Yes, this discussion is fine. As the messages are posted in a private Facebook group, the patient's name and location are not mentioned, and the trainee doctor is not responsible for the patient there is no risk that patient confidentiality will be breached.
Working with doctors Working for patients
Ki and Shona
Introduction
Ki and Shona are doctors in training who went to the same medical school. They are both on the Foundation Programme, working at separate GP surgeries.
While studying at medical school, some of their fellow students set-up an online group for students and trainee doctors using Facebook. Ki and Shona have been and continue to be enthusiastic members of the group, and they have been posting messages about their experiences at the surgeries.
The following is a conversation they had by posting messages on their group's Facebook page.
Ki
Any fun or interesting cases today?
Shona
Not so far. Lots of OAPs with the usual complaints, and the hypochondriac of course.
Ki
The same patient from yesterday?
Shona
Yep. Fourth day in a row, and a different complaint each time. So he thought he had a brain tumour on Monday, skin cancer on Tuesday, Swine Flu on Wednesday and yesterday was the Noro virus.
Ki
So what was today's self-diagnosis?
Shona
It was quite boring really, just a migraine.
See what they did
Another member of the Facebook Study Group Abdul saw the exchange between Ki and Shona, and is alarmed by their conversation. He sends them both a private message on Facebook explaining that their exchange breached patient confidentiality and risked damaging public trust in the profession. He explained that they could not control the information they had already posted online - even though the group had private membership. He also explained that it was unacceptable use of social media for a doctor. He recommended that they end the conversation and try to have the conversation deleted from Facebook.
Ki and Shona had thought their messages were private, but the message from Abdul made them realise that the group wasn't quite as private and secure as they thought.
They ended the conversation immediately and contacted the administrators of the Facebook group to ask them to delete the messages they had posted.
They agreed that they would no longer post messages that discussed patients directly or that might undermine public trust in the profession.
References
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 paragraph 4)
Bear in mind that content uploaded anonymously can, in many cases, be traced back to its point of origin. When communicating privately, including using instant messaging services, messages or other communications in private groups may also become public. We have a legal duty to investigate any concerns raised to us that reach our fitness to practise threshold.
(Using social media as a medical professional paragraph 9)
When using social media of any kind, you must maintain patient confidentiality and recognise and respect patients’ dignity and their right to privacy.
(Using social media as a medical professional paragraph 18)
Although individual pieces of information may not breach confidentiality on their own, the sum of information shared could be enough for a patient or someone close to them to recognise and identify their case.
(Using social media as a medical professional paragraph 19)
You must not disclose identifiable information about patients, when using social media, unless you have explicit consent to do so – for example, for educational purposes. In which case, you must follow our guidance: Confidentiality: disclosing for education and training purposes and Making and using visual and audio recordings of patients.
(Using social media as a medical professional paragraph 20)
Many improper disclosures are unintentional. You should not share identifiable information about patients where you can be overheard, for example in a public place or in an internet chat forum. You should not share passwords or leave patients' records, either on paper or on screen, unattended or where they can be seen by other patients, unauthorised healthcare staff, or the public.
(Confidentiality paragraph 13)