How to be a doctor in the online social media world.

Tips and ideas for physicians going online.

Why

The reasons physicians have a social media presence are varied. They go from feeling they have to for PR reasons, because their colleagues say they should or because scientific events such as conferences work with Twitter or other similar platforms. Others are clear that it is a way of getting their message across proactively, whether it be their own clinic or for a more widespread impact of their research. Others lurk without posting or tweeting but follow tendencies and institutions whose message is of their interest. And finally, there are those who find it relaxing and enjoyable to scroll through in their spare time and read up about non-medicine related topics. Their social media presence can be completely non-medical and reserved to friends and family on Facebook and Instagram. Most of us are probably a combination of all of the previous options and vary according to which social media platform we use.

Where

The choice of platform will be very much dependent on the why. Twitter lends itself to shorter interactions with people who you may never have met but work in a similar field. It is also a space where recent research can be discussed in a no holds barred manner, or with less reserve or diplomacy than would be the case face to face. The hashtag #MedTwitter is one way of starting on Twitter for those not already using it.

Facebook is often used more for family and friends, but it is also used for promotional reasons by physicians practising privately. Now that Instagram belongs to Facebook you can share images and posts across both platforms more easily.

YouTube has been used extensively in medical training and if a picture is worth a thousand words, a video must surely be worth a few thousand more especially when it comes to practical procedures. Personally I found the Lancet video from the REVERT trial on the modified Valsalva manoeuvre for supraventricular tachycardia much easier to understand than any written description.(1) YouTube is often the place you can find conference events, whether live or pre-recorded. You can save on time and money by picking out speakers and experts you respect to listen to in the comfort of your own home, and also access previous editions. For those who have a bit of cabin fever at the moment, that is the restlessness which occurs in the context of prolonged isolation I can highly recommend the World Extreme Medicine conference. It covers everything from basic medical attention in the Arctic to humanitarian planning, and also the adventures of medics themselves.

Who

Who to follow or interact with can be a bit daunting. Obviously national and international institutions and journals are easily found. This can lead you to experts in your field of interest as they will retweet or repost from accounts of people working with them. The blue tick next to a user’s name indicates that it is a verified account, i.e., it is truly the person or institution it purports to be. It does not however confer any prestige or validity to what that person does with that account. An easy example is to look at the account of the 45th President of the United States of America! Facebook and Instagram have similar systems in place to verify accounts. You should also be aware that many people delegate their social media presence posts and tweets to an online community manager. This is a person or team who work making sure that the person or institutions’ audience are engaged with their message.

The hashtag #followfriday can lead you to interesting new people especially if they are recommended by people whose recommendations you respect.

What

What you decide to post or not will be very much determined by the reason for which you are on social media. It can help to look at who you want to engage with and what your audience is likely to want to see. Twitter analytics will show you which posts have received the most interaction. The recommendations are to use photos or other types of media for maximum interaction. If you are retweeting information of interest you can do that without adding a comment by just not writing anything in the box which twitter puts up to encourage you to comment. Tweetdeck is another tool which you can use to program tweets, follow specific hashtags or accounts. You can also mute accounts or hashtags if you think you know enough about the 45th President of the United States for example. Of course, you can also go with your instinct and use social media in a less formal way and see where it leads you. A sense of humour goes a long way but in an online world without borders it sometimes gets lost in translation…

Regulations

The GMC, or General Medical Council in the UK, tells us that “The standards expected of doctors do not change because they are communicating through social media rather than face to face or through other traditional media, but new challenges can arise.”(2) It goes on to point out the advantages of international networks and engaging the public in health discussions whilst cautioning against the danger of confidentiality being breeched. You are warned by the GMC that no social media platform can guarantee confidentiality no matter what privacy settings are in place. The same obligations of confidentiality and respect for both patients and colleagues remain. Watching some twitter spats I’m not sure that everyone has read that last obligation. The GMC also reminds doctors that should they be approached by any patients on social media, they need to be redirected to official channels of communication and medical advice. How you present yourself is also regulated, you should not be an anonymous doctor, but instead if you do identify as a doctor, also give a name in order not to be mistaken for representing the opinions of the profession as a whole.

The Catalan College of Physicians has also published recommendations for doctors using social media.(3) It is based on the duty of the doctor being first and above all to their patient. As such this trumps, or comes before, the doctor’s freedom of expression in social media.  There is also a reminder that for much of society a doctor is always a doctor even in their freetime. This may be changing when you see prominent doctors doing their dance moves on tiktok in non-clinical contexts and also in different cultures where the status of a doctor no longer has the traditional gravity and prestige.

The IFMiL runs a course which goes into more depth as to how to ensure you have a professional online presence, how to acquire digital competencies and improve digital innovation.

1.        Appelboam A, Reuben A, Mann C, Gagg J, Ewings P, Barton A, et al. Postural modification to the standard Valsalva manoeuvre for emergency treatment of supraventricular tachycardias (REVERT): A randomised controlled trial. Lancet [Internet]. 2015 Oct 31 [cited 2020 Nov 29];386(10005):1747–53. Available from: http://dx.doi.org/10.1016/

2.        GMC. Doctors’ use of social media. Gen Med Counc [Internet]. 2013 [cited 2020 Nov 29];(April):7–9. Available from: https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/doctors-use-of-social-media

3.        Colegio de Médicos de Tarragona. 10 recomendaciones en las redes sociales para médicos – Colegio Oficial de Médicos de Tarragona [Internet]. [cited 2020 Nov 29]. Available from: https://www.comt.cat/es/actualidad-y-publicaciones/noticias-del-comt/3586-10-recomendaciones-en-las-redes-sociales-para-medicos

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