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Good Practice: The Best and Worst of Using Social Media

Out of the 3,000+ physiotherapists in Alberta, how many of you are on social media? I’m going to guess 98% of you said yes. Now, how many of you are on social media as a professional? I’m guessing 35% of you said yes to this one. Almost half of physiotherapists work in practice settings where there isn’t significant drive or desire to have a social media presence for professional reasons. That leaves about 1,000 physiotherapists who see social media as a way to generate more leads, provide education to the public, and try to carve out niche practices. 

It’s important to realize that it’s possible for social media to be a completely positive experience for both the physiotherapist and the public. But unfortunately, it doesn’t always work this way, so let’s refresh our knowledge on the Standards of Practice and Code of Ethical Conduct before we get into some scenarios when the use of social media didn’t have a positive outcome.   

Physiotherapists work in a broad array of settings such as research, management, education, and various forms of clinical practice settings. Researchers, managers, and educators must also adhere to the Standards of Practice, even though the way they interact on social media may differ from how most physiotherapists use it. 

Most of this article is based on the information found in the Advertising Standard of Practice, but here are other Standards of Practice articles that apply to physiotherapists and how they interact with the public.

Communication Standard of Practice 

  • Uses respectful, open, clear, and honest communication in all professional interactions (e.g., spoken, written, social media). 

​​Professional Boundaries Standard of Practice 

  • Confirms that any exchanges using electronic communication and social media are appropriate for therapeutic relationships established with clients.
  • Demonstrates sensitivity, accountability, integrity, honesty, compassion, and respect in all professional interactions.
  • Understands the impact of power, trust, respect, and physical closeness on relationships with clients, colleagues, students, and others.
  • Treats clients, colleagues, students, and others with respect, avoiding all situations, comments and/or actions (e.g., sexual, racial) that would reasonably be perceived as unprofessional, in violation of human rights, or discriminatory.

Evidence informed Practice Standard of Practice

  • Participates in sharing information related to evidence and best practices to support improvement of client outcomes and the delivery of quality services within the health-care system at large.

The Standard of Practice on Advertising is quite clear on what is acceptable, whether the advertising is done through social media, websites, or the use of print. The physiotherapist must advertise “in a manner that is truthful, accurate, verifiable, not misleading to the public, and in compliance with regulatory requirements.”

The public can “expect that advertising of physiotherapy services and products is not misleading, enables them to make informed choices, and that promotional activities do not unduly influence physiotherapy-related decisions.”

As we can see, there are many Standards that apply to our interactions on social media, and we must keep those in mind as we engage with the public, colleagues, and employers. This is in addition to the expectations of the Code of Ethical Conduct which include that the physiotherapist “act transparently and with integrity in all professional and business practices including fees and billing; advertising of professional services; and real and/or perceived conflicts of interest.”

So, no matter the area of practice or the platform you are using, the messaging should be consistent with the statements above. If one of your posts does not meet those requirements, then you must change the messaging.

Now that we have reviewed the pertinent information, we can begin putting these into practice, and can look at some scenarios….

Scenario #1: A Tale of Two Reviews

You get an email notification that Patient A has left you a 5-star Google review, and Patient B has left you a 1-star review.

Patient A:

“I came to see Melissa for my shoulder injury I hurt at work. She was a great listener and I really felt like she cared. I thought the exercises she gave were exactly what I needed, and my wife Deb is now seeing her too.” 

Patient B: 

“I called 6 times to get an appointment with Melissa and when I finally got in to see her for my knee injury, all she talked about was exercising more. I told her repeatedly that I wanted ultrasound and hot packs since it was what worked for my back injury. She didn’t listen and now I feel worse than I was before.”

Google Ratings can be useful for businesses and physiotherapists looking to build their brand and reach a larger audience. Businesses, business coaches, marketing managers, and even your clinic software push the need to have more google reviews. This bumps you up on Google, which is huge for a physiotherapy clinic. However, you have limited ability to control who posts reviews on your Google page. 

How you choose to respond to reviews and ratings is what is of concern for the College. 

Delving into personal information or accidentally revealing something about someone’s injury, treatment, or status creates a breach of the Privacy/Confidentiality Standard of Practice, even if the reviewer includes private information about themselves in their review. You can find more information in the Privacy Standard of Practice and in the Privacy Guide.

