A doctor has been reprimanded and suspended for his comments in online forums promoting violence against woman and racism.

Dr Christopher Kwan Lee, who was employed by the Tasmanian Health Service and then worked as an emergency doctor at Box Hill Hospital in Victoria has also been asked to step down from his position while the health district completes its own, separate investigation.

Dr Lee was found to have made a number of inappropriate and offensive comments in online forums in which he was readily identifiable as a medical practitioner, including stating that “some women deserve to be raped”.

The case of Dr Lee demonstrates the increasingly porous boundaries between professional and personal conduct.  The Tribunal stated that although the online posts were not made in the course of practising medicine and were posted after hours, there was nevertheless a clear nexus between the posts and Dr Lee’s profession, as he identified himself as a medical practitioner on multiple occasions.

Whilst Dr Lee’s case represents the extreme end of the spectrum, the ability for information shared on social media to be published immediately and disseminated widely means that caution should be exercised before any content is shared online.  

AHPRA also has a social media policy requiring practitioners to remain cognisant of the National Law, their National Board’s code of ethics and the guidelines for advertising regulated health services when using social media.

Here are some of the common social media pitfalls and how best to avoid them:

Social media can colour personal and professional reputations.

Personal Facebook pages can reveal a detailed account of someone’s personal life.

For example, it is easy to see that patients might question a practitioner’s professional competency if they were to find online embarrassing photographs of the practitioner, such as being drunk or involved with some sort of high jinks.

Other material that would be considered inappropriate or unprofessional if posted would be use of drugs, crime, nudity, sexual content or innuendo, patient information and criticism of others.

Therefore, be circumspect about the content you create and post online in order to ensure that you do not skew patients’ perceptions of the profession or the level of care they expect to be provided with.

Friending patients on Facebook

Practitioners who allow patients access to their personal information online (by either accepting a patient’s request to connect or extending a request to connect to a patient) may risk a variety of repercussions.

There is a risk of blurring the boundaries between a practitioners’ personal and professional life, which may complicate or change the nature of the relationship between a practitioner and patient.

By interacting with patients online, you may expose yourself to scrutiny of your personal life. Facebook profiles can feature some highly personal information, such as photographs, details of friends and family in your network and comments both written and received from others. A patient’s access to your personal information and could undermine the practitioner-patient relationship.

It is recommended that you politely decline any friend requests from patients on Facebook, to avoid the risk of blurring boundaries. You could send a polite message to the patient, or should the matter be raised in a later consultation, just politely explain that you cannot ‘friend’ your patients because of the importance of maintaining a strictly professional relationship.

Patient privacy and confidentiality

It is also important to consider patient confidentiality in a social media world, particularly in terms of photographs and videos that are uploaded.

You must be aware that the usual standards of patient privacy and confidentiality apply online, and refrain from posting identifiable patient information.  Even de-identified photos may be identifiable with reference to piercings or tattoos.

Clinical images are “health information” and must be treated with the same privacy and confidentiality as any other health record or information. They should only be taken with appropriate consent, stored securely, and only disclosed in accordance with the consent given, or if there is a legal obligation to do so.

Using clinical images for any purpose other than that for which consent has been obtained, or sharing them in a non-professional context, is inappropriate and risks you being the subject of a complaint to AHPRA or legal action.

Key tips

  • Pause and reflect before you post a comment or photo in any context.
  • The content should be scrutinised in terms of appropriateness as well as who may have access to that information. Check and update your security settings.
  • Use common-sense and do not comment about patients, cases or colleagues.
  • Politely decline any friend requests from patients.