Videos like the recording widely distributed on social media last year by Thomas Alan Holmes (aka Tom London) about his treatment at the Helen Joseph Hospital (HJH), is a form of cyber-bullying against doctors, writes a psychiatry expert.
In the video, Holmes detailed his admission, including the hospital infrastructure, hygiene concerns, safety, theft, death of patients around him and care by healthcare workers, focusing on the doctors and medical students.
The video was one of many in which he documented his experience at the hospital, referring to medical doctors as “cockroaches” who “don’t deserve to exist”. But Dr Tejil Morar, from the University of the Witwatersrand, argues in the SA Medical Journal that this constitutes a form of cyber-bullying and harms the doctors and students concerned. Additionally, she asks who is there to defend them?
Morar writes:
The narrative that unfolded after the videos posted by Holmes was interesting. On 8 September 2024, the Gauteng Department of Health issued a statement saying that “while the matter is being investigated it is important to note that nine months ago the department launched a provincial campaign called ‘I serve with a smile’, aimed at improving staff attitude and patient experience of care”.
The South African Medical Association (SAMA) issued a statement the very next day, declaring that “while there is no justification for doctors and nurses to mistreat patients, the conditions they work under cannot be ignored”.
“While there are many doctors who treat their patients well, a significant number still don’t have the attitude patients require doctors to have”.
Most medical doctors working in the state sector are affiliated with SAMA rather than the Medical Protection Society (MPS), as generally, medico-legal cover is provided by the government.
One of SAMA’s mandates is to represent medical doctors experiencing challenges at work
On 10 September 2024, the Dean of the Faculty of Health Sciences at the University of the Witwatersrand (Wits) – affiliated with HJH as a teaching hospital – Professor Shabir Madhi, issued a statement in which he urged Wits staff and medical students to treat patients with dignity, compassion and respect.
He “acknowledged and thanked the many doctors and healthcare professionals who carry out their duties impeccably and with distinction, despite the challenges they face”, but the conclusion was “should you come across students or staff who do not adhere to these values, please direct these complaints to the Head of School, Professor Daynia Ballot, and the Deanery, so they can be addressed immediately”.
There were no statements specifically defending medical doctors and/or medical students working at HJH at the time against the attacks made by Holmes.
On 11 March 2025, the Office of the Health Ombud released the “investigation report” into allegations against poor management at Helen Joseph Hospital.
The report found that Holmes’ allegations of unavailability of hospital beds and poor infrastructure in the facility were substantiated. Additionally, leadership challenges, substandard support services, staff shortages, finance and supply chain issues and governance challenges were highlighted.
However, allegations that doctors disrespect patients and treat them like “cockroaches” while providing poor clinical care were found to be unsubstantiated.
This editorial does not focus on the facilities, infrastructural challenges, staff shortages, working conditions nor the dignity of deceased patients in the public healthcare sector, although this does not minimise these challenges in any way.
The separation of the medical doctors from the hospital environment is important in this case, specifically to avoid scapegoating.
The focus is on the content of the videos targeting the medical doctors and medical students at HJH.
While patient feedback is extremely valuable in improving the quality of service doctors provide, aggression on social media targeting medical doctors and students is concerning. Weatherbee and Kelloway define cyber-aggression as “aggression expressed in a communication between two or more people using information and communications technologies, wherein at least one person in the communication aggresses against another to effect harm”.
Cyber-bullying is differentiated from cyber-aggression in that the former involves repeated acts and a power disparity between perpetrator and victim.
One might argue that Holmes’ social media post mentioning the doctors at HJH constitutes cyber-bullying.
Statements such as “shame on the doctors that think they have the right to call themselves doctors, that run around this hospital and treat ..patient like a cockroach … doctors. You’re the cockroaches … you don’t deserve to exist … not the patients you are busy experimenting on and killing”, and in another post, “the treatment is bad… I don’t know why doctors become that” can be considered aggressive, patronising, an over-generalisation, demeaning and harmful towards the emotional well-being and reputation of the medical doctors and students targeted.
The risk of this includes prejudice, and is likely to affect how the public view and treat all doctors and medical students at HJH, and possibly all doctors in the public sector.
Such statements also span multiple videos in repeated acts, and a unique power disparity exists between doctor and patient virtually.
While patients have the freedom to disclose the names of medical doctors publicly, doctors are bound by doctor-patient confidentiality and the Protection of Personal Information Act 4 of 2013.
Patients have the right to report medical doctors and students to the Health Professions Council of SA (HPCSA), hospital management structures and/or university authorities, whereas medical doctors do not have this right, are largely unaware of and/or have poor access to such avenues to report patients – perhaps another flaw in the system.
In the report released by the Office of the Health Ombud, it was declared that all requested documentation was received from HJH, barring the occupational health and safety certificate of compliance, as HJH does not possess one.
While legally this is a major concern, it can also be interpreted as inadequate in creating a safe workspace for employees (including doctors).
Communication, professionalism and health advocacy are part of the core competencies expected of healthcare practitioners by the HPCSA, and these are qualities all doctors and medical students should display.
However, should a doctor or student fall short in any of these domains, this does not constitute grounds for cyber-bullying or cyber-aggression.
There are proper channels for patients to follow in these instances, which should aim to protect the dignity and human rights of all parties involved, including medical professionals.
If these channels are not followed, and allegations towards doctors are found to be unsubstantiated, who is responsible for picking up the pieces from the harm done to the morale and reputation of these doctors and students in the public sector?
T Morar – Department of Psychiatry, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand
See more from MedicalBrief archives:
Helen Joseph Hospital woes symptom of a bigger problem
Patient’s viral video highlights state of public healthcare