Responding to a positive review with a sincere thank you and even including an emoji indicating your appreciation is completely fine. In the case of a negative review, it is best to thank the reviewer for their input and direct them to call you or the clinic to discuss the situation further, so you can come to a resolution privately, rather than airing it all out in public. 

Scenario #2: Great Expectations

Congrats! You have been notified that your clinic has been voted “Best Physiotherapy Clinic” by your local Chamber of Commerce. You are super excited and post the results to your social media account to let everyone know how excited and honoured you are. 

Before you rush to login to your social media account, there may be some issues with how this aligns with the Standards of Practice. As we reviewed earlier, advertising needs to be truthful, accurate, and verifiable. The public can always check with the Chamber of Commerce to meet the expectation that the advertising is verifiable. 

Whether this information is accurate and/or truthful poses a bit of an issue. How did the Chamber decide that you were the “best” physiotherapy clinic? Was it voting? Gathering data from online reviews? A board decision based on what their friends and colleagues told them? What was it that vaulted you to the top of the list to receive the award?

There is also the expectation that "the physiotherapist refrains from advertising that… Makes comparative or superlative statements about service quality, health providers, and products and/or endorses products for financial gain.” Even if someone else voted or awarded you as “The Best”, you should be aware that you promoting that statement contravenes the expectation of comparing your clinic to another. 

Again, these situations sometimes unfold without any input or direction from you or your clinic. But YOU are in control of what you post on your social media accounts and/or onto your website. Advertising that you are the “Best Physiotherapy Clinic” potentially contravenes our Standards of Practice on Advertising. 

Scenario #3: Oliver Twisted His Knee

Oliver is a physiotherapist that has a strong social media presence and has recently injured his knee. A company approaches him to provide him with a free knee brace if he promotes their product during his injury recovery. Is this appropriate?

The simple answer is no. Oliver cannot accept benefits or incentives from others to sell products. This would be a conflict of interest, since physiotherapists cannot receive “financial or other benefits from other providers related to accepting referrals, providing services, or selling products.”

Other than a conflict-of-interest issue, there is also the potential harm to the public’s perception of the physiotherapy profession. Public perception is a big deal and we do not want to erode the public’s trust in us as professionals. Although products are sold in clinics around Alberta, we have to set guidelines to ensure that we are providing patients with options of where to buy them and are giving them direction as a unique individual. 

Scenario #4: Hard Times on Google

A physiotherapy clinic is located in London, and they have been in the city for a long time but have noticed the clinic slowing down and referrals are starting to drop off. They are blaming the lack of patients due to the new clinic opening down the street, “London Physiotherapy”. 

London Physiotherapy has worked hard to promote their clinic through various social media channels, search engine optimization (SEO), and other marketing strategies. They have recently started posting that they are the premier clinic in London, that they provide elite training services, and are unlike “Other Physiotherapy Clinics”. They also claim they have a new amazing machine that can “cure” your pain.  

First of all, there is not an issue in naming the clinic London Physiotherapy. They chose a name that was available through the government and created an advantage in SEO algorithms. Second, there is not an issue with London Physiotherapy promoting their clinic on social media and other marketing techniques to attract new clients to their business.

However, the issues may arise in how they are promoting their clinic. We know the Standards apply no matter the setting, and advertising on social media is no different. So going back to our Advertising Standards of Practice, we know you cannot do the following:

  • Provide unsubstantiated claims or guarantees of successful results.
  • Make comparative or superlative statements about service quality, health providers, and products and/or endorses products for financial gain.
  • Question or diminish the skills of other providers or the services of other clinics or facilities.

By looking at these expectations, we now know that the messaging London Physiotherapy was putting out on social media was not consistent with the Standards of Practice, and they would have to be taken down or modified.

It is important to remind yourself that as a physiotherapist you are a professional. The majority of the issues that arise in the world of social media are the use of unprofessional and inappropriate pictures, comments, posts, etc. Next time you’re about to reply to a review, post a clever comment on your feed, or promote a service, make sure it complies with the expectations of the College and of your colleagues.  

Or maybe keep this quote in mind:

“My meaning simply is, that whatever I have tried to do in life, I have tried with all my heart to do well; that whatever I have devoted myself to, I have devoted myself to completely; that in great aims and in small, I have always been thoroughly in earnest.”

Page updated: 26/04/2022