Solicitor Magnus Boyd explains how the risks to a practice's reputation are even greater in the internet age, and advises on how to counter them
Your reputation is your most valuable asset, and will become more precious if practice boundaries are abolished as the Government intends.
Yet practices and their GPs are more exposed than ever to potential dangers to their reputations, largely through the development of the internet.
All GPs need to come up with a plan to manage those risks and protect themselves. Here are some tips on where to start.
1. Google yourself
Almost every GP has an online profile of some kind, made up of all the web references to them that can be accessed via a Google search. These range from the biographical details on their practice website to research citations or postings on social networking sites.
Whatever a GP's online profile is made up of, they must ensure that it is accurate at all times. A simple place to start is to set up a ‘Google alert' for your own name or some other internet monitoring service to help you police the online content about you and alert you when something new appears.
2. Check GP ratings sites
There are a growing number of GP rating websites and they have the potential to cause substantial long-term damage to a practice's reputation.
Sites such as NHS Choices and iwantgreatcare.org are moderated, but I am frequently contacted by doctors who want defamatory postings removed from forums set up for patients to post comments about the care they receive. Many allow people to post material anonymously and without responsibility or accountability.
False allegations can have a huge impact on a practice's reputation and GPs' careers have been destroyed by false information being published and quickly disseminated.
If a practice or GP has been the subject of a malicious posting, they should contact the website moderator or administrator immediately to request the inaccurate or defamatory posting be removed.
The NHS Choices site also offers the facility for you to reply to comments, giving your own point of view.
3. Be careful what you post on the internet
Many GPs have embraced the use of social networking sites, along with everyone else. But they need to be more sensitive than others about what they post.
The Medical Defence Union said last December that it had concerns over patients' amorous advances to GPs in online forums, such as Facebook, and issued advice to encourage GPs to ‘politely turn down' advances from patients online or potentially face a GMC probe (GPs warned of Facebook stalkers)
Clause 57 of Good Medical Practice states: ‘You must make sure that your conduct at all times justifies your patients' trust in you and the public's trust in the profession.' This opens up every aspect of a GP's life for inspection, including online activities.
Journalists may use online blogs and forums as a source of comment on stories. A responsible journalist will get your permission before publishing comments, but you cannot rely on this so be careful what you say.
4. Build good links with the press
News is no longer transient. As remote as it might seem for most GPs, you can quickly and easily become the focus for a story at a local level and these stories can be picked up by the national press. Articles are syndicated to other news agencies and are accessible to the public via the internet.
Building good links with local press and business magazines can prove invaluable to a practice in protecting its reputation. Make sure you are available for comment to place a story in context.
5. Keep good clinical records
GPs and other doctors hold a position of trust where higher standards of conduct are expected by the public.
As a consequence, most stories regarding GPs are about patient care, so good clinical practice is the best way of combating inaccurate or misleading allegations.
Protocols are easily recordable and therefore useful in preparing and maintaining a good database of evidence should it ever be required.
6. Speak about what you know
Stories need a face. The reporting of NHS schemes and initiatives inevitably focuses on individual doctors as stories have to be told through ‘the prism of people', but a doctor's comments may be picked up and used in an entirely different context.
GPs must take care only to speak to their area of expertise and keep a record of what was said.
7. Be prepared to back up what you say
GPs must be prepared to back up everything they say or publish. Where there are points of disagreement, GPs should acknowledge them and make a clear distinction between statements of fact and comment.
GPs deal in areas where differences of opinion are common. Speculative conclusions that overstep the mark can expose a doctor to a libel claim.
Despite these risks, no GP should be inhibited or constrained in expressing their conclusions to the media, as libel laws will protect many of the formal circumstances in which a GP publish their work.
8. Be aware of the power of new media
The general public's access to phone cameras and websites such as YouTube now means that GPs need to be acutely aware that their surgeries are accessible to the world.
A video of a queue outside a surgery placed on YouTube last year went viral within hours, and ended up with GPC deputy chair Dr Richard Vautrey having to defend access to GP surgeries on BBC News (Patient feedback for the YouTube generation).
The YouTube video was taken down after complaints – possibly from other patients in the queue concerned that their confidentiality had been violated by being filmed – but the BBC video remains, and the damage is done.
It may be distasteful for most GPs to feel that they need to factor such considerations into their practice, but the reality is that they do.
9. Have a clear, consistent media strategy
A practice needs to control communications both externally and internally. Develop a clear and consistent strategy for engagement with the media within your practice and keep a paper trail of all such communications.
10. Take professional advice if needed
A GP needs to be constantly alive to the threats to their reputation. However, that awareness is, in itself, usually enough to protect against the potential damage that can ensue. Take professional advice if necessary.
Magnus Boyd is a partner at Carter-Ruck solicitorsUseful resources
• The hidden dangers of social networking. MDU Journal 2009;25(2):12-13
• NHS Choices comments policy – go to www.nhs.uk and search for ‘comments policy'Ten tips on managing risk to your practice's reputation