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Dr Rachel Birch, Medico-legal Consultant at Medical Protection, provides advice on the promotion of a clinical practice
from a medico-legal perspective
Staying up to date on clinical knowledge and skills is fundamental to good medical practice, but doctors should also be mindful of how they present themselves, and their practice, to the public. Many doctors are innovative and seek new and effective ways to promote their practice; however, any practice promotion must be carried out in a way that is compliant with relevant guidance and regulation.
According to our recently published report Learning from cases – insight into the claims landscape for GPs, around 10 per cent of claims involved allegations arising from procedures or minor surgery performed within the practice setting. It is therefore essential that your services are advertised accurately and appropriately.
The Medical Council’s Guide to Professional Conduct and Ethics for Registered Medical Practitioners sets out, in paragraph 44, expectations for doctors with regards to providing information and advertising to the public. It advises doctors that any information about medical services should be “factually accurate, evidence-based, and not misleading”. It then goes on to provide some more specific advice.
Publicising your registration number and accreditation
Doctors must include their Medical Council registration number in any information they publish about their practice or services, as well as in their letter headings, medical prescriptions and all other documentation and records relating to their practice. This applies to both paper and electronic documentation. Letter headings should only include membership of associations or societies that are accredited by the appropriate training bodies. Whilst this may be obvious to some, it is important that information about your practice or services should also include an explanation that “doctors may only practise in countries in which they are registered”.
You may advertise an area of speciality only if you are registered for that specialty in the Specialist Division of the Medical Register. This may be shown on a “professional plate and sign” at your practice, but it must indicate your registered name, qualifications and specialties. The Medical Council advises that it may also be helpful to indicate hours of attendance, telephone numbers, services you provide, and details of emergency services.
Promotion of services
People who are seeking advice on medical services for themselves or their families may be particularly vulnerable to persuasive influence and it is important that they are protected from coercive advertising, such as special offers on treatment plans. The over-commercialisation of medical services may undermine public trust in the profession and could eventually also diminish the standard of medical care itself.
The Medical Council advises that any promotional content should contain information which is “true and verifiable, does not make false claims or does not have the potential to raise unrealistic expectations”. It advises against using photographic or other illustrations of the human body to promote cosmetic or plastic surgery procedures, as they may raise unrealistic expectations among potential patients. As there are risks associated with even the most minor treatments, doctors are advised to include information about any risks associated with the services provided.
While positive feedback from patients is usually welcome, doctors should be cautious about using exaggerated claims as testimonials, even if they are written by the patient. Posting ‘before and after’ photographs of patients is best avoided where they are recognisable or potential vulnerable, especially with regards to their mental health. If you do publish patient photographs, it must only be done with their fully informed consent, bearing in mind that they can withdraw their consent at any stage.
While market competitiveness is understandable, your fees should be “appropriate to the service you provide” according to the Medical Council. Before the consultation and treatment, you should inform the patient of all likely costs, including any fees for follow-up or the treatment of any unexpected complications. If you have any specific concerns relating to the promotion of your services, please contact Medical Protection or your medical defence organisation for further advice.
Sharing expertise with a pharmaceutical company
Dr T, a dermatologist, was asked by a pharmaceutical company to produce a short video about a common skin condition. She provided a short, factual explanation of the disease symptoms and treatment options. When she visited the company’s website to view the video, she was shocked to see that it had been edited to include clear reference and advertisement of a particular drug that the company manufactures. Whilst it was one of the available treatment options, Dr T felt that it would not be the first-line treatment for most patients. She was concerned that the video had been edited to suggest that she was recommending this particular treatment to patients.
Medical Protection’s top tips
- Consider any requests from organisations requesting your clinical input very carefully, especially if you will not have ultimate editorial control of the final publication or broadcast.
- Be aware of the purpose of any video before you agree to record it, ensuring that the expectation is not that you will be endorsing a particular product. It is much easier to know up front what you are agreeing to, rather than trying to correct misunderstandings later.
- Familiarise yourself fully with paragraph 62 of the Medical Council’s guidance, which provides advice on managing conflicts of interest.
- Conflicts of interest may arise if you receive financial support from a pharmaceutical company in connection with professional activities, for example lectures, presentations, publications or videos. In these circumstances, you should declare any financial interest and inform patients and other relevant parties about your professional relationship with the company.
Using social media in your practice
Ms G attended Dr A for cosmetic treatment, including Botox injections to her forehead and perioral dermal fillers. Delighted with the result, she posted before and after photographs on Twitter, recommending Dr A to her numerous followers and stating that he was the “leading doctor in his field”. Dr A’s receptionist saw this and retweeted it, adding that Dr A was “the best doctor” she had ever met. Other practice staff agreed and the tweet was shared several times, including from the practice’s official Twitter account.
A complaint was subsequently made to the Medical Council by a patient, Mrs S, who had become aware of the Twitter activity. She had not had such a good result from her cosmetic treatment with Dr A and felt that the claims in the tweets were unrealistic and unfounded.
Medical Protection’s top tips
- Familiarise yourself fully with paragraph 20 of the Medical Council’s guidance, which addresses the use of social media.
- Be vigilant about your social media presence and that of your practice staff members. Provide training to staff members about the risks of social media and the importance of patient confidentiality and consent.
- Always consider the potential impact of social media posts on colleagues, patients, and the public.
- Ensure that any information published about your services is accurate and does not make any unsustainable claims.
- Keep personal and professional use of social media separate, avoiding communication with patients through personal social networking sites.
- Do not share images of patients online without the expressed and fully informed consent of the patient.