The GDC have recently being taking a stance over professional conduct and particularly in regard to social media. The Standards say that we must not publically criticise colleagues unless this is done as part of raising a concern. I should like to make it clear at the outset of this blog that what follows is part of me raising concerns. Concerns that I feel are not being taken seriously enough, and some not even acknowledged as being concerning at all. This blog is in 2-parts. Part 1 will look at ‘bringing the profession into disrepute’ in the context of social media. It is perhaps timely in view of Mr Hill’s recent effort of justification over the need to suspend retired dentist Mr Pate under the pretext of ‘protecting the public’. Part 2 will look at my concerns over conflicts of interests. Both will, as usual, look at this in terms of recent events and cases.
So my part 1 concern relates to a fellow dentist who is a Clinical Advisor providing early advice reports to the GDC and the material posted on the public stream of their Facebook page. Our regulator tells us that we must not post material on public media that may undermine public confidence or bring the profession into disrepute. On this public-facing social media page, there is a joke about a sexual act, several slang references to parts of male anatomy and masturbation, a profile picture that is potentially racially-offensive (depending on the generation of the particular panel that might be selected by the GDC), but the finest one has to be the picture which blames patients for their gum disease and tooth decay because they are “*insertslangformasturbators*’’. Yet this Clinical Advisor, wrote in an early advice report for the GDC that a dentist who communicated with a patient using Facebook Messenger, was unprofessional for doing so. This would be funny apart for the stress that the registrant was put under as a result of it being included in their initial allegations which contributed to the case being forwarded for a full hearing. There will be more of this to come in another blog.
I emailed the current Director of Fitness to Practise to ask him what he thought about the content on this Clinical Advisor’s Facebook profile page, and whether he felt it was appropriate for someone affiliated with the GDC. The GDC ought to know how their Clinical Advisor was behaving whilst giving potentially life-changing advice about other registrants’ professional conduct. Perhaps my tip-off might assist them in getting their own house in order after a run of bad hearing outcomes for them and at a time when the mood of the profession is resembling that at the time of the ARF debacle. At the time I had started to draft this blog I had not received any reply, and suspected that the GDC’s email filters might have kicked my email with its supporting attachments of profanities straight into their Spam Folder. I have now received my reply, so I will come back to that later.
On this particular issue of ‘unprofessional’ social media comments, 2 registrants recently received letters from the GDC reminding them of their need to uphold standards when using social media. They had both used an inappropriate word, albeit on a single occasion, on a Facebook thread and a helpful colleague had very kindly pointed this out to the GDC without raising their concerns with the group moderators or the registrants themselves. The digital evidence suggests that the anonymous informant was another registrant. In terms of the naughty word used, it was quoted ‘verbatim and in italics’ in the GDC letter. If the GDC think that word is inappropriate they ought not visit the Dr Rant page and see their ‘affectionate’ nicknames for Jeremy Hunt which are used on an almost daily basis. The GMC don’t seem to concerned however, but perhaps doctors do not refer each other to their regulator over spats and spite instigated on social media platforms.
Anyway, I felt pretty strongly that this particular display of conduct on social media referred to above really should not go unquestioned, all things being considered.
The Standards apply to all and this Clinical Advisor who is a fellow dentist, is held to the same standards as us all. No-one should believe that they sit above us mere-registrants, somehow ‘protected’ by a relationship with the GDC. A colleague has a four-month suspension for alleged religiously-offensive statements made visible only to other dental registrants, yet I found his comments less offensive that this advisor’s silly, misogynistic and sexist posts. Also, someone with the infantile mentality that is publically displayed arguably unfit to assess whether any other registrants’ behaviour is professional, surely.
Whilst waiting for my email to be replied, rather hilariously, another registrant got a letter from the GDC courtesy of another anonymous informant reminding them of their professional obligations, and advising them to take action so they too could be better behaved in the future. However, the letter gave no information on what was posted that caused offense or deserved some kind of GDC-referral retaliation. An SAR sent the GDC may well clear that one up in time.
