Should the GMC Regulate Doctors on Social Media?

Medscape

7 hours ago

Dr Arya Anthony Kamyab
Doctors have always held strong opinions, but where these were once exchanged in the privacy of hospital corridors, they are now broadcast globally via posts on social media platforms.
In January 2024, the General Medical Council (GMC) issued updated guidance titled "Using Social Media as a Medical Professional." This document underscores the importance of maintaining professionalism, upholding patient trust, and establishing clear boundaries online. Among its central tenets is this recommendation: 'You must not use social media to abuse, discriminate against, bully, harass or deliberately target any individual or group.'
Implementing this principle raises difficult questions. Where is the line between legitimate critique and perceived harassment? Is a doctor who publicly challenges unsafe working conditions within the NHS engaging in necessary advocacy or crossing a line by targeting leadership? Are discussions about the role of physician associates constructive criticism or professional bullying? The GMC offers little definitional clarity, placing doctors in ethically ambiguous territory.
In practice, social media has become an increasingly fraught space for healthcare professionals. Platforms such as X are rife with disputes — among colleagues, with administrators, and increasingly directed at the GMC itself. The ongoing debate around physician associates has inflamed tensions further, with allegations ranging from misinformation and professional gatekeeping to outright bullying. While the GMC has acknowledged the increasingly toxic tone of online discourse, its response has largely been limited to expressions of concern rather than decisive action.
This leads to a broader, more contentious question: Should the GMC be responsible for regulating physicians' conduct on social media at all? Some argue that professionalism is not confined to clinical settings and that behaviour inconsistent with medical ethics, regardless of context, undermines public trust. Others view such oversight as overreach, contending that physicians retain the right to express personal views outside of work.
The GMC now finds itself in a delicate position. Excessive enforcement risks accusations of censorship and the stifling of free expression; insufficient enforcement, however, may undermine its authority as a regulator. The power of professional regulation extends beyond legal authority — it includes reputational impact. A doctor facing a tribunal over an online post may endure not only formal investigation but also public scrutiny and reputational damage.
Free to Misinform?
It is tempting to view this free speech debate from a legalistic standpoint: Free speech is a right, and any interference is therefore a violation. But this simplifies what is a very complex moral discussion. Doctors occupy a very privileged epistemic position. Our speech is not just personal expression; it carries what can be referred to as epistemic weight. When doctors speak, people listen, and they often shape their actions in response. This could be dismissed as their responsibility, but to say so is to be naive about the forces that influence human behaviour.
During the COVID-19 pandemic, doctors who spread misinformation didn't just express unpopular views; they misled millions precisely because they were trusted by the public. Any ethical analysis must therefore conclude that doctors, by virtue of their training and the trust they hold, bear a higher moral burden. Their views must meet a threshold of intellectual honesty and evidential rigour. Has it therefore ever been more important for doctors to understand the hierarchy of evidence and the scientific method as a route to knowledge?
The Value of Dissent
We must resist the impulse to reduce all nonconforming speech to danger, however. Recognising that not all nonconforming speech is equal is also vital. There is a long tradition of those who challenged prevailing consensus and were vindicated over time: Ignaz Semmelweis, a pioneer of antiseptics; and Gregor Mendel, with his groundbreaking studies on inheritance, to name just two. But what separates such figures from conspiracists and pseudo-intellectuals is not what they challenged but how they did it. If one engages critically with the evidence, welcomes scrutiny, and embraces the methodology of the scientific process, then dissenting speech becomes not only valid but vital.
Therefore, if the GMC wishes to guide online professionalism without veering towards censorship, it must distinguish between these types of speech. However, the danger is that even the most well-intentioned guidance can become irrelevant in the context of social media. Social media is not a neutral forum. Its algorithms do not select for truth. Rather, it is an attention economy optimised for outrage, tribalism, and performance.
Platforms such as X reward impulsiveness and reactivity over reflection and deliberation. If social media's algorithms are designed to fuel hyperbole and outrage, can professionalism be meaningfully maintained within this space?