We read with interest the letter by Lad and McGowan1 in which they present their views on the future of patient–doctor communication in healthcare. In response to their suggestions, there are four points we would like to address. Firstly, while a paperless NHS is a desirable, and perhaps inevitable, progression, we draw a critical distinction between IT and social media in achieving the ‘iSurgery.’ Indeed, the lack of security in social media is well documented2 and has many ethical and legal implications for patient confidentiality and consent, two inalienable aspects of good medical practice.3–4
Moreover, we disagree that the next logical step for IT in medicine is social media: there is little evidence to suggest traditional modes of communication (letters and telephone calls) between GPs and patients are ineffective or disliked by patients. As the old mantra states: ‘If it isn’t broken, why fix it?’ Effecting wide-sweeping change in the current climate of financial strain would be challenging enough without considering the steep learning curve for GPs and practice staff.
Thirdly, while mobile text and email interactions between GPs and patients have reportedly had positive outcomes, can we translate this to social media?5–6 Clearly, the former have significantly wider use across all demographics than social media. Furthermore, a move towards social media potentially increases the risk of excluding vast subsets of society who do not use or do not have access to such websites.
Finally, though the traditional paternalistic consultation is increasingly a thing of the past, in promoting telemedicine, there may be a danger of failing to adequately address patient concerns and overlooking key body language cues which would otherwise be apparent in face-to-face communication. The adoption of wide-ranging social media in healthcare would also be vulnerable to device failure and website maintenance, which occur commonly, leading to frequent periods of impaired communication between doctors and patients.
We commend Lad and McGowan in seeking improved patient–doctor communication, and agree that this should be a key area of future innovation and discourse among healthcare professionals. Overall, however, the practical and ethical detriments of social media in the healthcare setting outweigh the benefits outlined by the authors in their letter. We feel, instead, that the current focus in healthcare IT development should remain for the moment with greater harmonisation of disparate patient information networks coupled with continuing development of electronic patient notes and records.
- © British Journal of General Practice 2014