Social media is a continually growing and changing online tool. How and when it should be used professionally isn’t straightforward, especially for health professionals.

It’s been recognised that many speech pathologists are using social media to seek clinical advice and support. While there are obvious benefits to doing this, as it allows you to access professional support from a wide range of people, this also carries risks which need to be carefully considered and managed.

Specific individual client advice

It’s not appropriate to use social media to seek advice or recommendations for a specific individual client. This is because the level of detail which would need to be provided about that client to obtain individualised advice is too great and should never be shared on social media, even if de-identified. All health professionals need to remember that social media is never private, even if ‘private’ professional chat groups are created. It’s too easy for information to be shared further or used in a way not intended. It’s also possible that a client could be identified by the information shared.  A speech pathologist may be keen to seek advice from colleagues, in which case it’s appropriate to identify those with particular expertise in the field and contact them individually, rather than ask for specific advice on social media.

Asking clients for consent to share their personal information in order to ask questions about their care on social media is not an appropriate way to support decision making about future intervention. Although a speech pathologist may think about asking for consent to share information, social media is not an appropriate place to have individualised case discussions. Posting detailed health related information also poses numerous risks to a speech pathologist’s responsibilities under the Australian Privacy Principles. These include requirements to protect information from misuse or unauthorised access, and to dispose of personal information that is no longer needed. These requirements may be difficult or impossible to manage once personal information is shared on social media.

General advice

It’s acceptable to use social media to obtain general advice about a client group, such as if looking for tips when using telehealth for clients with autism. However, in these cases, the advice being sought must be broad, general, and applicable to various situations and clients. As soon as individual client characteristics are raised or discussed, this conversation can’t continue online.

Speech pathologists who are considering providing advice via social media should be mindful that advice should only be general in nature, e.g. useful resource or relevant journal article. Responses and advice provided via social media interactions carry a degree of risk as it’s unlikely all client details/circumstances will be shared as if you were in a more formal supervisory arrangement. When speech pathologists need professional support related to a client, social media can be a helpful place to “cast a wide net” and find someone with experience in the practice area. The following discussion about the individual client can then be held offline. When using social media to find supervision, mentoring, or peer support, speech pathologists should be careful to only share general information online. They should also verify the experience of the person offering that support, create an agreement that addresses client privacy and terms of the partnership, and document support sessions.

Case Study

Alex has recently started seeing a client who requires intervention in an area where she has little or no experience. She would like to extend her skills in this area of practice but has identified that she needs support and education to make decisions about how to manage this client.

Alex considers all her options and decides to:

• talk with her clinical supervisor who she knows has experience in this area
• ask a co-worker who’s experienced in this area in a private setting
• engage colleagues in a closed community of practice where participants have a confidentiality agreement and have acknowledged their experience
• search for the latest evidence from quality sources
• use social media to locate resources, ask for general information, or identify sources for continuing professional development

Alex thinks about asking which interventions should be used with this client on social media, but decides not to because:

• she would need to provide specific client Information such as diagnosis, age, location, etc.
• she has no way of determining if the information being shared is provided by individuals who have the relevant skills, knowledge and experience to make comments about the management of client issues.
• the post could be shared beyond the confines of the social media community without her or her client’s knowledge or consent.

Additional considerations…

• The knowledge, skills and experiences of those providing online advice cannot be verified, even if in a private group of speech pathologists. Individuals providing this advice usually won’t have insight or input into how the advice will be implemented in practice. Therefore, clinicians shouldn’t rely solely on advice sourced on social media platforms to make clinical decisions.
• Professionals sometimes turn to social media for quick advice to assist them in that moment.  However, what’s often needed is ongoing guidance and support. This need won’t be satisfied in a social media exchange.  Therefore, speech pathologists need to consider other avenues available to them for gaining the support and advice they need.
• Social media encourages short messages provided quickly and without a great deal of thought. Short messages can easily be misinterpreted or misunderstood. Professional support and decision-making require detailed sharing of information and thoughtful consideration by those who are both seeking and offering advice.
• The sharing of information online may lead to a clinician breaching their ethical obligations to confidentiality and privacy, and the responsibility to uphold the quality and safety of the interventions provided to a client. This can have broad implications as speech pathologists always represent not only themselves and their business, but also the wider profession.

In summary, social media does have a place for seeking out or sharing professional clinical information of a general nature. However, whether asking for or providing advice, all clinicians need to carefully consider the circumstances of online interactions and be sure appropriate professional standards are being maintained.