Taking screenshots from Facebook and using them to make complaints to the GDC is a rather petty way to retaliate against another dental registrant in my opinion. Those doing it really need to take a long hard look at themselves, especially if they are in the subset of registrants whinging about our high ARF.
As it happens, the GDC Annual Accounts and Report show that by 2018, 9-10% of incoming GDC complaints (as per my little infographic below) currently arise from other registrants. This is a record year. Well done registrants!! Keep this rate of progress up and in a few years we might actually beat the patients.
So actually, never mind the GDC: we also need to get our own house in order here. Please can we all stop being so childish? If you don’t like what’s on Facebook, get off social media, leave the groups that aren’t to your taste or contain people you don’t like, block people who wind you up, or if what’s being said is about you is that bad, spend your own money on legal proceedings rather than wasting all our money artificially inflating the ARF telling tales by the use of screenshots. Still, it’s nice to see that the GDC has healthy reserves of £20 million against a back drop of a decreasing number of incoming complaints. Maybe this is in preparation for the day we achieve a level of 100% of complaints arising from all the back-stabbing and bickering going on between ourselves.
This is the problem with the ‘duty to report concerns’:
LEGITIMATE CONCERNS REPORTED TO THE GDC OFTEN END UP IN ONE OR MORE REFERRALS IN THE OPPOSITE DIRECTION.
This is the sheer reality of the dire situation that faces us. The minute you act on a professional duty to raise concerns with the regulator, you are at risk that ‘concerns’ will be raised about you, and there will be GDC referrals all round.
But back to my email: I did get a reply regarding my Clinical Advisor issue. I was advised that I should use the online form to report the matter to the Initial Assessment Team.
It looks as though we are not the only group happy to throw dentists under the bus, which is always nice to know.
We have recently created a Facebook page for GDPUK, where we aim to publish news, blogs, articles and forum posts which are focused on UK Dentistry. We realise the creation of this page is a number of years late but it is better late than never!
Like all digital publishers, we use social media extensively to share articles and blogs. The GDPUK Forum facebook page will be another medium we will use to share our opinion and information on all things Dental.
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When I qualified back in the early 1990’s, social media wasn’t exactly on the radar. The thought of being able to connect with a multitude of people instantly was the stuff of imagination. The Pub was our Facebook, and the only ‘likes’ we had were the various guest beers.
Now it’s such a part of our everyday lives that normal channels of communication are seemingly used in the minority. When you can connect with the entire world’s population from the comfort of your home, and carry on multiple conversations about multiple subjects simultaneously, the days of popping out for a beer and a chat with a mate seem numbered.
But what about the social etiquette, and more importantly the professional etiquette we employ when online? The GDC have standards that we should adhere too, and indeed GDPUk is actually specifically mentioned in them such is the impact social media has made on the profession. Specific specialist sites like GDPUk aren’t generally the issue, and whilst there are sometimes a few comments made that might get the GDC or lawyers a trifle interested, these sort of sites are generally appropriately populated and commented upon.
The problem are the wider platforms especially those such as Twitter and Facebook. Some users don’t seem to get the fact they are in no way whatsoever a place to remain private and anonymous despite what you might think.
Whilst the ‘more mature’ professionals seem to have the general hang of the way we should conduct ourselves, I worry that some of the younger members of the profession haven’t quite got the gist of what being a professional is yet and how they should present themselves in public to the public. Because no matter what steps they take, if they have a social and professional presence on media like that, they are well and truly exposed to public scrutiny.
There are a multitude of Facebook pages for Dental matters. Some are better than others, but all suffer from the same fundamental problem. They are not private. In order to use them you have some sort of visibility. For instance, if I wanted to discuss a case over a beer in the pub with a mate, I wouldn’t be doing it whilst posing in a mirror with oiled muscles. But that’s what communicating with some of the personas on social media is like. Some of the fairer sex seems to be somewhat less than modest in their attire on occasion, and one has to wonder if this is what the public expect of its professional classes. A couple of clicks and you generally have a range of private information about ‘friends’, particularly the more self-obsessed ones.
