Social media created a "goldfish bowl of real-time commentary" on the junior doctors' dispute that made it much harder to resolve, the Government's chief negotiator has said.
Health Secretary Jeremy Hunt said he would impose new pay and conditions on junior doctors in England, following advice from Sir David that an agreement was "not realistically possible".
The decision was met with anger from medics and the BMA has vowed to fight the imposition.
Sir David, chief executive of Salford Royal NHS Trust, said social media meant compromise was "increasingly going to be difficult" but was not the main reason talks failed.
He told The Times: "It's been done in a goldfish bowl of people giving real-time commentary and that makes it more difficult to create the space for negotiations.
"In the cold light of day the gap between us is tiny. Is it really worth going on strike for more pay on Saturdays for the people who only attend work on Saturday once a month?
"There's an extent to which the dispute isn't really about the contract. The contract is the totem pole that people have danced around. But it's all the other factors - the not feeling valued, taken for granted - that are more at play than the terms of the contract."
Among those that attacked the Health Secretary was doctor Rich Bowman, 27, who said "screw you Jeremy Hunt" in a Facebook post shared more than 60,000 times at the time of writing.
"All we do is for our patients, how dare you try and turn them against us. All of this is your government's fault," he said.
Sir David's comments come after several hospital bosses distanced themselves from suggestions they agreed to a new junior doctors contract being imposed after their names were linked to a letter Mr Hunt used to justify the decision.
The names of 20 NHS health trust bosses in England were attached to a letter from Sir David advising the Government to do "whatever it deems necessary" to break the deadlock.
But more than half of the chief executives named have said they did not agree to the contract being forced on medics, though they backed the terms being offered by the Government.
The BMA has already staged two walkouts and further strikes and legal actions are possibilities, while Hunt has been warned to expect an "exodus" some junior doctors may refuse to sign new contracts which are due to be implemented from August.