The ongoing case of Orthodontist John Mew, whose “mewing” techniques have racked up nearly two billion TikTok views, has again shone the spotlight on the care healthcare professionals must take when using social media.

General Dental Council (GDC) professional conduct committee heard Dr Mew seeks to treat children with “head and neck gear”.  It reported that, Lydia Barnfather, representing the GDC, said comments made by Dr Mew, who claims to help “alter the cranial facial structure”, on his YouTube channel were “pejorative” about orthodontists.  Dr Mew’s techniques have sparked an online trend of sharing results on social media platforms like Reddit.

Social Media and Fitness to Practise

Health and care professional regulators in the United Kingdom have four main functions: setting standards, maintaining a register, setting standards for and quality assuring education and training and investigating and hearing allegations that a registrant is not fit to practise.

The relevance of social media in the context of fitness to practise touches on a number of these functions; setting standards, investigating complaints and registrant’s fitness to practise.

Healthcare regulators expect healthcare professionals and workers to uphold their standards and codes, including acting professionally and lawfully at all times.

This applies to the use of social media as much as it does to other aspects of professional conduct.  Specific standards will vary between regulators but broadly speaking, standards of conduct in relation to use of social media includes not:

1. sharing confidential information inappropriately;
2. posting pictures of patients and people receiving care without their consent;
3. posting inappropriate comments about patients;
4. bullying, intimidating or exploiting people;
5. building or pursuing relationships with patients or service users;
6. stealing personal information or using someone else’s identity;
7. encouraging violence or self-harm; and/or inciting hatred or discrimination.

It is important to note that from a regulatory perspective, standards expected of healthcare professionals and workers do not change because they are communicating through social media rather than face to face or through other traditional media.

Sanctions & regulatory action

The fitness to practise process for the UK’s health and care professional regulators is broadly similar.

If a complaint is made to the regulator about a registrant, their regulator can initiate an investigation that may result in the regulator taking action against that person’s registration.

In order to manage fitness to practise cases, all regulatory bodies record the nature of the case or the allegations within a case.  Each case that passes through the fitness to practise process will be categorised under one or more labels, depending on the regulator.

In the context of fitness to practise and social media, not all healthcare regulators are equal.

Research by the Professional Standards Authority found that:

“…only three of the regulators (GMC, GPhC and NMC) mention social media in their category lists. The GPhC lists it once, whilst the GMC has two specific social media categories ‘Fail to maintain trust -social media’ and ‘Breach of confidentiality -social media’. The NMC has made social media into a category with branches of sub-categories…”

Fitness to practise cases relating to social media complaints and incidents that breached standards are comparatively low.  For example, research conducted in relation to the General Dental Council (GDC) found that 2.4% of fitness to practise cases published on the GDC website over a three-year period were related to breaches of the social media guidelines.”

More importantly, all the GCD cases looked at in the research were proven and upheld.  This is of course no indication of findings relating to other healthcare regulators but, the point is, the significance of misusing of social media by healthcare professionals and workers should not be underestimated.  The full range of sanctions and regulatory action is available to healthcare regulators, including suspensions and strike off orders.

Advice – Do’s and Don’ts

Do:

• act professionally
• treat people with respect
• maintain confidentiality and privacy at all times
• maintain proper professional boundaries
• think before you post, privacy settings do not mean that something will remain private and a statement that these are your own views means little in practice

Don’t:

• bully, harass or intimidate
• unlawfully discriminate
• post inappropriate comments
• share information about patients or their care
• get drawn into negative, unconstructive discussions

Regulator’s Guidance

• General Medical Council (GMC): https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/doctors-use-of-social-media/doctors-use-of-social-media | GMC social media case studies
• Nursing and Midwifery Council (NMC): https://www.nmc.org.uk/standards/guidance/social-media-guidance/
• Health & Care Professionals Council (HCPC): https://www.gmc-uk.org/-/media/documents/professionalbehaviourcasestudies-dc10903_pdf-73316932.pdf
• Social Work England – https://www.socialworkengland.org.uk/concerns/guidance-documents/fitness-to-practise-guide/
• General Dental Council (GDC) – https://www.gdc-uk.org/docs/default-source/principle-4/guidance-on-using-social-media.pdf?sfvrsn=abf03a63_2
• General Pharmaceutical Council (GPhC) – https://www.pharmacyregulation.org/sites/default/files/demonstrating_professionalism_online.pdf
• General Optical Council (GOC) – https://www.optical.org/en/news_publications/Publications/ebulletin-/ebulletin-april-2019/social-media.cfm
• General Osteopathic Council (GOsC) – https://www.osteopathy.org.uk/standards/guidance-for-osteopaths/social-media/