[ Words: Philip Johnstone, Dentolegal consultant team leader, Dental Protection ]

The world has rapidly transformed into a highly technological place, and the field of dentistry has been significantly and largely positively affected by this revolution. Social media can be a powerful and effective tool for dental professionals, but there needs to be an appreciation of the potential risks when using an online platform.

Social media encourages a collaborative approach to education with the intention of improving engagement with patients and stakeholders, and it can be used for promotion or brand messaging. However, the risks of social media cannot be ignored. Hazards to be wary of include misinformation, negative feedback, indiscretion and breach of confidentiality, stalking or trolling as well as defamation.

Misinformation

The internet has irreversibly changed the way people access data and information. Knowledge can be ‘pulled’ instantly from a device in your pocket and answers can be found to most questions. Social media allows information to be ‘pushed’ even more easily on many different platforms.

A survey exploring the ways in which the public finds out about orthodontic treatment found that nearly three in four respondents (71 per cent) would rely on the internet while just over one in three respondents (35 per cent) will have a discussion with their dentist. ¹ 

The internet certainly holds useful and important information regarding orthodontic treatment, but it cannot replace a discussion about an individual’s unique clinical circumstances with an appropriately trained clinician. 

Breach of confidentiality

Dental professionals have a duty of confidentiality to their patients. The Dental Council expects all members of the dental team to respect patient confidentiality and not post information or any comments about patients on social network sites. Clinicians are able to share anonymised cases that illustrate discussions relating to best practice but must be extremely careful that the patients can never be identified. 

It is very important that dental registrants are always aware of this principle when using any social network, even if it is to communicate with colleagues. Advice to dental professionals is never to publish any information about patients on social media unless they have explicit consent. 

Negative feedback

Social media is an attractive tool to promote a dental practice or offer dental services. However, it also potentially exposes dental professionals and businesses to unwelcome and sometimes undeserved negative feedback. In fact, patients – real or trolls – are actively invited by several agencies to review the care that a practice or clinician provides and it can be very difficult for dental professionals to manage negative feedback.

Dento-legal organisations receive many calls from dental professionals who ask for advice about responding in these circumstances. Questions include whether to reply to the negative comments on the same social media platform or whether to contact the patient directly. 

Advisers are frequently asked if other members of staff can post positive reviews to defend the reputation of the practice or a clinician.

The advice is that a dentist should never respond to patient’s complaint directly on line because of the duty of confidentiality. Rebutting an online complaint by a reciprocal posting is also fraught with the risk that it develops into a public spat. 

The Dental Council has an expectation that a clinician’s use of social media should be both responsible and discreet. Engaging in a dispute in a public forum may be considered to be neither of these, and as a consequence could leave the clinician open to fitness to practice proceedings.  It is, in any case, better and more effective to ask satisfied patients to post reviews.

Stalking and trolling

The line between personal and professional use of social media can often be unclear. It is commonly accepted that there is no such thing as a ‘private’ forum on social media. 

Dental registrants and other team members must ensure that their behaviour on social media is professional at all times. The Dental Council states in 15.2 of the Code of Practice relating to Professional Behaviour and Ethical Conduct that; “your conduct should not lower the public’s opinion of the profession”. ² 

Dental professionals should stop and think before posting a comment in any forum even if, on the face of it, the post will only be read by a few people known to the poster. Ultimately, it must be assumed that any comment can be passed on, accessed and read by anyone. 

Maintaining professional boundaries with patients in a world in which social media is an easy and swift way to communicate can be a tricky balancing act. Informality, however, lends itself to unintended challenges to professionalism. 

The code also advised that a clinician should not ‘friend’ their patients on social media networks. Even if the professional relationship appears to be non-threatening at the time, the risk of subsequent stalking or trolling by the patient must be appreciated. 

Your indemnity organisation will offer guidance on the benefits, risks and considerations of communicating via social media. 

References

1 Singh, P. 2017.  Adult Orthodontic Patients in Primary Care and their Motivation for Seeking Treatment, Orthodontic Update, VOL. 9, (NO. 2). Available at: https://www.magonlinelibrary.com/doi/full/10.12968/ortu.2016.9.2.69

2  Code of Practice: Professional Behaviour and Ethical Conduct. Available at: http://www.dentalcouncil.ie/g_dentalethics.php

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