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Dr Sam Walker is a doctor in training in the Accident and Emergency department of a hospital and he has been working since early morning. During his break, he is in the hospital coffee shop and he is using his smart-phone to access Twitter. He uses his Twitter account mainly for personal use, although he follows a number of healthcare organisations and other doctors. Recently, he has started to occasionally comment on health issues in the news and to re-tweet posts from other doctors.

A friend of his has tweeted a cartoon of a tired and hung-over female character in a business suit asleep at her desk with the text 'This is why you should never drink on a Sunday night #hatemondays'.

Sam enjoys the cartoon and retweets the message for his followers on Twitter from his account @dr_sam_walker and adds the text 'Exactly how I feel this morning!'

A few minutes later, Sam receives a phone call from his friend Chris.


That cartoon you posted on Twitter was hilarious, I've retweeted it too. But you could have told me you had the morning off today - you still owe me a game of squash remember?

Dr Walker

Sorry to disappoint you, but I'll have to beat you at squash another time, I'm at work at the moment and will be heading straight to bed when I finish.


Oh, well... are you sure that Tweet you posted is ok? It makes it sound like you were out drinking last night and you're hung-over at work.

Dr Walker

Of course it's OK - I just meant that I'm asleep on my feet - I've been on since 5am in A&E.

And don't worry, nobody's going to see that message apart from my Twitter followers like you, so it doesn't matter if they get the wrong end of the stick.


You're wrong about that mate. It's a public message, so anyone could search for it and see it ' even if they're not signed up to Twitter. And your account name and photo make it pretty easy to tell it's you.

I'd delete the message if I was you - you wouldn't want any patients seeing it. Let alone your bosses. Mind you, you'd have more time for squash if you get sacked...

What should the doctor do...?
(Select A, B, C or D)


Change his Twitter profile so that all his Tweets are protected from now on (ie they are only visible to approved followers and are not public)?


Delete the Twitter message and any other previous messages that may offend or worry people, then be more careful when posting messages in the future?


Close down his Twitter account and stop using social media all together?


Change his Twitter account name so he can tweet anonymously?

See what the doctor did

Until the conversation with Sam, Dr Walker hadn't been aware that Tweets he'd meant to be seen only by his friends might be easily accessible to the public. With hindsight, he saw how his innocent message might be misconstrued.

He still wanted to keep on using Twitter in his private life, so he decided to delete the message and resolved to take greater care with what he posted in future.


You must make sure that your conduct justifies patients’ trust in you and the public’s trust in your profession.
(Good Medical Practice paragraph 81)

You must be honest and trustworthy, and maintain patient confidentiality in all your professional written, verbal and digital communications.
(Good Medical Practice paragraph 88)

When communicating privately, including using instant messaging services, you should bear in mind that messages or other communications in private groups may become public.
(Good Medical Practice paragraph 93)

The standards expected of you as a medical professional do not change because you are communicating through social media, rather than face to face or through other methods of communication. However social media is constantly evolving, as are societal norms and expectations.
(Using social media as a medical professional 4)

When interacting with or commenting about individuals or organisations on or using social media, be aware that communications are subject to the same laws of copyright, defamation, discrimination, and harassment as written or verbal communications – whether they are made in a personal or professional capacity.
(Using social media as a medical professional 15)

If a patient contacts you about their care through your private profile, you should direct them to an appropriate healthcare setting for further support with their query.
(Using social media as a medical professional 17)

The same principles of behaviour apply whether you are interacting in a face to face, telephone or online setting. You must also follow our guidance on Using social media as a medical professional.
(Maintaining personal and professional boundaries paragraph 7)