Health promotion or Self Promotion?

Written by Dr. Kate McCann
16th September 2023

“Can you put my name in there?” T. asked me.  He’s suddenly looking over my shoulder as I write.  Since he’s learned to read, I’ve been more careful what I have visible on my laptop when he’s hanging around — so it’s pretty dully stuff he’s looking at.

“In where?”  I asked.  (The page in front of me is a rough draft of upcoming article for Men’s Health Month in November.)

“The blog. Did you put my name in there when I helped?”  T. says.

Ah, now I’m putting it together.  He’s only recently been aware that I have a blog and post some on social media. A week ago, I asked him to double-check a phrase as gaeilge that I used in the piece on School Toilet Anxiety. (He had checked it and then informed me that they don’t actually say anything. It’s way cooler – they just make an “L” sign with their index finger and thumb to show the teacher that they are heading to the leithris.)

“No, your name is not in it, anywhere.  And just so you know, your picture isn’t in it either.” **

He looked upset for a moment.  “Why not?”

I explained to him it was about his privacy.  I’m very proud of him, as everyone in the family WhatsApp group is only too aware.  But he hasn’t been old enough to make an informed decision if he is comfortable with his information or identity being out there.   And even now, I wouldn’t be confident that he could truly understand how there is no control over who reads things, how it can be out there forever, and how it can be used. And even if he thought it was okay today, he might not feel that way if it ever re-surfaced in some context when he is 10 or 15 or 21 or 35.

I am cautious. I’m first to acknowledge that, to a degree, it is likely unnecessary — 2 weeks ago, a patient in a hospital waiting room stopped me and asked if I was, well, me.  She had recognized me from social media.  I note this because this is the first – and only – time this has ever happened in 5 years.   It’s really not surprising for a number of reasons.  But the main reason that, if you have been following this project for a while you will note, I didn’t put my face or name on the project for the first 3 years.

Why was that?  Quite simply, health promotion (which I am passionate about) to be unbiased should not be self-promotion.  This has to be balanced against the fact that transparency of expertise and credentials has become increasingly important to validate health promotion information.  There’s little governance in the arena of doctors on social media, so it’s up to an individual doctor to set their own ethics.  So, while I’ve decided that I’m very comfortable sharing photos of my dog without her informed consent, this most certainly is not the same for my children.  While I actively use my platforms to tag not-for-profit health resources and link further reading material families can trust,  I’m certainly not comfortable endorsing products.

What's okay to put in Blog or Post?

What can doctors -and healthcare professionals – say on social media? Here are some guidelines most follow: For legal reasons, we can’t obviously – or should be obvious – never put any patient details. Any clinical stories that we share from real life practice have an real element at the core of the story, but always have to have enough details changed that the patient won’t even recognise themselves. We also can’t give personal medical advice. If you’ve ever messaged my social media accounts, you’ll be reminded that while I’m a doctor, I’m not your doctor and social media just isn’t the place for medical advice. Most docs and healthcare professional do tend to share general health information or point you in the direction to the best resources available. All docs on social media (should!) have similar. After that it gets grey, here are some ethical consideration you might want to think about: If a doctor or other healthcare professional takes money from a drug company (far rarer than you would think, mind you!), supplement/vitamin company, or owns something like a hyperbaric oxygen chamber or has shares in private diagnostic facility, for example, that has the potential for conflict of interest. So if relevant to health information being shared, this conflict of interest should be declared if it isn’t obvious. Obvious being, for example, when Dr. Joe Bloggs swears that Dr. Joe Bloggs brand vitamins are just the best – this should also come with a #ad or #sponsoredcontent Giving patently false, inflammatory, or misleading medical information to get shares, clicks, and likes or for political reasons was something that, in the wake of the pandemic, we should have had a serious, public, and global discussion about. It’s way overdue.  Along those lines are misrepresenting an area of expertise (i.e. a toe surgeon may know very little about influenza epidemiology, for example) Lastly, is misrepresentation of qualifications on social media and across internet sites. In Ireland, the Medical Practioner Act of 2007 prohibits misreprepresenting yourself as a medical practitioner if you are not registered. Protected terms can only be used by properly qualified and registered professionals.  For example, literally anyone can call themselves a nutritionist.  And I do mean anyone. However,  “dietitian” is a legally protected term for INDI/CORU registered practitioners. Always check IMC (medical), PSI (pharmacist), CORU (allied health) registration status of health care professionals, especially anyone advertising any sort of medical consultation.

It’s a discussion that all of us will be – and should be – having more and more.  Do we continue ignore the problem of those who post misleading/false medical information for profit, politics,  or attention, especially when it has potential to cause real harm?  Doctor or not, is it okay to use to promote your message or brand when they are too young to give informed consent?  Is promoting a supplement and vitamin okay as a doctor or registered healthcare professional?* I’m firmly in the “absolutely no” camp, but there are plenty who disagree.

My Conflict of Interest?  This is on my mind because I will be discussing Doctors on Social Media as part of a panel of other Irish doctors who are all on social media at the upcoming WiMIN Conference next month.

*The link will take you to a piece I wrote last year about the ethics of vitamin/supplement endorsement and promotion for US-based group “Doctors on Social Media” 

 

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