Doctors on Twitter

This blog piece is on my thoughts about Australian doctors on Twitter using their real names or pseudonyms. Those of you who follow me on twitter may have observed how I rant and rave on this issue.  I have had this blog piece on the subject sitting incomplete for a number of months, mainly for the reason that I have not had time to finish it.  The impetus to get on and finish this blog piece came about when one of my favourite twitter colleagues, Dr Gerry Considine, tweeted me to inform me that the General Medical Council in the UK has formulated recommendations on this very matter.  He was well aware of my views on the matter and I appreciate being given the heads up. It is always good to hear that a well respected professional body is aligned with your own thoughts on a matter.

What we say on Twitter as doctors, particularly with medically related topics, carries a lot more weight than might always be recognized.  By saying we are doctors gives our tweets a greater level of authenticity that is not commonly afforded to other users. By virtue of what we do and who we are, we enjoy a level of respect, trust and admiration that is not generally held for many of the other professions. 

All of this stems from the fact that medical practitioners have a privileged position in society.  Not only do we hold power with knowledge, we are respected for the judicious use of our knowledge which has been painstakingly acquired over many years and enhanced by a responsibility for life long learning. 

It is incumbent upon us to not abuse this privilege and for this reason, professional organisations such as the Australian Medical Association has a Code of Ethics . Whilst this Code expresses how we should behave in the interests of the public, I see it as a manner by which we as doctors should expect of ourselves.    The Australian Health PractitionersRegulation Agency (APHRA)  also maintains a Code of Conduct for Doctors in Australia

More recently APHRA has moved to develop a policy on Social Media behavior for health professionals. I do not wish to get into a discussion on the deficiencies of the draft documents that have been publically available but it does provide a timely reminder that there is increasing interest on how we as doctors behave on Social Media.

In my personal experience, the vast majority of doctors who declare themselves as such, will either use their real name or have reference to easily attribute their real name to what is written on their tweets.  Personally, I make the choice to use my real name “Henry Woo” as my Twitter Name and for my Twitter User Name, a short form of my name “@DrHWoo”.  My bio indicates that I am a doctor.  My website link would give reference to my real name even if my Twitter Name and Twitter @ User Name did not have such information.  I don’t think it really matters if it is your user name or bio or link that has your real name as a doctor, as long as what you say is easily attributable to you as a real person.

If you are a doctor hiding under a pseudonym, why is it that you need to hide your real identity?   If there is a specific issue that you wish to remain anonymous for, why not create a separate identity and state that this is the case.  If you really wish to remain anonymous on Twitter, then may I suggest that you do not say that you do not mention that you are a doctor in your bio – the only reason we mention that we are a doctor in our bio because we know it adds to the authenticity and respectability of what we tweet on medical matters, so do not abuse this privilege.  I know of a number of doctors who tweet but do not make any mention that they are doctors - I have no concerns about this – in fact I respect these doctors for not abusing the privilege of what the title doctor means. 

What is rather interesting is that the pseudonym doctors tend to gravitate to each other and engage each other moreso than those of us who use our real names – take a closer look at this next time you look at pseudonym doctors.

In a free and open society, there is should only be very exceptional circumstances in which doctors in Australia should feel the need to use a pseudonym – this might include whistleblowing, a commercially sensitive employer, risk of identifying healthcare workers and patients with uncommon diseases/conditions and there may be others.  But to hide because the individual wishes to publish inappropriate or controversial medical tweets indicates a lack of courage or conviction in their thoughts to use their real name.

One example of inappropriate behavior is here where a user made a comment that undermines what we are trying to achieve in improving cancer care and this is not the type of cynicism about medicine that should be promoted -  the vast majority of us take cancer care very seriously since lives are at stake.  Some have an agenda to undermine the profession by pointing out our mistakes with references to already published news articles – as they are not the authors, there should be nothing at stake by using their real names.  Just today, I saw one of our pseudonym doctors giving personal medical advice on an ultrasound result without having taken a full history or even having seen ultrasound images (allowing for the fact that real time ultrasound visualization is the optimal approach).

To conclude, I confirm that I do not have a problem with doctors being on Twitter nor do I have a problem with any individuals using pseudonyms on this public medium.  I do have concerns when a doctor declares themselves as such and then tweets on medical issues or topics and then hides under a pseudonym.