Abstract
A new generation of general practitioners has embraced social media for the purposes of peer support, ranging from Facebook groups to less public-facing messaging applications such as Telegram and WhatsApp. This growing trend moves away from traditional forms of peer support, such as Balint groups, long relied upon for support in general practice. We explore the pros and cons of being involved in such groups through members who kindly shared their experiences via an online questionnaire.
GP club: The first rule of GP club is to talk in GP club
The group evaluated was formed originally through like-minded GPs known to each other from medical school or training programmes and gained new members along the way. Like many similar groups, members share cases that they find interesting and current guidelines. They also seek support and validation for the more emotionally challenging experiences in the day-to-day dealings of a typical GP:
The 18 responders to the questionnaire were all in their first 5 years of general practice and 80% used two or three groups for peer support Interestingly, when asked if this medium could replace traditional Balint groups there was an almost equal split between Yes/No/Maybe with the remaining 10% being ‘unsure’ Just under 80% of the group felt membership had improved them as GPs; the rest being unsure. The same split in opinion appeared when asked about the group’s effect on building resilience Around 95% of the group felt that activities such as these should count towards continuous professional development points, and one member had included involvement in appraisal evidence
What the group members feel
The qualitative side of the questionnaire looked at the benefits and challenges of group membership. Two main themes were identified.
Fulfilling patients unmet needs and a doctor’s educational needs
On the whole, peer support of clinical knowledge in a safe environment was widely perceived as the major benefit of group membership. Examples included keeping updated on changing topics (such as Coronavirus guidance) by sharing up-to-date links and where to find resources, discussing specific educational needs and quickly obtaining opinions from colleagues in the group. Some expressed concern that too much input on the same subject could cloud issues and create disappointment in the lack of expertise among the group. There was acknowledgement of a tendency for the group to favour opinion based on seniority. Confidentiality was another challenge raised; for example, the use and sharing of photography to aid diagnosis.
Building resilience
Letting off steam after difficult patient encounters in a protected environment was felt to be a positive feature. However, some felt that contributions could become inappropriate - encouraging behaviour that might lead to disciplinary action. Opinions differed on the merits of the online format for meetings. This format supported a better work–life balance for some, particularly during the pandemic, but others felt that a lack of personal interaction could lead to feelings of isolation.
An interesting point was raised about feelings of anxiety and stress induced by not following group advice. Some felt there was a danger of overreliance on the group that could prevent participants from managing their own learning. Some expressed concern that posting in a group of strangers could be intimidating.
Response time seemed to cause the most divergent opinion. Some found it difficult to obtain information quickly enough for their needs and others felt there was too much activity around specific themes, making it hard to keep up or document for personal professional development.
Final thoughts
Considering the recent pandemic and the necessity for social distancing, the advantages of using social media for peer support are clear. It is noteworthy that in an established group there was no consensus as to whether such online meetings could replace face-to-face meetings, such as for Balint groups. Some of the criticisms could be addressed by using a trained group moderator: a role formally defined in Balint groups. Formal moderation, however, could stifle input. Who would take on that role in an informal group? This could be a thorny issue. Some of the criticisms could be addressed by an informal set of rules about group etiquette.
It is evident in the responses that members have widely differing expectations of the group. Everyone has their own threshold for what is considered acceptable for response times and for the volume of information provided. As life slowly returns to some semblance of normality, organisations and individuals who have developed virtual communities should appraise the use and value of this new modality for meetings and peer support. How much can be delegated to the digital realm and how much should be reserved for traditional meetings, with participants sitting together and discussing things over a cup of tea? The answers may have to be tailored to individuals. Evaluation will help us use digital tools to their highest potential. We want the use of new technology, as ever, to bring improvements and not leave some unintentionally worse off.
ORCID iDs
Dr Philip Sadler https://orcid.org/0000-0001-6870-7166
Dr Suleman Kanani https://orcid.org/0000-0003-1006-588X