Amy Wilson, Year 2
A row over female doctors in bikinis has led to fresh debate over privacy and how behaviour on social media might affect the public image of the profession. It began when the Journal of Vascular Surgery published an article entitled ‘Prevalence of Unprofessional Social Media Content Among Young Vascular Surgeons’ (Hardouin et al., 2020). The article was later retracted and the authors apologised on Twitter after it sparked a hashtag on social media that has seen doctors of all genders post pictures of themselves in swimwear to protest traditional views on professionalism.
It was written by three senior vascular surgeons with the aim of evaluating how levels of professionalism on physicians’ social media affects doctor-patient relationships (Hardouin et al., 2020). The surgeons created fake Twitter, Instagram and Facebook accounts to surveil the feeds of 480 of their peers—without their permission (Hardouin et al., 2020).
Though their methods caused debate, it is their conclusions that raised the most objections. The biggest area of contention was around what Hardouin et al (2020) called ‘inappropriate/offensive attire’, referring to female doctors who posted ‘provocative’ images of themselves in bikinis or Halloween costumes.
The way in which female doctors were singled out in the study—despite the authors concluding that unprofessional conduct did not differ significantly between men and women—sparked a huge response. ‘#MedBikini’ went viral across multiple social media platforms, prompting many doctors to post pictures of themselves in bikinis and other similar attire in an open criticism of restrictive views on professionalism.
So, is this behaviour actually unprofessional? Given the conclusion that there were no violations of the Health Insurance Portability and Accountability Act (HIPAA; an act designed to protect patient health information), nor was there anything requiring disciplinary action, this would suggest that it is not unprofessional behaviour.
While this was a US study, the problem of how doctors use social media remains relevant here in the UK. The General Medical Council (GMC) guidelines do not explicitly call this behaviour unprofessional. In ‘Doctors’ Use of Social Media’ (GMC, 2013), the GMC calls for doctors to maintain a professional boundary and not to do anything to jeopardise trust in the profession. The question this raises is whether a balance can be had in maintaining both professionalism and liberty in a doctor’s free time. Does wearing a bikini really jeopardise trust in a doctor?
The answer is, unfortunately, yes. It appears that this traditional view of professionalism stems from subconscious biases about what a good doctor should look like. A 2017 study by the University of Cambridge found that attractive women are thought of as being worse scientists than their peers (Gheorghiu et al., 2017). A public statement by the editors of the Journal of Vascular Surgery has suggested that this bias was present in the study; the researchers admitted that one error in their review process was the presence of conscious and unconscious bias on their part (Shapiro, 2020).
Dr. Mudit Chowdary, a Chief Resident in Radiation Oncology at Rush University in Chicago, openly criticised the study. He agreed with the idea that doctors should be held to a higher standard of professionalism, especially when it comes to issues of confidentiality. However, he saw the medical field’s view of higher standards as ‘highly conservative and misogynistic’ (Kato, 2020).
This is not the first time there has been a viral hashtag surrounding conservative views of what constitutes professionalism. In 2016, #ILookLikeASurgeon began to trend, drawing attention to gender and racial diversity in a typically white and male-dominated field. Dr Elizabeth Comen, a New York oncologist and breast cancer specialist, summed up the importance of these hashtags by saying ‘The more attention we give to these issues, the less women will feel alone in their experiences’ (Kaur, 2020).
Feelings of restriction, both in professional and personal life, can easily lead to medic burnout. Toniya Singh, chair of the American College of Cardiology’s Women in Cardiology Council, said, ‘What is inappropriate to one person may not be inappropriate to another person’. She added that the study seemed to ask for, ‘physicians to censor themselves from just doing things that normal people get to do’ (Cox, 2020).
The nebulous nature of what the study considered unprofessional did not only apply to clothing choices. Although the vascular surgeons study did reference issues like patient privacy, behaviour labelled as unprofessional also included drinking alcohol and ‘controversial social topics’, such as discussions of LGBTQ+ rights, abortion and gun control (Hardouin et al., 2020). Elisabeth Bik, a blogger on science integrity, wrote: ‘Is a doctor who posts about gun control laws after sewing up another gunshot victim being unprofessional?’ (Bik, 2020)
The #MedBikini debate continues. Many are calling for changes to long-established, conservative views about what it means to look and act a doctor. Those changes might be a while coming, but they also raises vital questions about the role of a doctor. Perhaps it was put most succinctly by Christina LaGamma who tweeted: ‘In medical school we are taught to honour the body, including all physical, mental, and emotional aspects. That should not preclude me from loving and being confident in my own’ (Cox, 2020).
References
Bik, E. 2020. #MedBikini paper will be retracted. Science Integrity Digest. 26 July [Online]. [Accessed 31 October 2020]. Available from: https://scienceintegritydigest.com/2020/07/26/medbikini-paper-will-be-retracted/
Cox, C. 2020. #MedBikini vs JVS: Paper Spurs Debate Over Sexism, Social Media in Medicine. TCT MD. 30 July [Online]. [Accessed 31 October 2020]. Available from: https://www.tctmd.com/news/medbikini-vs-jvs-paper-spurs-debate-over-sexism-social-media-medicine
General Medical Council. 2013. Doctor’s Use of Social Media. London, GMC. 22 April [Online]. [Accessed 6 October 2020]. Available from: https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/doctors-use-of-social-media/doctors-use-of-social-media#paragraph-4
General Medical Council. 2013. Maintaining a professional boundary between you and your patient. London, GMC. 22 April [Online]. [Accessed 6 October 2020]. Available from: https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/maintaining-a-professional-boundary-between-you-and-your-patient/maintaining-a-professional-boundary-between-you-and-your-patient#paragraph-3
Gheorghiu, A. I., et al. 2017. Facial appearance affects science communication. Proceedings of the National Academy of Sciences. 114 (23), 5970-5975
Hardouin, S., et al. 2020. RETRACTED: Prevalence of unprofessional social media content among young vascular surgeons. Journal of Vascular Surgery. 72(2), 667-671.
Kato, B. 2020. Doctors are sharing bikini selfies after study criticizes ‘inappropriate’ attire. NY Post. 24 July [Online]. [Accessed 31 October 2020]. Available from: https://nypost.com/2020/07/24/doctors-share-bikini-selfies-to-protest-controversial-study/
Kaur, W. 2020. “Too Pretty To Be A Doctor”: Female Physicians, #MedBikini, And Who Determines What’s ‘Professional’. Elle. 10 September [Online]. [Accessed 6 October 2020]. Available from: https://www.elle.com/beauty/a33796252/women-doctors-medbikini-sexism/
Segal, J. 2020. Bikinis and Unprofessionalism. Byrdadatto. 3 September [Online]. [Accessed 31 October 2020]. Available from: https://www.byrdadatto.com/banter/bikinis-and-unprofessionalism/?utm_content=139104967&utm_medium=social&utm_source=twitter&hss_channel=tw-732612374306258945
Shapiro, N. 2020. Viral #MedBikini Response To Controversial Manuscript Leads Editor To Retract Article. Forbes. 23 July [Online]. [Accessed 6 October 2020]. Available from: https://www.forbes.com/sites/ninashapiro/2020/07/25/viral-medbikini-response-to-controversial-manuscript-leads-editor-to-retract-article/#39a8fd331f47
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