julian walter on social media: law & order
TRANSCRIPT
Law and Order in Social Media
A new frontier or the wild west?
Dr Julian WalterMedico-Legal Advisor (Solicitor)
Same problems, different
ways
COMMUNICATION
Same problems, different ways
= TROUBLE
Old problemsNew mediumNo time to think
Wide audience
Same problems, different ways
“Not quite the tablets I had in
mind”
Same problems, different ways
Same problems, different ways
Where are we now?
Same problems, different ways• Widening use of social media by medical practitioners
September 2012
Same problems, different ways• AHPRA speaks ........... And we wait
http://t.co/5h04G4Gk
Same problems, different ways
WHAT DID AHPRA SAY?
• Advertising• Maintaining Professional Obligations• Professional Boundaries• Professional Behaviour
• Confidentiality & Privacy
Same problems, different ways
Is this the end of Social Media before it even began?
Same problems, different ways
We have to ask the right questions
What are the ‘rules’?
What are the ‘RULES’?
MEDICAL BOARD OF AUSTRALIA
CODE OF CONDUCT
http://www.medicalboard.gov.au/documents/default.aspx?record=WD10%2f1277&dbid=AP&chksum=eNjZ0Z%2fajN7oxjvHXDRQnQ%3d%3d
What are the ‘RULES’?
AMA
https://ama.com.au/social-media-and-medical-profession
What are the ‘RULES’?
American Medical Association
http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion9124.page
What are the ‘RULES’?
British Medical Association
Professional Boundaries
Professional Boundaries
BOUNDARY VIOLATIONS
Professional Boundaries
“Professional boundaries are integral to a good doctor–patient relationship. They
promote good care for patients and protect both parties”
Professional Boundaries
“Never use your professional position to establish or pursue a sexual, exploitative or
other inappropriate relationship with anybody under your care”
Professional Boundaries
“Avoid expressing your personal beliefs to your patients in ways that exploit their vulnerability
or that are likely to cause them distress”
Professional Boundaries
Professional Boundaries
MORAL PANIC ??
Professional Behaviour
Professional Behaviour
www.foxnews.com
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”
Respect for colleagues
Respect For Colleagues
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”
Confidentiality
Confidentiality
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”
Confidentiality
Photography
PhotographyYOU
3rd Party
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)
Photography
To infinity ...... and beyond!
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)
Photography
IMPORTANT POINTS:
- Informed consent, audience and purpose-Maintain confidentiality & privacy- Part of the record- Secure storage- Beware the Policy
Photography
Photography
Clinical images Explanation only
Research - Written ConsentEducation - Written Consent Publication - Written ConsentBranding - Written ConsentAdvertising - Written Consent
Photography
Does a unique image identify the patient?Obtain consent even for de-identified images
Online doctor rating
Online doctor rating
Currently in the US, approximately 16% of doctors rated on this sitehttp://www.jmir.org/2013/2/e24/
Online Rating
Difficult area
Just ‘over the fence banter’
Or
Something more serious ?
Online Rating
Legal solution is not ideal
Online Rating
Legal solution is not ideal
Defamation action:Who is the poster?Opinion? Fact? Defamatory?
Risks: expensivecostlyno guarantee of successpublicises complaint
Online Rating
Social Media driving the profession?
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?
QUESTIONS?
Dr Julian WalterMedico-Legal Advisor (Solicitor)