Opinion

Social media is damaging relationships in health care

On a recent Thursday, I started my workday by reading six texts from a client. She was so angry at the care she was receiving by the evening staff that she threatened to kill me.

A few weeks prior, I was consoling a physiotherapist because she had found a zero star Google review of herself. The reviewer named her and blamed her poor technique on not being able to walk (there was no mention of this patient’s recent stroke and subsequent brain damage).

There are formal surveys completed by families and patients living in Continuing Care; for example, by the Health Quality Council of Alberta (HQCA), with valid survey methods and results. However, the quick (and often biased) Google reviews seem to have a greater impact on staff morale.

As social media platforms began to emerge in the early part of this century, there was hope that patient engagement and health-care ratings on social media would have a positive influence on the quality of care. Social networks could allow for peer support and offer a wide knowledge source for patients. The thought was new technologies would encourage more collaboration between patients and care providers; the past behaviour of “doctor knows best” would be replaced.

Instead, new trends have developed. Keyboard warriors, trolls and chat bots are vying for online space in the attention economy. Multiple online forums exist for rating health-care workers. There are “health” influencers spreading health misinformation that contrasts with advice given by mainstream experts.

Violence toward health-care workers, including online attacks, has worsened since the pandemic. Social media presents more potential harms to health-care workers than just physical or verbal forms of violence because a negative post can spread misinformation with no limits in terms of time, space or personal boundaries.

Social media posts can be blunt, negative and subjective. Negativity can fester on the internet and breed more negativity.

Negativity can fester on the internet and breed more negativity.

In many health-care professions, building personal rapport between the provider and the patient is an essential part of the relationship. If health-care workers are attacked by chat bots and negative comments taken out of context, building a trusting relationship with any patient can become difficult.

The high rates of violence toward health-care workers (including cyberbullying) can lead to high staff turnover, burnout, absenteeism and poor quality of care.

For our part, expectations of health-care associations and regulatory colleges are that members should be professional when engaging on social media. Comments and opinions made on social media even when a health professional is “off duty” could still be considered to represent a professional opinion and the regulatory bodies may investigate.

The International Nurse Regulator Collaborative (INRC) groups set out the “6 P’s” for nurses to follow when interacting with patients on social media: professional, positive, patient-free, protect yourself, privacy and pause.

Social media is used by health professionals to spread awareness and combat misinformation. New styles of health-care engagement also are emerging. For example, a study found that counsellors and social workers were able to develop better therapeutic relationships with at-risk youth through social media than using traditional methods.

Another positive trend is the use of natural language processing systems for patients’ online comments to organize the data and make quality improvements.

Improved public awareness of the impact of social media posts on health-care workers needs to be taken seriously. There needs to be consistent policy at the organizational, provincial and federal levels to protect health-care workers against cyberbullying and hold people accountable for their online actions. Underreporting of cyberbullying toward health-care workers is common. Documenting cyberbullying as an act of violence will help to quantify the issue.

There needs to be education offered to health-care workers and the public on how to use social media effectively, including the privacy rights for both patients and health-care workers.

For social media to be an effective tool in health care, there needs to be a balance between keyboard warriors and the rest of the population. The noise of some should not drown out the needs of many.

Governments, health-care agencies and the public can work together to fight against the negativity and continue to use social media to our collective advantage.

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Authors

Lara Fowler

Contributor

Lara Fowler is a LTC unit manager; she started her career as a physiotherapist in the early 2000s when people were still learning how social media could impact health-care delivery.

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