Doctors have been warned by regulator AHPRA to tone down critical comments on social media regarding COVID-19 responses and issues such as infections among healthcare workers.

In the statement issued by AHPRA on Twitter last week, the regulator said it had “received concerns about the conduct of some health practitioners engaged in online discussion, including in semi-private forums”. It did not detail which comments had been the subject of complaints.

While AHPRA said it “appreciated the importance of a vigorous national debate on public policy” regarding COVID-19, its statement read:

“However, we remind all registered health practitioners that their obligation to comply with their profession’s Code of Conduct applies in all settings – including online.”

AHPRA published new guidance on health practitioners legal obligations in relation to using social media in November last year.

The regulator’s statement on COVID-19 comments, which was shared by the Victorian Chief Health Officer Professor Brett Sutton, sparked a spate of angry responses from health professionals on Twitter. Several highlighted the fact more than 3000 Victorian health workers had been infected with COVID-19 and a number declared they would not be silenced from publicly criticising the handling of the crisis.

Many also took issue with Victoria’s Deputy CHO, Dr Nick Coatsworth when he alluded to aggressive “megaphone” criticism on social media.

Thanks to the many doctors, nurses and other health professionals who have communicated constructively with us over the past 6 months, and who realise that instead of a megaphone, if you just pick up the phone, you are heard. #covid19

— Dr. Nick Coatsworth (@nick_coatsworth) September 3, 2020

New Code of Conduct gives guidance on public comment

The AHPRA warning comes as the Medical Board of Australia prepares to implement its new Code of Conduct on 1 October, which includes new and more specific advice for doctors regarding their right to make public comments.

The new code has stepped back from an earlier draft version that stated: “If making public comment, you should acknowledge the profession’s generally accepted views and indicate when your personal opinion differs. Behaviour which could undermine community trust in the profession is at odds with good medical practice and may be considered unprofessional”.

The wording was dumped following widespread criticism. Instead, the final Code includes a section entitled: “Public comment and trust in the profession” which states:

“While there are professional values that underpin good medical practice, all doctors have a right to have and express their personal views and values. However, the boundary between a doctor’s personal and public profile can be blurred. As a doctor, you need to consider the effect of your public comments and your actions outside work, including online, related to medical and clinical issues, and how they reflect on your role as a doctor and on the reputation of the profession.”

Doctors’ social media comments have been in the spotlight, after a Tasmanian doctor was suspended by a tribunal last year for professional misconduct following offensive comments he made in an online forum and chat site.

Another GP is appealing the suspension of his registration in May after a tribunal found anti-vaccination views published on his Facebook page posed a risk to the way he practised medicine.

Should all doctors use social media?

Dr Tanya Selak, an anaesthetist based in Wollongong, NSW, who is an active social media user under the moniker @GongGasGirl, believes all doctors should be active on social media.

“It is part of our responsibility to educate the population and correct medical misinformation,” she said.

Dr Selak said doctors were a diverse group with widely differing views, and it appeared the new Code of Conduct would enable them to continue to join robust public debate, as long as they did so “respectfully”.

“It gives doctors a fair amount of freedom,” she said, adding that she doubted it would gag doctors from critiquing public policy.

For example, Dr Selak suggested the high number of health workers infected with COVID-19 in Victoria was an issue that warranted public questioning by the profession.

“Six months into the pandemic, I think it is OK to critique what is happening,” she told the limbic.

Most doctors were already required to adhere to social media policies put in place by hospitals, their colleges and medical indemnity insurers, she added.

However, Dr Selak cautioned about a trend, especially in the US, for groups such as the well-funded anti-vaccination lobby to target doctors who publicly criticised them with vexatious complaints to regulators. She said she hoped the Code would not see any increase in such complaints.