Social media as a force for anti-racist good
Dr Punam Krishan
I’m a GP from Glasgow. Recently, I shared two experiences I had at the practice I locum in. Both Tweets struck a chord with the public and went viral. The whole process, as overwhelming as it was, has given me food for thought about modern-day medical practice in the current model of our NHS. Having qualified 12 years ago, I’ve heard nothing but pessimism and crisis chats; resources and funding have remained static; and, worst of all, doctor morale is lower than ever.
As 21st Century doctors living in a clued-up society, maybe we need to get more innovative. But how can we create positive discussions and mass engagement within the realms of good medical practice, and steer the boat in a direction that alleviates some of our daily woes?
Social media has its problems, but my recent experience show that it's a powerful conduit for conversation and change. Patient questionnaires, surveys and groups all play important roles, but are we being idealistic in thinking these represent the masses? Sure, we need the data, but we also need to get realistic.
Doctors should not be afraid to share their thoughts, reflections and feelings
My first Tweet sparked nationwide debate about missed appointments. I wrote it on a day where care was limited due to public holidays, and five patients who had booked appointments failed to show up. Upon contacting them, I discovered they had no legitimate reason for not calling to cancel. My Tweet came from a place of frustration - I felt bad for those patients who needed appointments but couldn't get access, causing me to stay and deal with them. As a mum, I'd wanted to get home on time for once, on Christmas Eve, but due to the inconsiderate no-shows, this wasn't possible.
With a reach of two million, the Tweet was picked up by the press– unbeknown to me – but the topic of missing appointments, potential fine systems and naming and shaming got discussed at scale, reaching all corners of society, planting seeds and getting people thinking. Guilt was felt, a sense of pride for their NHS was ignited and ownership of responsibility for one’s part in the health journey of others was highlighted.
My second Tweet came from heartfelt gratitude to my receptionist, who empowered me by standing up to a racist patient. I’m an ordinary person who's Scottish, but I have an Asian heritage. This patient had refused to see me because I was Asian, and wanted to see a Scottish doctor instead.
Patient “I don’t want an Asian doctor”— 𝙳𝚛 𝙿𝚞𝚗𝚊𝚖 𝙺𝚛𝚒𝚜𝚑𝚊𝚗 (@DrPunamKrishan) 15 January 2019
Receptionist “she is Scottish”
Patient “she doesn’t look Scottish.”
Receptionist “what do Scottish people look like?”
Silence. Appointment card taken. So proud of my team 🙌🏽🙌🏽🙌🏽🙌🏽#endracisim #equalitydiversityandinclusion
With a global reach of 4.9 million, the Tweet took on a life of its own, with #EndRacism trending across all news platforms. Doctors, nuses and other healthcare professionals came forward to speak about their experiences, and the public united in solidarity for the greater cause. A tiny minority of trolls did hurtle personal abuse, but I accept this is what happens when you put yourself out there.
The mass responses weren’t because I’m good at Tweeting (quite the opposite!), but from a place of honesty and transparency. As healthcare workers, we are no less fragile, vulnerable or human than the rest of society. Money or politicians cannot change this interface – conversations need to happen at a grassroots level, and food for thought needs to be given out in abundance.
Social media, when used appropriately, is a powerful platform for relaying information, public education, and, most significantly, gauging public opinion about service provision. Doctors should not be afraid to share their thoughts, reflections and feelings, because for too long we have shown a robotic resilience, which only led to us feeling isolated.
Standing up and speaking out against abuse of the NHS and our peers is the only way to try to change the status quo. Of course we have guidance from the GMC, where patient confidentiality and personal professional conduct is paramount. I believe messages can be delivered, however, via accessible ways and can create powerful impact.
A song my five-year-old loves listening to resonates deeply. In the words of Ninjago, ‘If you don’t like what the world’s saying, it’s time to start a new conversation’. Maybe we should be doing just that.
Dr Punam Krishan is a sessional GP in Glasgow