A recent Twitter controversy opened old wounds about the use of professionalism as a tool for policing ethnic minority doctors, writes Aaliya Goyal

Those who are active on Twitter will have noticed “Philip Lee” trending on Thursday 24 June 2021. The outpouring of support for Philip Lee from the #MedTwitter community came after Lee, a consultant physician in acute medicine and medicine for the elderly, was targeted by a member of the public for his stance on wearing masks on the tube. This incident sent ripples through #MedTwitter, not only because a doctor was being abused on social media for advocating mask wearing, but also due to the response from the General Medical Council (GMC). The GMC’s reply tapped into deeper feelings held by many healthcare workers about how our professional regulator responds to complaints about doctors who are from ethnic minority communities. 

For those who may be unaware, Lee is a well known and much respected member of the medical Twitterati and has amassed a significant following of more than 67 thousand people. He is known to tweet humorous observations and commentary on medicine and life in general. He is, like many health professionals, a strong advocate for following government guidance during the covid-19 pandemic, including wearing masks in public enclosed spaces. He is of Chinese heritage. 

On 22 June, a Twitter discussion was started about being wary of people who did not wear facemasks on the tube. As well as replies agreeing with the points raised, the thread attracted responses from people across the world who’ve taken an “anti-mask” stance and who used Lee’s position on wearing masks to question his ability to care for his patients. 

Lee’s tweet “Also if I was in a tube carriage where half the people have their faces exposed, I too would be wary, CAUSED BY THEIR DISEASE SPREADING FACE HOLES” was quote-tweeted by an individual calling himself Phil Edwards. This account had an emoji of a glass of milk next to his name—a known symbol of white supremacy. The quote tweet included a screenshot of Lee’s tweet and a screenshot of Lee’s GMC entry and GMC number. The accompanying tweet tagged in the GMC, referenced the GMC’s guidance “Good Medical Practice,” and read as follows: “Attn @gmcuk I report below conduct. I contend the language is wholly unbecoming falls foul of pa.65 of the GMP: “You must make sure that your conduct justifies…the public’s trust in the profession.” and corresponding Social Media guidance on containing said requirement.” 

Instead of ignoring the tweet, the GMC responded early the following working day on their Twitter account with a link to their complaint form. This provoked an outcry from #MedTwitter, appalled by the response on multiple levels. 

The pandemic has seen a wave of abuse directed at healthcare and science professionals on social media. These professionals have worked hard to deliver public health messaging on top of a sustained increase in workload for over a year. Many have felt demoralised and unsupported by the government and our professional bodies during this time. 

The GMC’s tweet was interpreted by many as encouraging a complaint against an ethnic minority doctor from a white supremacist. It came at a time when trust in the GMC is particularly low among doctors from ethnic minority communities. At a recent employment tribunal, the GMC was found to have racially discriminated against a consultant urologist, Omer Karim, a judgment the GMC says it intends to appeal. This follows high profile cases involving other ethnic minority doctors, including Hadiza Bawa-Garba and David Sellu. 

The GMC’s own statistics on the disproportionately high percentage of complaints referred to and pursued by them against ethnic minority doctors (action partly paid for by the annual registration fees of other ethnic minority doctors) has led to deep mistrust and discussions about the use of professionalism as a tool for policing ethnic minority communities. The GMC’s statistics also show that ethnic minority doctors are also more likely to be sanctioned than their white counterparts. We know that the process of being investigated takes a huge toll on doctors’ mental health, and the GMC has recently set targets to put an end to the disproportionate number of referrals that ethnic minority doctors receive. 

Many doctors highlighted the need to show solidarity with Lee by changing their name to Dr Philip Lee or variations on Twitter, in protest at the GMC’s tweet. Hashtags including #IAmPhilipLee and #DrPhilipLee began to trend, and a tweet was copied and pasted by numerous #MedTwitter accounts which read: “I am Philip Lee. And so is every HCW who has worked through the worst public health crisis in living memory. Promoting mask wearing is not a crime. HCWs do not deserve targeted abuse from conspiracy theorists and threats of reports to their regulator for promoting public health.” 

And what of Philip Lee himself? He deactivated his much followed account. Colin Melville, medical director and director of education and standards at the GMC, tweeted the following day to say he had had a discussion with Lee, including how the GMC can signpost information more clearly. Yet the GMC still has a long road ahead to repair doctors’ frayed trust in them.

Aaliya Goyal is a GP and deprivation health fellow. She is on the RCGP Midland Faculty Board. Twitter @Aaliya_UK

Competing interests: none declared.