22 June 2016

Doctors behaving badly

Social Media

“I am amazed at how badly you are f&^%ing up probably your most valuable product – the comments section.”

 This is just one of the many inappropriate – in my view – comments made by what seems to be a relatively small group of doctors in our medical magazines. In this case, the commentator was unhappy about the time it took editors to moderate and publish online comments by readers.

I wonder whether this a good example of how we should approach editors? Is this the language the medical profession should be using when communicating in online forums?

Yes, it is critical to speak up and be honest. We should always defend the right to express opinions without censorship or restraint. But at the same time we must remain professional and courteous.

Have a look at this comment on an article about income differences between female and male GPs:

“It’s just that men don’t need guidelines because they inherently know better and women earn less because they inherently can’t make as much money as men.

I expect many colleagues would question that men don’t need guidelines or inherently know better. The commentator also makes a sweeping statement about the earning capacity of women, which may be perceived as hurtful.

Or take this comment:

“Also, if you are part time, which more women are than men are, you have less patient loyalty and as you have less “continuity of care”, this results in longer but less efficient consultations. In my opinion, the most efficient GPs were workaholic males (…).

I’d love to see proof of this supposed relationship between working part-time and patient loyalty. The conclusion that working part-time leads to longer but less efficient consultations can also be challenged.

A frequent theme in the comments section is the personal frustrations with our professional peak bodies (disclosure: I am involved in both RACGP and AMA). Unfortunately commentators don’t always get their facts right:

“For years the AMA opposed bulk billing. Now it opposes people paying GPs even one cent.

“The RACGP ought to hang its head in shame. They remain snug in bed with the Govt. of the day, having betrayed us GPs overall.

Both statements contain incorrect information. When making comments in professional forums, it’s important to check the facts before hitting the post button.

Of course, we need to keep representatives of our professional bodies honest, but we should also be mindful that many of our colleagues are putting time and effort into these membership organisations, often with little or no remuneration. Well-informed, constructive feedback would be appropriate, and probably more effective.

We keep professional feedback rules in mind during our interactions with patients, staff, students and registrars, and we should be following the same rules in collegial environments, including online forums.

Many website and blogs use a set of basic rules of engagement to encourage friendly, collegial conversations. I am strongly in favour of a real-name policy, especially in professional and collegial environments. Anonymous posts should be avoided as much as possible.

As a profession we should embrace our diversity and at the same time continue to challenge each other, within the realm of our professional duties and responsibilities.

The Medical Board Code of Conduct clearly states that health professional should be “behaving professionally and courteously to colleagues and other practitioners, including when using social media”.

The AMA Code of Ethics states: “Recognise that your personal conduct may affect your reputation and that of your profession,” and “refrain from making comments which may needlessly damage the reputation of a colleague.”

We should be able to make our point without being rude or disrespectful.

I believe it is time editors review their policies for posting online comments. I would like to see better-informed exchange of information, more sharing of inspirational and motivating thoughts and ideas, and respectful collegial discussions – even if we disagree. Comments should not be published unless they comply with the comments policy.

When commenting we should always play the ball and not the person, be thoughtful about the other person’s dignity and always aim to avoid unnecessary upset.

The keyword here is respect. And, of course, it is best to refrain from posting when we’re angry, upset, have had a glass of wine, or when we’re tired.

Dr Edwin Kruys is chair of RACGP Queensland. He blogs at Doctorsbag.net