1. 1 Medico-legal Issues and Risks For Ophthalmologists By Deborah Jackson

2. 2 Claims Against Ophthalmologists Source: MDA National Data

3. 3 Claims and Complaints Insertion of incorrect intraocular lens “Refractive surprise” – consent process Loss of vision – endophthalmitis – retinal detachment Triage by administrative staff

4. 4 Social Media – What is it?

5. 5 Social Media in Health Care Price Waterhouse Cooper study: – 42% used social media to access health-related consumer reviews – 30% have supported a health cause – 25% posted about their health experience – 20% joined a health forum or community

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7. 7 What are the “Rules”? MEDICAL BOARD OF AUSTRALIA CODE OF CONDUCT http://www.medicalboard.gov.au/documents/default.aspx?record=WD10%2f1277&dbid=AP&chksum=eNjZ0Z%2faj N7oxjvHXDRQnQ%3d%3d

8. 8 AHPRA Guidelines

9. 9 Respect for Colleagues

10. 10 Professional Behaviour www.foxnews.com

11. 11 Confidentiality “Patients have a right to expect that doctors and their staff will hold information about them in confidence, unless release of information is required by law or public interest considerations”

12. 12 Confidentiality

13. 13 Professional Boundaries “Avoid expressing your personal beliefs to your patients in ways that exploit their vulnerability or that are likely to cause them distress”

14. 14 Professional Boundaries

15. 15 Online Professionalism Points Online actions by or about doctors reflect on the individual doctor and the profession Always check whether your online content is publicly appropriate – “pause before you post” Strongly avoid online network relationships with patients (past or present) Make privacy settings as tight as possible Know the policies of your organisation, e.g. internet usage, professionalism and harassment Always acknowledge conflicts of interest DeCamp et al 2013, Dizon et al 2012, Leiker 2011, St-Laurent-Gagnon & Coughlin 2012, Wiener et al 2012

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17. 17 What Can a Doctor Do? What is defamation? A matter has to be published to a third person ✔ Publication identifies the aggrieved person ✔ The publication bears a defamatory meaning ✔

18. 18 What Can a Doctor Do? Ask the patient to remove content (if you can identify patient) Difficult to bring an action in defamation in the US Ask the site to review and remove the comment/content YouTube Write a letter of demand threatening legal action (may make things worse – other websites Chilling Effects and medicalquestionsandanswers)

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20. 20 Advertising Guidelines

21. 21 What is Advertising? All forms of printed and electronic media that promote a regulated health service and includes any public communication using: – TV – radio – newspapers, books, magazines – internet – social media

22. 22 Advertising Examples “20/20 promise” “Throw away your glasses” “Two eyes for the price of one (if you sign a waiver)” “Kiss a pig and win free LASIK” Pay full price for first procedure, 20% discount on second procedure Introduce a friend to the practice – if they have a procedure you receive discounts for further procedures Improve employment prospects Feel better about yourself

23. 23 Section 133 National Law 1.A person must not advertise a regulated health service, or a business that provides a regulated health service, in a way that: a)is false, misleading or deceptive or is likely to be misleading or deceptive; or b)offers a gift, discount or other inducement to attract a person to use the service or business, unless the advertisement also states the terms and conditions of the offer; or

24. 24 Section 133 National Law 1.A person must not advertise a regulated health service, or a business that provides a regulated health service, in a way that: a)uses testimonials or purported testimonials about the service or business; or b)creates an unreasonable expectation of beneficial treatment; or c)directly or indirectly encourages the indiscriminate or unnecessary use of regulated health services.

25. 25 Testimonials in Advertising Positive statement about a person or thing You cannot use testimonials in your own advertising – e.g. on your Facebook page or website You are not responsible for trying to have removed unsolicited testimonials on a website or in social media over which you do not have control

26. 26 Advertising a Surgical Procedure Where a surgical (or “an invasive”) procedure is advertised directly to the public, the advertisement should include a clearly visible warning, with text along the following lines: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

27. 27 Advertising Breaches Use of “before” and “after” photos Use of testimonials – e.g. on your website Include names of prescription medication – breach of therapeutic good legislation No warning statement for surgical procedures Misleading academic titles or memberships

28. 28 Breach of Advertising Requirements Criminal offence Court may impose penalty: – up to $5,000 for an individual – up to $10,000 for a body corporate Area of interest for ACCC Complaints to AHPRA – unprofessional conduct

29. 29 Advertising – Does The Law Apply to You? Any practitioner registered under the National Law Employers of practitioners Other persons who provide services through the agency of a registered health practitioner Obligation is on practitioner – cannot be delegated

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