Jim, AOP member
“I am a locum optometrist, often working in practices with an exam room where I am the only optometrist working that day. With no other clinician to discuss case outcomes with most of the time, I am thinking of joining a whatsapp group with my peers for clinical support, allowing me to discuss results and management options What should I keep in mind when joining, sharing and using the advice shared in such groups ?”
Dr. Peter Hampson, Clinical Director and AOP Professional
Before joining one of the many WhatsApp groups or other social media forums that exist for optometrists, there are several things to consider.
The first is, if you plan to share information, what information you share, and whether you have patient consent to share images. Anonymized information should be safe to share, but you should ask the practice owner or manager for approval in advance, and you should ensure that you do not provide any information that identifies the patient.
Even anonymized information can be traced back to a specific patient if the condition or presentation in question is rare. The easiest way to ensure that you are allowed to share is to obtain patient consent and document it in the records.
You should then carefully redact the recordings before sharing the images. You should also consider how these images are redacted. AOP has seen complaints where someone took an image of the screen on their phone and then used markup to obscure patient data. In that complaint, because the markup could be removed later, it was suggested that an alternate removed sensitive patient data from the practice.
The next consideration is who is providing the advice and how do you know if it is accurate. Forums and WhatsApp groups contain a mixture of people. Some are very knowledgeable, and others may appear knowledgeable but in fact are not. The only way to know for sure is to read around the subject yourself, which to some extent defeats the purpose of the intended interaction.
Sharing an interesting case is a great form of peer learning, but it’s important to make sure it’s helpful and encouraging and doesn’t introduce risk.
Even those who are knowledgeable may not have all the information needed to provide good advice. More importantly, would they be prepared to follow this advice in the event of a claim or complaint? It should also be considered how a defense before the General Council of Optics or a court of “Someone on WhatsApp said it was…” would like to watch.
This is further amplified in the case of drug prescribing decisions, and the risk increases further with disease severity. Choosing to prescribe a drug without clear clinical guidelines or an established evidence base, because someone else anecdotally reports a positive result, is very risky and would also be incredibly difficult to defend if things go wrong. Although this may be unlikely for a new eye lubricant, for any disease where sight loss is more likely, this could pose a real risk to both patient and practitioner.
This does not mean that WhatsApp groups, social media and forums do not present an opportunity for learning, but it is better to do so in retrospect and by sharing interesting cases, rather than consulting real-time advice and directions. Thinking about an interesting case and sharing it is a great form of peer learning, but it’s important to make sure it’s helpful and encouraging and doesn’t introduce risk. Discussing the case once the patient has been successfully cared for and determining where you could potentially do better next time is invaluable, and sharing this learning process with colleagues can help everyone learn.