What about commenting into the perceived anonymity of an electronic device in such a way that you wouldn’t do in person? I’ve witnessed many an argument that would never happen in real life due to the social ethics the majority of us have; but once in the safety of the digital world the ‘keyboard warriors’ tend to lose all sense of propriety and the moral compass seems to have lost its direction. And then there are the artists of self-promotion who feel every other comment has to be some form of pseudo advert for a business venture, or course you can’t possibly miss. I’m becoming guilty of the last one as my Twitter account now is used almost solely for the promotion of this blog and GDPUk. You see, the boundaries of who you are as a person, and who you are as a professional are becoming so grey with social media like Facebook that it feels safe to make that sort of comment, and think there is no comeback.
Finally, there are the vast numbers of photos of patients and cases that we see bandied around social media. The GDC is very clear on this, in standard 4.2.3, where it states ‘You must not post any information or comments about patients on social networking or blogging sites’. Period. We can use ‘Professional Social Media’ but social networking sites are a no-no according to the exact wording. Personally, I think the GDC are possibly a little behind the times on this, as there are a good number of very good Facebook pages where some quite good discussions take place; however it remains to be seen if the GDC feels this is ‘professional social media’ when used in this way, as after all, they are the ones who get to decide….
The big problem though is that many people forget just what can happen to these comments and photos once they've been posted.
I’ve heard stories of people using screenshots of comments made on social media and then threatening to use them as evidence to send to the GDC. Screenshots can be shared outside the domain we think we are posting in, and as such can be disseminated far more than we might have considered when we posted. Unfortunately the self-righteous are rife on social media, and often mistake what is only free speech for something to get offended by, and take draconian steps.
I’ve seen the fallout when comments in a public section of a site then get even nastier privately; and I’ve seen wholesale bar-brawls break out in some places (although they’re usually involving musicians ? ). This is like taking a voice recorder or video camera to every meeting you have with a professional in case they say something that offends you so you have evidence and can report them. Since the GDC love nothing better than a good old Fitness to Practice case, we need to really be aware of what we put on social media, how we do it, and the persona we use on there. I think it is only a matter of time before there will be a full-blown case against a registrant involving some indiscretion or inappropriate comment on social media.
Now I’m no Luddite, prude, or some ‘holier than thou’ observer; as a forthright Yorkshireman I tend to say how it is and if you don’t like that then that’s your problem not mine. I’ve got patients as Facebook friends, and I tend to be exactly the same person online as I am in real life. I’m aware that anything I say there is something that I should be happy to share in a professional environment. I’m a real person and don’t have any airs and graces or chip on my shoulder that mean I think I’m some sort of superior being because I’m a dentist. But I can’t help thinking that some of the comments, personas, and attitudes we see as the public face of some of those in dentistry give the GDC every right to be concerned about the public perception of the profession, because if people can’t differentiate between a digital persona and a real one when they are posting then they really do deserve the attention of our regulator. The rationality and politeness filters seem to disappear from some of our profession when they get infant of some kind of keyboard. Couple all this with a competing bunch of the self-righteous, and the self-obsessed and we have a recipe for the profession to start imploding.
It certainly feels like it is one rule for the GDC and one for us where social media is concerned; the sheer fact you can ‘like’ the fact a colleague has been struck off, suspended etc, is not what I call professional. There’s also no associated comment when a colleague has been exonerated, like in the case of the Scottish dentist Keith Watson, who then attempted to take a vexatious patient with an apparent history of suing dentists, to court for defamation, which unfortunately he has had to abandon at great financial cost to himself.
But, this case shows there can be huge good come out of social media and its immediacy. In the space of less than 24 hours a fund had been created to support Dr Watson, a newly qualified member of our profession who would no doubt be financially challenged by a huge legal bill this early in his career.
http://www.gofundme.com/keithwatson Not only that, the messages of support for Keith have been flying around social media all day and latterly on GDPUK itself. When used appropriately then, we have a fantastic medium to help people.
We need to embrace social media as its here to stay; it can be hugely useful, and massively informative; but we must use it appropriately, and think about the consequences of our presence in the virtual world. That’s what it means to be a professional.