Why is everyone really so annoyed about the AHPRA social media guidance?

The Australian Health Practitioner Regulation Agency (AHPRA) has managed to enrage health professionals across the country over the last month with their new rules around advertising through social media. And, as when every other major organisation releases a social media policy,  we have witnessed a very public outcry on social media (see GMC social media guidelines for another example).

In fairness, AHPRA really haven’t said anything too ‘out there’. It all comes down to three main principles:

• Comply with professional obligations
• Comply with privacy and confidentiality obligations
• Do not make unsubstantiated claims

However, it is the ‘unsubstantiated claims’ part that is causing all the fuss. AHPRA reinforces the National Law which says that you ‘…cannot make misleading or unsubstantiated claims, or claim unreasonable expectation of benefits’. The bottom line is that AHPRA, and the National Law does not allow advertising via testimonials on social media.“Advertising…requires an advertiser’s intent to promote a health service”
“Testimonials are statements making a recommendation about a service or its quality.”

That means you cannot retweet nice comments about yourself from patients; cannot put them on your website; and cannot have them on your Facebook page.

The main controversy, though, has been about Section 6.2.3 in their Advertising Guidelines:“A practitioner must take reasonable steps to have any testimonials associated with their health service or business removed when they become aware of them, even if they appear on a website that is not directly associated and/or under the direct control or administration of that health practitioner and/or their business or service. This includes unsolicited testimonials.”

Clearly that’s impossible. You are not going to be able to hunt down every random mention of you on social media and spend time getting it deleted. And so, Jill Tomlinson, a Plastic Surgeon in Melbourne, took the lead in taking action. She quite rightly, and very successfully gathered support from other health professionals using #ahpraaction and argued that these guidelines were clearly created by people with no understanding of how social media works. Holding healthcare professionals to task for testimonials on other people’s websites is completely unreasonable.

It would be fair to say that AHPRA haven’t handled it well. But they have listened to the healthcare social media response and have adjusted their guidance and even tried to engaged in a twitter Q+A #ahpraqanda (don’t bother looking up the chat, @AHPRA barely got involved).

Healthcare professionals still seem outraged in spite of AHPRA’s about turn. Part of that is that Section 6.2.3 hasn’t actually been removed. But AHPRA have released an FAQ to accompany the Advertising Guidelines and are clear that:“Practitioners are not responsible for removing (or trying to have removed) unsolicited testimonials published on a website or in social media over which they do NOT have control.”

So what’s the problem? After the dust has settled it boils down to private doctors wanting to be able to advertise their services by using patient testimonials. AHPRA does not allow this. Finally AHPRA and I agree on something related to social media. A testimonial stating that ‘Doctor X is the best doctor and he cured my y” is not exactly substantiated. It’s completely unscientific and biased. Patient opinion is essential for evaluating our own service and practice but it shouldn’t be used by us to try and attract more business.  Patients posting testimonials on independent review sites is different from us posting them on our own sites/pages to promote ourselves.

It moves away from the focus being on good patient care and moves towards a competitive field of asking for testimonials and creating your own personal medical brand. It allows us to ask patients to say lovely things about us and then encourage them to publicise them. Even worse, it abuses our position of responsibility by using patients to bring us more income. As a Brit in Aus, sometimes I really do miss the National Health Service.

Further Reading

• Guidelines for advertising regulated health services, AHPRA
• Resources for the revised codes (including link to FAQs), AHPRA
• Guidelines for Social Media, AHPRA
• #AHPRAqanda highlights and FULL transcript PDF
• #AHPRAaction – Jill Tomlinson
• #AHPRAaction – Edwin Kruys
• #AHPRAaction – Philip Darbyshire
• GMC guidance on social media use by doctors, St Emlyn’s blog