The perils of social media

Social media is a powerful tool, but a recent case of a suspended doctor demonstrates that health practitioners need to be aware of their professional obligations when making comments on social media.

How well do you understand your professional obligations with respect to the use of social media? It’s certainly a powerful tool being used every day to effectively market and promote dental practices, communicate with and educate patients, and engage with other dental and health practitioners. But it can also be a double-edged sword if people aren’t careful.

A recent case has highlighted the need for people to understand both the guidelines governing social media use for registered health practitioners and the broader ethical and professional obligations they have, and although it appears to be an extreme example, there are some important lessons for everyone given the increasingly fractious nature of discourse on social media.

Earlier this month a Victorian doctor was suspended from practising for disparaging colleagues and denigrating and demeaning different groups on social media, including members of the LGBTIQ+ community and people of Islamic faith and Chinese heritage. The doctor was initially suspended in 2020, and a recent hearing upheld his suspension until at least 2025, demonstrating the seriousness in which these cases are taken.

The social media posts were found to fall below the standard of professional values and qualities expected of a registered medical practitioner and included statements about Muslim and Chinese immigration to Australia, brainwashing children about sexual identity and views regarding vaccination, chemotherapy, and treatment for COVID-19 and other health topics that had no proper clinical basis, were contrary to accepted medical practice or were otherwise untrue or misleading.

Many practitioners may attempt justify some of this as a legitimate expression of free speech, and that regulatory action should not be used in this manner. However, as Ahpra’s social media guidelines note:

‘the views of registered health practitioners on clinical issues are influential …personal views about social and clinical issues might impact on someone's sense of cultural safety or could lead to a patient/client feeling judged, intimidated or embarrassed’.

Practitioners are free to express views on a range of social issues but they must be mindful of how those views may be perceived by members of the community, not just the patients that they treat.

Similarly, the guidelines are quite specific when it comes to commenting on health care and in particular public health measures, saying:

‘while health practitioners may hold personal beliefs about the efficacy or safety of some public health initiatives, they must make sure that any comments they make on social media are consistent with the codes, standards and guidelines of their profession ... A registered health practitioner who makes comments, endorses or shares information which contradicts the best available scientific evidence may give legitimacy to false health-related information and breach their professional responsibilities. Practitioners need to take care when commenting, sharing or ‘liking’ such content if not supported by best available scientific evidence.’

Where social media commentary becomes problematic is when it impacts on public trust and patient care. People from the LGBTIQ+ community may be reluctant to visit a health practitioner who expresses negative or discriminatory views, or less likely to disclose information about their sexuality which may then compromise their health care.

It is important to recognise that even so-called private or closed social media groups do not always provide protection, with the ability for members of these groups to take screenshots and share comments outside of the group.

Ahpra provides some guidance on the types of commentary that may or may not warrant scrutiny:

Social media activities that are unlikely to warrant investigation

• Advocating for a peaceful resolution of a war or conflict: A practitioner posts content on social media that calls on governments to use United Nations and other processes to bring about an end to hostilities or a war.

• Calling for accuracy, truth and impartiality in reporting on a conflict or war: A practitioner criticises a media outlet’s coverage of a political tension or war. It calls for truth, accuracy and impartiality in journalistic coverage

Social media activities that are likely to warrant investigation

• Political content that calls for inappropriate action: A practitioner posts to social media a condemnation of citizens of a country, or a cultural or religious identity. The post includes a call to action, such as signing a petition or attending a protest march, specifically aimed at denigrating or discriminating against a population or group

• Political content that is deliberately biased and not factual: A practitioner shares intentionally misleading content about citizens of a country, or a cultural or religious identity that is biased, inflammatory and has the potential to incite racial hatred, intolerance. The content is intended to influence and persuade and is not factual.

It’s not just commentary directed at or influencing patients. Practitioners also have an obligation under the Code of Conduct to behave professionally and courteously toward colleagues and other practitioners at all times, including when using social media. Social media can be a robust space to share information and ideas, but as we have all seen, it can quickly descend into something less edifying.

Budget disappointment as oral health misses out (again)

Despite an increasing number of Australians cancelling or delaying their routine dental check-ups or raiding their superannuation to pay for dental treatment as cost-of-living pressures continue to bite, the Federal Budget provided no immediate relief or hope for future reform.

There are two main areas in the Federal Budget for dental care – the Federation Funding Agreement (FFA) that is paid to states and territories to support their public dental services, and funding for the Child Dental Benefits Schedule (CDBS).

The FFA is critical for anyone working in the public dental sector, since it represents about 10% of total funding. However, the amount of $107.8 million budgeted for 2024-25 is exactly the same as was spent in 2017-18 – so in fact with the impacts of inflation and wage increases, this actually represents a cut in funding in real terms.

Similarly, CDBS funding in 2017-18 was $326 million, and the estimate for 2024-25 is $328 million. Now this operates slightly differently in that the amount actually spent in based on utilisation. That said, the projections out to 2027-28 see spending reducing to $324 million, suggesting that the government is not doing anything to increase the uptake of the scheme, which currently sits below 40% of those eligible.

There were certainly sweeteners in other areas of health (such as $227 million for 29 more Medicare Urgent Care Clinics or $90 million over three years to increase the number of overseas-trained doctors) which simply reinforces the view that oral health is not a priority area.

What is clear that is that this is a budget with an eye on the next election. What remains to be seen is whether advocacy efforts will lift oral health into the mix during the election campaign.