Monday, July 7, 2014

Still trying to get my head around social media and testamonials for midwives in Australia

A couple of months ago, the regulatory body for midwives (and health professionals) in Australia, AHPRA, brought out guidance about the use of social media and testimonials which caused a kerfuffle to say the least. Now that guidance has been clarified and the dust has settled, I have gone back to finalizing the Australian College of Midwives' guidelines for social media so that we can get on and publish them. But having re-read the latest AHPRA advertising and social media guidelines I find myself still in a bit of a dither about exactly what the ACM should be advising its members.

I understand that a testimonial is a "statement that says something positive about, or recommends a midwife’s qualification, care/service/business, character or conduct". This may be solicited or unsolicited. What I cannot get my head around is what AHPRA sees as the difference between a testimonial and a favorable comment posted on a midwife's social media site. I am also struggling to see how birth stories that midwives publish fit into the picture - are they commentary, or could they be perceived as testimonials?

Here is the draft of what I have written so far.

1      Advertising and testimonials

The National Law states that midwives must not use testimonials to advertise their services. A testimonial is a statement that says something positive about, or recommends a midwife’s qualification, care/service/business, character or conduct.  Midwives are not allowed to use testimonials to advertise their services because the testimonial may unduly influence the public,

mis-represent the service, business or midwife, or prevent consumers from making informed choices about their care. In the ‘Guidelines for Advertising Regulated Health Services’ (2014), AHPRA states that midwives “cannot use or quote testimonials on a site or in social media that is advertising a regulated health service, including patients posting comments about a practitioner on the practitioner’s business website.”
Best practice points:

  • If social media is used to advertise midwifery practice/business, the midwife should always publish full name and contact details, as well as professional qualifications.
  • Do not publish solicited or unsolicited endorsements, testimonials or materials that could be perceived as recommendations in any online space.
  • If a woman would like to provide a favourable comment or review of a midwifery service, request that she do this in her own online space. 
  • Do not publish a woman’s birth story if it describes or comments on quality of the midwifery care provided.

  • For further direction visit ‘Health of the Net (HON) Code of Conduct’ (; an internationally recognised standard for health professionals on how to provide online health information to women and families.
Best practice example

A new mother wrote a long comment on her midwife’s blog thanking her for the excellent care she received from the midwife. The midwife thanked the mother very much for her lovely compliment, but explained that she had to remove the comment because it could be perceived as an testimonial. Before the midwife deleted the comment, she took a screen shot and saved it as evidence of her practice for the next time she had her Midwifery Practice Review. 

What do you think? Too conservative, or about right? What would you change and why?

Image: 'Free Social Media Networking Icons - 154 Orange Grunge Stickers'


Sarah Stewart said...

NMBA FAQ to accompany the AHPRA advertising guidelines which makes these issues a little easier to understand:

moira stephens said...

Tricky. Reading this excellent attempt to provide clear guidance in a such a changing and indeed slippery are arena arena, the first thing that comes to mind is LinkedIn. It activively promotes the use of endorsements for practice and recommendations - it is part of it's very fabric. Is this acceptable as it is framed in a professional arena ? Can everyone except midwives - and therefore any member of a healthcare team - not use linked in? What of the professional woman who happens to give birth and wishes to endorse the professional services of her midwife - is there a veto? I know this isn't helpful but it is an extremely difficult and labile space - ethical guidance may be the only compass?

Joy Johnston said...

Sarah I think the NMBA has taken an excessively conservative approach to birth stories in particular, and that the midwifery profession should resist this restriction. I think we can argue that a birth story written by a client, posted on a midwife's business website, is not necessarily advertising, and should not be classed a testimonial.

I consider these deeply personal accounts, which may coincidentally identify the midwife, to be educational ranter than testimonials. There is nothing at all of an advertising nature in them.

On the other hand, if a midwife were to distribute a flyer advertising her services (or do the digital equivalent on social media), and use a statement such as "Sarah was my midwife and I found that I could trust her at all times, Sally Jones" - that's a testimonial, and even though it might be true, and might have been written in good faith it's clearly being used in advertising, and is prohibited in the health practitioner law.