about a drug written by a doctor who takes money from the manufacturer versus one from a doc who takes no drug company money it should make a difference as to how you consider what you’ve read. Without knowing who wrote the post, it is a little like taking candy from a stranger. However, I will always maintain that sourced data is better than knowing the name of the author, but yes, both are preferable.

The GMC also warns doctors that their anonymity can be easily unmasked! Yes, at anytime Sherlock Holmes and Dr. John Watson stand at the ready to tear down the veil and let the whole world know your true identify. In reality, it doesn’t take Scotland Yard to find out who’s who on the Internet, just someone with a rudimentary knowledge of computers and the Internet and a little extra time on their hands. Anyone who thinks they are truly anonymous is in for a shock. Perhaps it bears repeating, but it doesn’t warrant censure. Reminding doctors that anonymity is no guarantee is a little bit like reminding one not to play in traffic. There are risks. Take them at your own peril.

The GMC forgets that anonymous providers have the opportunity to whistle blow. What if a hospital is doing something terrible? Maybe there’s a problem in sterile processing that is being ignored potentially putting people at risk? Maybe a surgeon is doing unnecessary surgeries? Maybe a senior doctor is making unwanted sexual advances on a junior doctor? While it would be nice if everyone had the courage to speak up, not everyone does. However, some people might feel that they could speak up if they could do it anonymously. My understand of British libel laws is that it’s a lot harder for scientists to speak up about pharmaceuticals in the United Kingdom. The GMC wants to make this even harder?

But for me, the biggest error in the GMC requiring that doctors use their real name is the unmentioned but obviously incorrect assumption that only anonymous doctors post shitty information and ever doctor who tweets/posts/blogs under their own name is an honest, true, prophet of evidence based medicine. Has the GMC never visited Dr. Joe Mercola’s website? He sells tanning beds (among other things). You know. the ones the World Health Organization say are carcinogenic? And have they never heard of the good Dr. Oz? Promoter of cleanses and the homeopathy starter kit? Thousands of doctors in the United States sell snake oil via the Internet (the hCG diet is a great one) and they all do it under their own names! I don’t know the purveyors of fine British snake oil, but I have to believe they exist.

While reminding physicians that no one is truly anonymous isn’t a bad thing (though a little nannyish if you ask me), banning anonymous posting is a bit like passing around the Victory Gin and forcing everyone to drink. Instead of restricting the way physicians use the Internet anonymously, the GMC should join the 21st century and focus on patient education regarding Web 2.0 and how to search for accurate medical information. Teaching doctors how to post evidence based content isn’t a bad idea either. And hey, it would be nice if they censured doctors who peddle useless tinctures and other assorted crap as well, but that should happen whether they do it online or in the office.

I don’t post anonymously, but I will defend anyone else’s right to do so.

Jennifer Gunter is an obstetrician-gynecologist and author of The Preemie Primer. She blogs at her self-titled site, Dr. Jen Gunter.

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