When Doctors are Shamed on Social Media

We need to talk about doctor shaming on social media. This month alone, I have seen three separate posts in which a patient’s watcher, presumably a relative, snaps a photo of the involved physician or intern, and then posts the image on Facebook with either a disgruntled remark or an agonizing narrative. The post invariably generates commiseration in the form of likes and comments, only a few of which could be considered constructive, some even bordering on harassment and libel.

The outcry: “Ipa-viral ‘yang doktor/intern na ‘yan!” (Let’s make this doctor/intern viral!)

There were probably similar posts outside of my social media circles, and I should say that the three posts reached my newsfeed only because colleagues were quick to defend the doctors in them. I am not sure if the authors had anticipated the onslaught of negative reactions from the medical community when they hit the post button.

It should be pointed out that the root cause of these online grievances is our inadequate health system, particularly in the public sector. It has always been, long before the Philippines became the world’s social media capital; it’s just that our patients and their families have realized that it’s much easier to voice out their concerns and have an exponential audience in Facebook, compared with tabloids or public service programs on TV and radio. Everyone has a voice, and everyone is just as eager to click and share.

The truth is, the concerns are mostly valid, although the demands not always realistic in government hospitals that are short of health care workers and run with limited resources. Immediate attention, efficient service, courteous medical and nursing staff, and positive outcomes—all of us would want only the best possible care for our loved ones.

Still, doctor shaming is an alarming trend for several reasons.

First, it is unlikely to stop, not while our health system is far from ideal. We cannot expect our patients and their families, especially when veiled by pain or grief, to completely understand the motives of our actions every time. It is impossible to explain to every single person who enters a hospital that overworked doctors and medical students may fall asleep at the patient’s bedside, or that medical interns use their mobile devices to check drug doses or laboratory values and update their supervising residents. The vicious cycle of cyber-bullying (sadly, from both sides) will just keep repeating itself, albeit with a different setting and cast each time.

Second, the practice discourages doctors from using social media. I have been writing online since 2002, back when I was still a second year pre-med student. Establishing an online presence requires generous amounts of guts and a willingness to be vulnerable, but I continue to do it because I have seen the positive impact it has on people I would not have reached, were it not for the Internet. The aversion of many doctors to Facebook and Twitter is understandable when our reputation is always in the crossfire, which is a shame, because social media is an effective platform to make reliable health information easily accessible to all.

Last and most important, I doubt if any doctor-shaming post ever led to a positive resolution. The medical and nursing staff are put on the defensive. Relatives and carers are labeled overbearing. It becomes difficult to salvage a strained doctor-patient relationship, and the patient will inevitably be at the losing end.

The viral posts should remind us that no matter what the circumstance, there is no excuse for arrogance among health care workers when dealing with patients and their loved ones. In adherence to our oath, we owe them the same amount of diligence and respect, regardless of their social status or personal beliefs. The “Feeling pay, charity naman” retort should stop.

Should we find ourselves backed into a corner, it is always best to resist the impulse to argue with aggrieved relatives. There is hardly any benefit to proving ourselves right in this situation. The best recourse will always be to call our supervisors for help, and when threatened, to seek advice from the hospital’s legal office.

To protect our selves, all intervention should be carefully documented in the medical chart, accompanied by a clear assessment and management plan, ensuring that everything has been explained thoroughly to the family concerned. Public posts on our social media profiles should be restricted, and it is always a good idea to Google one’s name every so often.

More than ever, our skill in establishing rapport has become essential. Messy misunderstandings could only be avoided by letting our patients and their families feel that they could always voice out their concerns, either by talking to us directly or addressing their woes to the hospital’s public assistance office.

It is in this aspect where a hospital can help keep its workers safe from online abuse and its reputation intact. It is just unfortunate that today, some people would rather bring out their phones and complain online, when most of the time, the straightforward solution would have been to call the attention of the doctor or medical student involved and to resolve the issue right there and then.

The downside of social media interfering with medical practice is that a doctor’s empathy, given freely and out of genuine concern, may now feel contrived to patients and their families, only because any perceived wrongdoing could be the next trending post in Facebook and Twitter. And for us doctors and medical students, that would take away the joy of medicine, wouldn’t it?

We just do what we do best, and that is to help others. For as long as we know that in real life, we have done all that we could for our patients, there shouldn’t be anything in the virtual world to worry about.

 

HealthXPh is doing a Twitter conversation on the topic “How should health care professionals respond to a medically related social media posting?” Join the conversation today, Saturday, July 9 at 9pm MLA/9am EST by following the #HealthXPh hashtag!

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10 comments

  1. This is the best response I’ve read about the issue. Not arrogant, but very humbling. Coming from someone like you. You always take a step back, look at the bigger picture, and then write.
    You’re right. Communication is the key.
    Thank you doc!
    Continue to write, and inspire us!
    -Gem, 3rd year medical student

    • Hi Gem, I think it comes with the surgical training. It is good practice to detach ourselves from our emotions in order to have an objective course of action. Thanks for reading! 🙂

  2. Dr Bats, was once a student at Top Notch always a fan of your biochem lectures. We had 1 incident a month ago here in CDO. The doctor involved was my fellow 2nd year IM resident. Although she was not named but the hospital FB page was tagged. I was furious because of the adjectives he used. I wante to post back in retaliation, but after thinking about it, i thought would just make things worse. And a nurse posted in our defense. I was right. It became viral and was like wild fire. He did take down his post after several hours and eventually deactivated his account. In the end, he was the one where his name and reputation wad damaged because of the online bashing he got.

    • Hi Yoshi, it doesn’t end well for both sides, that’s what usually happens. Everyone needs to use social media responsibly. Thanks for reading Yoshi!

  3. Nellie Buenaventura

    Very well said ?

  4. Shaming is general does not bring any good.

    Aside from Responsible Parenting, Reproductive Health, Voter’s Education, should we also start a Responsible Social Media User campaign as well?

    It’s not the people nor the government that is controlling the society, it’s social media now 🙁 🙁 and not in a good way.

  5. Doc Roni! 🙂 I dont know where to leave my message but I hope you’ll read this asap. i just want to tell you that you are an inspiration not only as a doctor but also as i writer. I am glad that you will be a guest speaker in APMC Visayas this Saturday. Looling forward to see you soon doc!

  6. […] physicians still posted more measured responses, however. Dr. Ron Baticulon wrote in his piece on the topic, for example, […]

  7. […] Ronnie Baticulon MD, a paediatric neurosurgeon based in the Philippines, talks about a culture of doctor-shaming over social media, whereby relatives or friends of a patient post a picture of a doctor along with a “disgruntled remark or an agonizing narrative”. He says that these posts are a reminder that there is never an excuse for arrogance from a doctor in the face of a patient or carer, echoing the Charlottesville nurse in saying that everyone deserves equal care regardless of social status or personal beliefs. He believes doctors should refrain from using social media in response, as genuine sincerity may come across as contrived. […]

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Names, dates, and events may have been changed to protect the identity of patients. The stories are not meant to provide medical advice for specific illnesses. The author neither accepts online consults nor gives medical advice online. Please consult your trusted physician.