The Rise and Risks of Medical Influencers
Medical influencers have become a popular source of health information online, particularly since the start of the Covid-19 pandemic. Influencers use their online presence on social media platforms to generate interest in topics, brands or products. With 53 million people in the UK using social media platforms such as Instagram, TikTok and Twitter, it is clear that online influencers have a huge potential audience, this makes them a powerful tool for health promotion. This is not lost on commercial organisations and we increasingly see medical influencers receiving payment to promote brands or endorse products. There are now growing numbers of well meaning medics jumping online to help provide advice to the public; unfortunately sometimes these good intentions can go wrong! Like all technology, if not used responsibly, social media can create safety and liability issues. Additionally, because social media changes rapidly, standards and best practices are not always well defined.
The GMC’s Doctors’ use of social media provides guidance on the use of social media and the standards expected. There is also helpful guidance by the British Medical Association (BMA), Ethics of social media use, both documents provide guidance on confidentiality, maintaining professional boundaries and issues such as dealing with trolling and harassment.
People generally have less experience of advertising on social media and it is not always easy to recognise what constitutes an advert online. Therefore, it is important that medical influencers have a clear understanding of when content posted on social media counts as advertising.
The Advertising Standards Authority, Recognising ads: Social media and influencer marketing rules, state that adverts must be obviously identifiable and understood by the audience. Adverts on social media must be declared prominently at the beginning of the post, #AD is often used. Any label needs to be visible regardless of the device used, so it is important to consider how a post will look when accessed on different devices.
An influencer who receives a payment from a brand must be aware that any resulting posts promoting the brand then become subject to consumer protection law, which is enforced by the Competition and Markets Authority (CMA). Receiving gifts, products or services free is considered as payment and therefore the audience must be made aware that the post has been ‘paid for’ and if this is not clear then the post risks breaking the law.
The GMC in Doctors’ use of social media advises that:
Para 19 “When you post material online, you should be open about any conflict of interest and declare any financial or commercial interests in healthcare organisations or pharmaceutical and biomedical companies”.
Choose wisely what to post
Part of maintaining a professional presence online is maintaining professional boundaries and monitoring the quality of information posted. Information posted should be accurate, current, objective, and unambiguous. It is therefore vitally important when posting information that you ensure that you are sufficiently knowledgeable in that area. As a medical influencer, you may be contacted for medical advice.
Be particularly careful about giving advice to an individual who is resident in a country in which you are not registered with the medical regulator or indemnified to provide care.
Signposting people to sources of information and providing general advice is unlikely to be problematic. However, you should refrain from giving any kind of personalised health advice. Both the GMC and BMA advise against this type of interaction. Offering medical advice could arguably establish a duty of care, which may then lead to a GMC complaint or clinical negligence claim if the person is dissatisfied with the advice given.
Remember that the same principles of confidentiality apply whether you are communicating offline or online. Social media should never be used to discuss individual patients, living or dead. Sharing a photograph of a patient’s condition or posting details of a clinical case, even if anonymised, without patient consent constitutes a breach of confidentiality.
Be mindful that even when posting comments on social media about your working day, you may inadvertently breach confidentiality.
There are many benefits to the public from the rise of medical influencers. They can serve many useful purposes in healthcare for example, enhancing information sharing and health promotion. However, with these opportunities come risks, therefore when using social media in your professional capacity it is important to be clear about professional boundaries, conflicts of interest, quality of information and whether the item you are posting would be classed as advertising.
Finally, ensure you have appropriate insurance or indemnity in place for any work you undertake in your capacity as a doctor, in accordance with the GMC Good medical practice para 63.