DR. RONNIE ENRIQUEZ BATICULON
Dr. Ronnie E. Baticulon is a pediatric neurosurgeon, teacher, and writer. He posts his stories in his blog, http://ronibats.ph.
Feedback welcome at email@example.com.
We need to talk about doctor shaming on social media. This month alone, I have seen three separate posts in which a patient’s watcher, presumably a relative, snaps a photo of the involved physician or intern, and then posts the image on Facebook with either a disgruntled remark or an agonizing narrative. The post invariably generates commiseration in the form of likes and comments, only a few of which could be considered constructive, some even bordering on harassment and libel.
The outcry: “Ipa-viral ‘yang doktor/intern na ‘yan!” (Let’s make this doctor/intern viral!)
There were probably similar posts outside of my social media circles, and I should say that the three posts reached my newsfeed only because colleagues were quick to defend the doctors in them. I am not sure if the authors had anticipated the onslaught of negative reactions from the medical community when they hit the post button.
It should be pointed out that the root cause of these online grievances is our inadequate health system, particularly in the public sector. It has always been, long before the Philippines became the world’s social media capital; it’s just that our patients and their families have realized that it’s much easier to voice out their concerns and have an exponential audience in Facebook, compared with tabloids or public service programs on TV and radio. Everyone has a voice, and everyone is just as eager to click and share.
The truth is, the concerns are mostly valid, although the demands not always realistic in government hospitals that are short of health care workers and run with limited resources. Immediate attention, efficient service, courteous medical and nursing staff, and positive outcomes—all of us would want only the best possible care for our loved ones.
Still, doctor shaming is an alarming trend for several reasons.
First, it is unlikely to stop, not while our health system is far from ideal. We cannot expect our patients and their families, especially when veiled by pain or grief, to completely understand the motives of our actions every time. It is impossible to explain to every single person who enters a hospital that overworked doctors and medical students may fall asleep at the patient’s bedside, or that medical interns use their mobile devices to check drug doses or laboratory values and update their supervising residents. The vicious cycle of cyber-bullying (sadly, from both sides) will just keep repeating itself, albeit with a different setting and cast each time.
Second, the practice discourages doctors from using social media. I have been writing online since 2002, back when I was still a second year pre-med student. Establishing an online presence requires generous amounts of guts and a willingness to be vulnerable, but I continue to do it because I have seen the positive impact it has on people I would not have reached, were it not for the Internet. The aversion of many doctors to Facebook and Twitter is understandable when our reputation is always in the crossfire, which is a shame, because social media is an effective platform to make reliable health information easily accessible to all.
Last and most important, I doubt if any doctor-shaming post ever led to a positive resolution. The medical and nursing staff are put on the defensive. Relatives and carers are labeled overbearing. It becomes difficult to salvage a strained doctor-patient relationship, and the patient will inevitably be at the losing end.
The viral posts should remind us that no matter what the circumstance, there is no excuse for arrogance among health care workers when dealing with patients and their loved ones. In adherence to our oath, we owe them the same amount of diligence and respect, regardless of their social status or personal beliefs. The “Feeling pay, charity naman” (They feel like they’re paying patients, but they’re charity patients) retort should stop.
Should we find ourselves backed into a corner, it is always best to resist the impulse to argue with aggrieved relatives. There is hardly any benefit to proving ourselves right in this situation. The best recourse will always be to call our supervisors for help, and when threatened, to seek advice from the hospital’s legal office.
To protect ourselves, all intervention should be carefully documented in the medical chart, accompanied by a clear assessment and management plan, ensuring that everything has been explained thoroughly to the family concerned. Public posts on our social media profiles should be restricted, and it is always a good idea to Google one’s name every so often.
More than ever, our skill in establishing rapport has become essential. Messy misunderstandings could only be avoided by letting our patients and their families feel that they could always voice out their concerns, either by talking to us directly or addressing their woes to the hospital’s public assistance office.
It is in this aspect where a hospital can help keep its workers safe from online abuse and its reputation intact. It is just unfortunate that today, some people would rather bring out their phones and complain online, when most of the time, the straightforward solution would have been to call the attention of the doctor or medical student involved and to resolve the issue right there and then.
The downside of social media interfering with medical practice is that a doctor’s empathy, given freely and out of genuine concern, may now feel contrived to patients and their families, only because any perceived wrongdoing could be the next trending post in Facebook and Twitter. And for us doctors and medical students, that would take away the joy of medicine, wouldn’t it?
We just do what we do best, and that is to help others. For as long as we know that in real life, we have done all that we could for our patients, there shouldn’t be anything in the virtual world to worry about.
September 2016 Health and Lifestyle