As I outlined previously AHPRA recently release updated advertising guidelines and added a new social media policy. These changes came into effect on 17th March 2014.
The changes to the advertising guidelines caused widespread outcry from health practitioners, due to the stance taken by AHPRA regarding patient reviews and testimonials. The updated guidelines effectively made it the practitioner’s responsibility to seek removal of reviews containing comment on clinical matters from all websites and social media, whether they are in their control or not.
I won’t go into the full details here, as I have covered this comprehensively already.
Regulated Health Practitioners have been understandably very upset about this new obligation, with many practitioners voicing their concerns via social media. The medical board attempted to ease concerns by issuing a media release stating (in part):
“The Board expects practitioners to take reasonable steps to remove testimonials they are using to advertise or promote regulated health services they provide, or when the testimonials are used by someone advertising the regulated services on their behalf. (This could be a third party who is advertising the services the practitioner provides at the practitioner’s request). But the Board recognises that practitioners are unable to control what is written about them in a public forum.”
Media coverage called this statement a backflip. However it failed to ease the concerns of may practitioners, as there was confusion about why AHPRA had not officially commented, where this left practitioners of other regulated health professions and were doctors to follow the revised guidelines, or the media statement.
I contacted AHPRA to seek clarification personally, however I received no response.
The AHPRAaction Movement
Last Week Melbourne Surgeon Jill Tomlinson, who had been active in the debate since the guidelines were released announced she was presenting AHPRA with a submission outlining community concerns regarding the revised guidelines. The twitter discussion around the issue was also organised around hashtag #AHPRAaction and the Twitter account @AHPRAaction was recently launched to promote the cause.
AHPRAaction also released this video:
On Monday 17th March, the day the revised guidelines came into effect AHPRA released a revised FAQ document to accompany the guidelines. This FAQ is intended to:
“ help people understand what they need to do to comply with the advertising requirements of the National Law. We hope they also help the community understand what the law requires practitioners to do and not do. “
The document contains a number of statements that directly contradict the guidelines, by removing the burden of policing third party online reviews from practitioners. Here is an excerpt from the extensive FAQ document:
“Advertising and testimonials
There is a clear difference between advertising – which requires an advertiser’s intent to promote a health service – and unsolicited online comment, which does not involve an advertiser’s intent to promote a health service.
Social media and testimonials
How do the advertising guidelines and social media policy apply to online comments about practitioners?
The National Boards recognise that practitioners are often unable to be aware of and control what is written about them in a public forum.
The advertising guidelines apply only to advertising of regulated health services. They do not apply to unsolicited online comment over which practitioners do not have control.
As a practitioner, National Boards expect you to:
ensure that your own advertising, or that done by others on your behalf, meets the requirements of the National Law
take steps to correct your advertising if you are advised by AHPRA that your advertising does not comply with the National Law
comply with the Boards’ social media policy and code of conduct if you are active on social media, and
keep a close eye on any form of advertising you control.
The Boards do not expect you to monitor social media except as described above.
What is a testimonial?
The National Law prohibits the use of testimonials or purported testimonials in advertising.
Testimonials are statements making a recommendation about a service or its quality.
This means it is not acceptable to use testimonials in your own advertising, such as on your facebook page, in a print ad or on your website.
The National Law does not prohibit the use of social media or comments in social media if they do not involve a practitioner or their representative advertising a regulated health service.
The guidelines do not prohibit unsolicited public discussion and opinion sharing about practitioners outside the context of advertising a regulated health service.
Social media is part of everyday life so why can’t I use it?
Social media is part of everyday life and these guidelines do not stop people participating in it.
National Boards have a Social media policy that applies to all registered health practitioners and provides further guidance about what the National Boards expect in relation to social media.
In relation to advertising – advertisers cannot use testimonials in social media to advertise their regulated health service.
The guidelines do not prohibit unsolicited public discussion and opinion sharing about practitioners.
The National Boards recognise that practitioners are often unable to control what is written about them in a public forum and the law and the guidelines do not require this.
What if someone else publishes a testimonial without my knowledge? How can I be held responsible for what other people say about my services?
Advertisers are responsible for removing testimonials published on a website or in social media over which they have control.
Practitioners are not responsible for removing (or trying to have removed) unsolicited testimonials published on a website or in social media over which they do NOT have control.
What happens if someone complains that I am using a testimonial?
AHPRA will review the complaint. If it appears you are using a testimonial in your advertising, AHPRA will write you a letter that asks you to remove the testimonial. You will generally only be penalised if you don’t take any action in response to repeated requests.
Can comments that I don’t control become advertising?
Testimonials that are not initially made in an advertising context can be used as advertising if you actively draw attention to them, such as by sharing, forwarding, retweeting or otherwise using a comment about your clinical performance to advertise your practice, even if the comment was initially made somewhere other than on a site you control. Promoting your practice using testimonials made in other contexts could breach the ban on using testimonials in advertising.
Does the definition of social media include closed discussion forums and message boards? What about personal social media pages such as my personal Facebook page?
The advertising guidelines apply to social media only when social media is advertising and intends to promote a regulated health service.
Social media includes personal Facebook pages, closed discussion forums and message boards.
Social media is discussed in section 7.1 of the Advertising guidelines and a separate Social media policy is published on each National Board’s website. Each Board’s Code of conduct or equivalent document also contains guidance about the required standards of professional behaviour, which apply to registered health practitioners whether they are interacting in person or online.”
While the release of the FAQs is a step in the right direction, the #AHPRAaction movement are continuing to push for a revision of the guidelines, not just a release of FAQs.
If you would like to add your name to the AHPRAaction petition you can do so here.
Where Does this Leave Practitioners?
It seem that AHPRA does not intend to enforce the guideline revisions that make it the practitioner’s responsibility to police third party online comments.
However as per the excerpt above practitioners are still responsible for ensuring that testimonials are not used for marketing purposes, this includes social media properties and websites under the control of the practitioner, it also includes drawing attention to unsolicited online reviews in your own marketing
It is important all practitioners understand:
There is still confusion around the release of the FAQ document does not clarify the guidelines it actually contradicts them. I would hope AHPRA takes steps to revise the guidelines.
As many commentators have note in the past couple of weeks bureaucracy often struggles to keep abreast of real world changes. If AHPRA can commit to upholding the “clarifications” it releases in the FAQ documents, could this possibly provide a faster way to implement urgent change in extraordinary circumstances than the traditional path of submissions, review panels and guideline revisions that AHPRA indicates will occur every three years?
Am I being too optimistic?
*Italics are direct quotes from AHPRA/Medical Board documents.