I have a colleague who is a pediatrician in private practice in the suburbs. He has a great practice and loves his patients. One day, he walked in 15 minutes late to a 7:00 a.m. meeting we both attend. “Moms are calling early today.” Parents in his practice have learned to bypass their elaborate phone triage system. They have learned that if you press “1” for emergency, an actual doctor will call you back within 15 minutes, regardless of whether an actual emergency exists. When I asked what can be done to curb such behavior, he shrugged and replied, “We’ve tried a few things, but then we just get slammed on Facebook … and that’s bad for the practice.”
Another physician friend provided factual and evidence-based testimony as an expert witness during a legal proceeding. When the proceedings did not go in favor of the plaintiff, they took it upon themselves to post slanderous comments about this physician (not their own personal physician, mind you) on various online forums, including comment sections on advocacy group websites.
Anyone who uses social media knows the vitriol that spills forth should anyone dare make a public statement about topics such as vaccines, essential oils, or GMOs. But this is different. Physicians who are active on social media, which I fully support for many reasons, know going in that they can become a target. It’s part of the job description. In fact, you know you’re actually starting to make a difference once the hateful Tweets start flying.
But what about those physicians or practices that become unwilling targets on social media? What recourse do they have? What can be done? Unfortunately, not much. We are simply playing by a different set of rules. Physicians need to always be mindful of HIPAA laws and patient privacy. If a patient is unhappy with their physician and takes to Twitter or Facebook to post hateful comments, that physician cannot publicly defend themselves. They can’t even acknowledge that they know the patient or that the visit took place as that violates HIPAA. They have to sit back and take their medicine.
This type of patient behavior is inappropriate on many levels. Social media affords anyone a platform and ability to type whatever they wish, regardless of merit or truth. Anonymous accounts are the worst offenders, offering strong opinions with no repercussion aside from a suspension of their social media account should enough people complain. What happened to accountability for one’s words or actions?
It is important to acknowledge that patients are wronged every day. Some physicians offer poor care to their patients. Personalities may not match, and patients may not feel like their concerns are being heard. There absolutely must be a mechanism for patients to voice their complaints, and there are numerous ways this can occur. But this cannot occur through public-facing social media accounts, and needs to go through the proper channels. Patients can speak with an ombudsman if their physician works at a hospital or file a complaint with the State medical board. Written documentation is necessary to communicate concerns and also formulate a record that protects the patient and affords the physician an opportunity to discuss their interpretation of events. A third party can then remediate, and disciplinary action can take place when warranted.
In the meantime, physicians need to be aware that this behavior is occurring. They also need to be trained on how to handle these situations. Physicians are not allowed to address any public comments, acknowledge that they know any patient, and especially cannot fight back with negative comments of their own. Hospitals and medical practices can start addressing this by clearly posting information about the process involved for patients who have a complaint. They also need to monitor social media outlets and take these interactions offline as soon as possible. It will take time to see where all of this leads but a collective effort will be necessary to help the medical community respond appropriately.
David R. Stukus is a pediatric allergist and can be reached on Twitter @AllergyKidsDoc.
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