Social Media at Your Practice: What Happens When Employees Rant?

Social media is proliferating at physician practices, and not just as a tool for self promotion. 

A recent survey of 4,033 clinicians conducted by online physician community QuantiaMD and Care Continuum Alliance revealed that nearly 90 percent of physicians use at least one social media site, such as Twitter, Facebook, or LinkedIn, for personal use. And more than 65 percent have used at least one social media site to support their professional practice.

But it’s not all fun and games for social media-savvy practices when it comes to the issue of employees who complain about their job.

The National Labor Relations Board recently answered a question on whether a physician can fire an employee for complaining about the practice on a social media site, the American Medical Association reported.

As it turns out, the offending employee may be fired if he or she is the only one complaining. But if multiple employees are talking online, particularly to one another, and have legitimate gripes, no one can get fired, according to NLRB.

But is firing an employee for griping via social media the best way to handle the situation?

Chris Mills, a partner at New Jersey law firm Fisher & Phillips, told the AMA that practices should ask themselves several questions in order to judge if an employee’s comments are offensive. One of the most important ones: Where and when did the social media conversation take place? If online content - and gripes about work - was produced during company time, Mills said, there might be legal cause for termination.

We asked a few physicians how they would handle this situation. What would they do if a physician or other employee at their practice posted one or more negative social comments via Twitter or Facebook?

“This situation is very similar on how a practice should handle negative comments,” said ophthalmologist Randall Wong, a contributor to our Practice Notes blog who runs a small practice in the Washington, D.C., area and consults with physicians on social media. “In many ways, this is the same situation. I would not want a policy that limits what an employee can or cannot say on social media. Those that want such limitations are clearly not well versed in the power of social media. Allowing social media gives you a pulse on your working conditions, and can show that the practice is transparent and strong enough to withstand criticism, albeit from within.”

Another thing to consider is that permitting complaints gives other employees or patients who favor the practice an opportunity to respond to the complaints, but favorably, “thus neutralizing any complaint,” said Wong.

Family medicine physician Craig Koniver, who also contributes to Practice Notes, said there are too many variables to have a blanket policy that an employee at a practice should be outright fired for ranting on a social media site about the practice. That said, practices should be very clear about what is allowed at work and what is not, in terms of Internet and social media use.

“Whether that is in a written-down policy or accepted as the culture of the workplace is up to the employer,” said Koniver. “But every employee needs to know what they can do at work. So if an employee understands where they are in terms of what they can do while at work, that will help everyone be on the same page.”

Family medicine physician and blogger Mike Sevilla said a social-media policy can be as simple as a "Social Media" section of the employee handbook or something that is included under the “Code of Conduct” section.

“There is usually a section about patient privacy, like not talking about patients in places like hallways or elevators,” Sevilla told Physicians Practice. “Adding something about not talking about patients on social media would be appropriate here.”

Koniver suggests reviewing written policies with new employees as well as talking them out. But if more than one employee takes to the web to voice their work-related frustration that could point to a larger issue.

“I think that if an employee feels the need to complain via social media, then there are some serious problems in the first place,” said Koniver. “Why would the employee feel they could not go to the employer and complain? Are they doing it out of spite? Are they doing it to embarrass the employer?”