Doctors & online identity

A very brief interpretation of new guidelines for points not covered much so far. I don’t profess to be an expert or anything, I just tweet a lot, and have had numerous discussions with other tweeting healthcare professionals on this issue.

I’ve scooped a selection of links to guidelines and blogs regarding doctors and social media. For good quality guidance, read the excellent RCGP Social Media Highway Code, which was developed after extensive collaboration with online professionals. Below, I’ll try and interpret how the GMC guidelines will affect decision-making when it comes to your online presence.

Many healthcare professionals alter their names on Facebook so that employers/patients cannot easily find their accounts. New GMC guidelines say if you also identify that you’re a doctor, you SHOULD (not must!) use your real name. So three options for Facebook users: use real name and identify as a doctor, use altered name but don’t identify as doctor, or ignore. The general consensus is that in all likeliness, ignoring new guideline is probably fine for Facebook. BUT privacy settings frequently change and must be reviewed regularly. It’s easy enough to check how other people, including public, can see your profile.
If you use full name and also make it clear you’re a doctor, then be vigilant with privacy settings, not forgetting that location services are embedded with every status and photo uploaded unless turned off (turn them off). For example, you can post a status saying “I’ve had a shit day at work” and your location services automatically tag you at the hospital. Same applies to photos. Location services are found in settings and are often app-specific. You can also change these within apps too.

Don’t forget that with Facebook, privacy settings are constantly changing. Friends can now share some statuses/photo which immediately removes a level of privacy as they are open to a widened audience. You also now have to request a photo be removed if you’ve been tagged rather than just untagging if you’re not happy with it. Finally, something to be aware of is that Facebook needs to make money. It now sells some users photos to 3rd party companies for use in advertising/market research etc. There’s very little you can do about this, other than delete photos you’re not happy with, as and when they arise. It’s very unlikely that any serious consequences would occur out of such a scenario but best be aware of it.

The other biggie is twitter. Opinions are divided over being anonymous or ‘coming out’ with real name when tweeting. In most circumstances, it’s best to use your real name. It stops you saying things you might not be prepared to say in ‘real life’. However, a very good argument for being anonymous, which seems to have been overlooked by new guidelines, is for people with strong views on certain aspects, or who tweet about issues that they don’t want patients or employers necessarily knowing. Examples would be gay/lesbian/trans doctors who just get on and do their jobs at work but who want to tweet about their experiences doing this whilst dealing with whatever issues or challenges their identity brings up. When tweeting, there’s a tougher initial decision on whether to use your real name or go against best practice and be anonymous.
Some tweeters have a compromise where they use their first name, and discuss their specific job and rough location publicly, so that other professionals will likely be able to trace back to work out who is tweeting, but patients are less likely to be able to google their doctor using their full name. This works pretty well for most people with this set-up.

Lastly, for sites like Linked.In etc where professional networking and discussion takes place, obviously full name is the best way to go.

Most importantly, for all online activity, NEVER breaking patient confidentiality is vital, as in ‘real’ life, and issues like whistle-blowing should go through the appropriate channels.

For the most part, nothing will change, but it’s good to be aware of changes and stay up to speed.



  1. Dr. Allison L. Stelling · March 28, 2013

    I do non-anon commenting on technical issues for a Reason. If people want to argue with me, that’s cool. I love to argue :). But our online MDs should not be afraid to be h00mans!! And they should NOT be fired for personal views, or being incorrect about something. However, if they are being incorrect about something, I like to be able to fact check with the MDs who made the claim.

    The internet has become the equivalent of Terry Pratchett’s “the man in the pup”. It’s fine to talk in the pub, and no one should get fired for being mean- or because their Boss just doesn’t like what they say on their own time.

    However, if you are going to say incorrect things about the laws of the natural universe and how us folks in discovery science discover them, then yep I would like to be able to look you up. I really do not like having my darling humanities Facebook friends coming to me with wrong information that they found on some anon MD’s blog.

  2. Internal Optimist · March 28, 2013

    Really useful, thanks for the summary! I wonder if it will remain OK to blog anonymously, or whether soon – if you become a doctor – it will be expected for you to reveal your full name…

    • fakethom · March 28, 2013

      Social media includes blogs, so best practice will be revealing full name. However, if you have a defendable reason not to, and don’t break any rules in the content posted, then should be ok as guidelines are SHOULD do, not MUST do. That’s just my interpretation however.

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