Guild Insurance Limited ABN 55 004 538 863, AFS Licence No. 233 791.  This article contains information of a general nature only, and is not intended to constitute the provision of legal advice. Guild Insurance supports your Association through the payment of referral fees for certain products or services you take out with them. 

Facebook has evolved greatly overtime, and so has our use of it. Gone are the days of it simply being used to chat with friends and share holiday photos. Professional use of Facebook has grown to the point where many people expect businesses to have a Facebook presence. With ever evolving algorithms and functions and various accounts settings, it can be difficult to stay on top of best and safe practice. Most concerningly, these changes can bring misunderstanding about the many risks and issues all businesses, including speech pathology practices, need to consider before creating a professional Facebook account.

Reasons for a Facebook account

Creating a business Facebook account because many other businesses or practices have one isn’t a good enough reason. As with all other decisions and plans made for your speech pathology business, creating a Facebook account needs to be well thought through with the pros and cons considered carefully. Risk management is especially important as issues can quickly escalate due to the nature of how the platform can easily share and distribute information.

Your speech pathology practice should have a process and policy for the following in relation to a business Facebook account and its usage:

• What information will be shared
• How responses to comments will be managed
• Who is responsible for managing the account
• How client permission, if posting information about clients, will be obtained and recorded
• Who is responsible for ensuring the content is appropriate for advertising speech pathology services

Did you know?

Facebook was created in 2004 as a social networking tool for college students. Now, there are over 2 billion Facebook users and almost 1.5 billion daily users[1].

94% of Australia’s social networking users have a Facebook account.  And these Facebook users have an average of 234 friends each[2]. 

Ethics of posting information about clients

It’s becoming more common to see speech pathology practices sharing information about clients on Facebook. Even when done with the permission of the client, or the client’s parents, it’s important to consider how ethical or professionally appropriate this is. When intending to post information about client progress on Facebook, first consider the following:

• Could the information be shared without identifying the client? Is there any real benefit in identifying the client?
• How many people will be able to see the information being posted (consider how many people follow your page and then their ability to share this further)? And who are these people? Is it possible that friends of the client could see the posts?
• If the client is a child, as they get older how may they feel about their health information being shared publicly?

Client permission isn’t always enough when sharing confidential health information. The reasons for and implications of this sharing need to be considered.

Blurring of professional boundaries

Using Facebook, and any other form of social media, can contribute to professional boundaries starting to blur. Social media encourages an informal means of communication which may be different to how you’d communicate with clients when face to face. This can alter the dynamics of the professional relationships between clients and clinicians. Professional social media use can also lead to clients contacting clinicians on their personal social media accounts. When using social media for work purposes, it’s important to maintain the professional separation and relationship with clients by not altering the way you interact and communicate with them.

Privacy

Privacy on Facebook is almost a contradiction. When using Facebook remember:

• Posts and comments can never be completely deleted, especially if someone has taken a screen shot of them.
• Privacy within groups can’t be guaranteed. It’s not uncommon to hear of people creating fake accounts to access private groups and share their information.
• If there’s something you don’t want to be seen by a regulator, client, colleague or competitor, never post it on Facebook.

Appropriate use of social media for advertising

Speech Pathology Australia has published a Code of Ethics – Advertising Policy which describes appropriate advertising of speech pathology services. The policy applies to all social media advertising (Facebook included) as well as any other forms of advertising that the speech pathologist has control over. The required level of professional language used and information shared in all advertising is also required when using Facebook.

Seeking advice

When using Facebook in a professional setting, consider the appropriateness of the conversations held in that forum, even if it’s a conversation with other speech pathologists in a private or “closed” community.

While peer support has many benefits, using forums such as Facebook groups to seek and provide specific clinical information can pose a significant risk to speech pathologists. The risks not only relate to confidentiality of sensitive client information, but also provision and use of advice that is suggested without access to adequate information on which to base decisions. In many situations/scenarios, very little information may have been supplied about the case being discussed. Even if a lot of detail is provided, which carries risk for maintenance of confidentiality, the advice you provide to a colleague could potentially be clinically inappropriate or incorrect. Following advice provided via social media groups that may not be appropriate for your client poses a risk for the treating speech pathologist.

Speech pathologists have an ethical obligation to provide quality and competent professional services which follow evidence-based practice principles. Although general advice provided through a discussion of general clinical scenarios on a social media platform may be appropriate, for a discussion regarding client specific information speech pathologists are advised to consider how they seek professional advice, such as working with a supervisor.

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