Several years ago, when the British Medical Association openly warned U.K. docs and med students NOT to make “personal or derogatory comments” online about their patients (guidelines mercifully updated since then), I became even more alarmed than I had been. Why, I wondered at the time, was it even necessary to issue this warning to intelligent, educated brainiacs who practice medicine? And are there some physicians who should simply not be allowed on social media?
Lately, I’ve been rethinking my former alarm. And the reason for the rethink is this: I’ve noticed that many of you physicians might be in danger of abdicating your traditional role as our medical educators. . .
There is far too much unadulterated trash masquerading as reliable healthcare information out there for informed medical professionals to sit silently on the sidelines anymore while viral misinformation continues to spread.
Case in point: the truly cringe-worthy gospel preached by that wildly popular cardiac surgeon-turned-medical hypester Dr. Oz (like “Five Libido-Boosting Super-Foods That Will Save your Marriage” ). We have the makings of a wholesale hostile public rejection of sound medical knowledge around every corner.
(And by the way, there are NO “libido-boosting super foods that will save your marriage” if people are now willing to count on a food item as its only salvation).
We already see evidence of this kind of public rejection in the disturbingly lowered vaccination rates and higher epidemics of measles (a leading cause of vaccine-preventable childhood mortality) as parents follow the unabated anti-science voice out there. Just think about this stat from the World Health Organization: measles cases reported in the first three months of 2019 were 300% higher than in the first three months of 2018, with outbreaks in every region of the world, even in countries with high overall vaccination coverage where it spread among clusters of unvaccinated people.(1) That’s the “herd immunity” benefit of vaccinations: with 90-95 per cent vaccination rates, the disease is prevented. Without it, it is not.
I now believe that unless more of you who actually know what you’re talking about step forward to help balance the onslaught of rampant bafflegab, health misinformation that goes viral will become the rule, not the regrettable exception.
As a concerned heart patient and blogger, I’ve observed a one-sided tidal wave of online health misinformation that’s being met with an underpowered, willingly un-armed response from those on the other side – the ones who are actually most likely to have a credible voice if only they were willing to use it.
There are at least five good reasons for doctors to become more active in social media, based on the online experience of radiation oncologist Matthew Katz, MD (on Twitter as @subatomicdoc):
- learning from patients
- teaching patients
- continuing medical education
- learning about your profession
- exchanging information with other healthcare providers
There are already a number of health care professionals who are doing this online in a big way. For example, here’s just a tiny sampling of some experts I follow and trust:
- Kentucky electrophysiologist John Mandrola, MD blogs wisely on what works – and what doesn’t – for heart patients diagnosed with atrial fibrillation and other cardiac issues. He’s on Twitter as @DrJohnM.
- Vancouver’s James McCormack, PharmD is a professor at the University of British Columbia, who – along with family physician Mike Allan, MD – produces the lively Best Science Medicine online podcast that they call “BS without the BS”. Dr. McC. also teaches annual drug therapy courses (“healthy skepticism when it comes to the use of new and old medications”) for docs, nurses, nurse-practitioners, pharmacists, and med students. He tweets at @medmyths.
- Dr. Yoni Freedhoff teaches us about our relationship with food and the food industry’s relationship with that food. He also teaches at the University of Ottawa. Check out his blog Weighty Matters and his posts on Twitter (@YoniFreedhoff).
- Dr. Jen Gunter is a Canadian OB-GYN and pain specialist practicing in San Francisco who is especially wary of snake oil misinformation aimed at women. She tweets prolifically at @DrJenGunter. She also writes a New York Times health column, hosts the Jensplaining TV show, and is the author of the best-selling book, The Vagina Bible. Her popular blog most recently addressed a woman whose fiancé insisted she have a premarital exam checking her hymen – to be performed by her father-in-law and witnessed by other future male relatives.” (If you already know and love Dr. Gunter’s feisty ways, you can just imagine her response to that goofy scenario.)
NOTE FROM CAROLYN: I must comment here about Dr. Gunter’s latest public scuffle. It was with the once-venerable Scientific American, who ran an opinion piece that The American Council on Science & Health called a “bizarre, anti-medical rant” attacking Dr. Gunter’s personal style, her qualifications, and worse, her credibility. The writer took specific aim at how Dr. Jen sometimes starts her Twitter replies to those pushing health nonsense (Hello, Gwynneth Paltrow!) with “I am a board certified OB/GYN, and…”
The writer’s open hostility is not uncommon when an informed woman dares to stand up to speak her mind. We take it in stride if a male expert authoritatively expresses his opinion along with his credentials, but when Dr. Gunter does it, she gets entire op ed pieces thrown at her head. In the end, however, I’m happy to say that she won that scuffle. SA ultimately removed the article.
What all doctors do have at the very least is the ability to start compiling a basic list of credible online health resources you could recommend to your own patients. Get them printed like you would a prescription pad.
Because if doctors don’t do the recommending, their patients will seek out the Gwynneth Paltrows and Jenny McCarthys out there who will.
While I’m primarily addressing physicians here, I would also love to see more Physician Assistants, nurses, nurse-practitioners, paramedics, pharmacists, dietitians and other healthcare professionals share their specific expertise on social media. What are the questions your patients are asking, and how could you share your responses to help more of us?
Ali Jalali, MD (@ARJalali) of the University of Ottawa’s Faculty of Medicine reminds his colleagues of this crucially important fact:
“Your patients, your students and your residents are already on social media, and they may not be safe on it. It’s part of your social accountability to be there to help them.”
And please docs, since we’re talking about enhancing credibility here – please use your own name on social media.
In the spirit of sharing good advice, never forget Dr. Farris Timimi‘s brilliant 12-word rule of health care social media:
“Don’t Lie. Don’t Pry. Don’t Cheat. Can’t Delete. Don’t Steal. Don’t Reveal.”
Dr. Timimi (@FarrisTimimi) is the medical director for the Mayo Clinic Center for Social Media. He likes to refer to social media participation as a “conversation” for which doctors should know the risks and behave accordingly, but not be so risk-averse that they do not participate.
Don’t be like the Emergency physician in Rhode Island who was fired for posting identifiable content about her trauma patient. Don’t be like the two idiots who posted a ‘thumbs up’ pic of a dead patient, a decision that got them kicked out of medical school (that’s so hilarious, kids!) Don’t be like the five California nurses fired for openly discussing their patients on Facebook.
In other words, don’t be stupid.
Start by browsing what’s out there to help discover your own niche. “Address those societal needs that you think are most important” is the first suggestion of the Mayo Clinic Social Media Network’s guiding principles for physicians, along with other solid social media tips. Check out those healthcare colleagues whose work you respect – see what they’re up to online. Learn the tools.
And as Dr. Timimi warns his colleagues:
“The biggest risk in healthcare social media is not participating in the conversation.”
1. “New measles surveillance data for 2019”. WHO. 15 April 2019.
Carolyn Thomas is a heart attack survivor, Mayo Clinic-trained women’s health activist, speaker, Heart Sisters blogger, and author of “A Woman’s Guide to Living With Heart Disease” (Johns Hopkins University Press). You can find her on Twitter or in short Vimeo films like this 2-minute one, or featured in many media interviews. Last year, she quit the time-suck that is Facebook after yet another security fiasco there.
Question for Patients: Which health care professionals do you like to follow on social media?
- Mayo Clinic’s online training certification course in Social Media Basics for Health Care (eligible for AMA PRA Category 1 Credits™)
- The Medical Hierarchy Shift
- The questions you don’t ask your doctors
- Why don’t we listen to doctors’ heart-healthy advice?
- Why don’t patients take their meds as prescribed?