How social media is changing leadership and innovation

The GP curriculum and social media

Professional module 2.02: Patient safety and quality of care states that:

As a GP you are in a strong position to influence the care of your own patients, that of your practice population and that of the wider healthcare community

Professional module 2.03: The GP in the wider professional environment states that:

The purpose of clinical leadership is to improve health outcomes and quality of care for your patients

Professional module 2. 04: Enhancing professional knowledge states that:

You should be able to demonstrate the competences of shared leadership so as to maximise the effectiveness of healthcare delivery

The rise in the use of social media by doctors

The general practice community is facing increasing pressures and requires novel approaches to overcome its problems. Social media has become increasingly popular in recent years, resulting in a wider audience. Facebook and Twitter are more common platforms for discussion and LinkedIn is often used to establish individual professional contacts and sharing information. Facebook groups are initially set-up by individual doctors and grow by invitation or request to join, followed by professional verification. Subject threads are started from an individual’s post to the page. They range from educational content and discussion of difficult cases, to promoting solidarity using resilience and political debate. Twitter has gained particular popularity recently for political reasons, with hashtags relating to the junior doctors contract receiving national press coverage. The platform has an established use for educational resource promotion and theoretical case discussion, allowing a large group of students or doctors to share ideas.

Unlike the traditional medical community, social media groups have an alternative hierarchy based on impact, quality of content and exposure. It is not necessarily established through years of experience or position. Therefore, by the very nature of the platform, all contributors can achieve an equal voice if they can develop the skills to ensure that they are heard. Those new to a group, organisation or specialty can mix with established leaders and offer ideas and opinion without distinction.

There are some constraints within closed groups, as moderators can police membership based on content shared, but initial posts are given equal exposure on a timeline. Access to groups is determined only by professional verification, but has an extremely wide inclusion, attracting diversity in its followers. This potentially creates a level playing field for anyone within that group to express their opinion. However, social media skills development is the key to achieving sufficient impact; it must also be remembered that communication via social media should be completed with the same professional standards that we hold in any professional conversation.

This relatively new model of communication can also isolate those that are not familiar with social media and create a new select group of individuals to influence change. It cannot replace traditional organisational structures or the benefit of face-to-face discussion. It is, however, a vitally important tool and one that should be introduced to the wider GP community to augment traditional models. Once basic skills are learnt, the accessibility of social media can be harnessed and used to make new introductions and to keep up-to-date.

The growing popularity of social media within the general practice community is best explained by its accessibility. With increasing time pressures during the working day, a way of feeling part of a larger team at any time of day or night is attractive to many. Social media allows introduction to individuals through sharing commonalities and brings these individuals together free of geographical constraint. It counters the feeling of struggling on alone. In recent years, the rise in Facebook groups and their status on a national level demonstrates the importance of developing a sense of community and how this can empower individuals. Discussing topics of interest with relative strangers allows one to be bolder when compared with any other medical platform. It also involves a much larger spectrum of potential contributors from medical students through to retired doctors.

How to get the most out of social media

The first step to getting the most out of social media is to be involved in it. Consider creating a professional profile for each major platform with relevant and bold information about yourself, your interests and ideas. Different groups of people will be reached through each platform and ideas can be shared widely across all. Once this is achieved the next step is to encourage likes, followers and connections depending on your platform. The expansion of support may be accelerated by gaining permission to post within established groups and actively encouraging the sharing of posts to broaden exposure. Positive feedback and support through others posting your material is hugely satisfying and will boost confidence in an idea or opinion. Those who follow do so out of choice. They demonstrate approval because they choose to listen and spread your ideas as a result of being inspired to do so. The knowledge of this is empowering and results in individuals becoming more courageous with their posts, leading to better content. This is the power of followership. Ironically, new leaders can be born from a platform without a hierarchy at all.

Use social media to inspire shared purpose but be careful not to ‘preach to the converted’ within a self-selecting group. Search groups or individuals more loosely associated with your core audience to add variety. Be bold with those you follow and look at who they are following. There may be groups or organisations that you have never heard of, but they may keep you relevant and up-to-date. When tweeting, include twitter handles such as @RCGP_InnovAiT for something educational or @SomersetLMC for something relevant to local GPs. The theory of this is that they may Retweet your comment and therefore you will reach all those who follow them. Each time an individual receives a new follower they are alerted. Companies use this tactic so that each individual is made aware of their existence and may look to see what they do. Therefore, a clear profile message is important.

Social media and the NHS Leadership Model

The NHS Leadership Model (NHS Leadership Academy, 2013) is formed from nine ‘leadership dimensions’ (Fig. 1) and was produced to help those who work in health and care to become better leaders. The importance of promoting medical leadership in all trainees was highlighted in the Francis report. The model provides a framework through a series of reflective statements. It can be used to evaluate leaders and indeed helps identify how one can personally develop as a leader. It applies equally to the variety of roles and care settings that exist within healthcare. It was developed to help understand how personal leadership behaviours affect the culture and climate that individuals and teams work in. OPEN IN VIEWER

Placed at its core is ‘Inspiring shared purpose’. This dimension sits very comfortably within social media and gives required self-confidence to question the way things are done. For example, one Facebook group was started to promote resilience in general practice; those who started it demonstrated the leadership qualities mentioned in this section by taking the initiative to put things right outside their own remit. By doing so they have provided an environment of support helping a larger team of colleagues to challenge the way things are done. Resilient GP started as a Facebook page but is now a much wider organisation offering courses in resilience and mentorship.

‘Engaging the team’ is another dimension in the model. In general practice that team may be a team of doctors, the entire practice, a federation, Clinical Commissioning Group or indeed using social media it can be the wider general practice community. Social media allows not only inclusion of all those teams but also an ease of communication previously unavailable. Posting or Tweeting statements or suggestions is in effect asking for contributions from a wider team and raising their engagement, as suggested in the model. It allows wider engagement because contributing seems more comfortable from behind a thumbnail picture than face to face in a meeting room with strong characters.

The model highlights the importance of looking out for opportunities to celebrate and reward high standards and sharing stories and symbols of success that create pride in achievement. This is certainly reflected through various Twitter handles and hashtags. Individuals comfortably Retweet stories of achievement, spreading positivity and celebrating the success within general practice. Current challenges faced by a general practice, and indeed the wider NHS, have been met with a sense of pride and solidarity. Social media has been responsible for a swell of political activity. Traditionally, there were a handful of general practice leaders. Now anyone with an active social media account can champion a mind-set of high ambition for a national or indeed international audience.

Perhaps the most natural fit social media has had with the model is the dimension of ‘Sharing the vision’. This questions whether as a leader one communicates honestly, appropriately and at the right time with people at all levels. Social media has been used to establish ongoing communication strategies to deal with the more complex and difficult issues. By its nature it encourages others to become ‘ambassadors’ for a vision and generates excitement about long-term aims. In doing this on an open platform it can demand confidence and integrity under robust and public criticism.

As GP trainees we are often the ones best placed to see opportunity for improvement. It is possible to effect change and those in influential positions can be reached and do welcome innovative ideas. Active involvement in the growing social media platform in medicine gives the opportunity to both understand the issues better and to become involved with the push for effecting change.

Key points

Search for current leaders via social media and browse through their connections or those who they follow; use this to build your own network