Deborah A. Fisher, MD, MHS

 

Gone are the days when social media was primarily used by millennials and those early adopters on the diffusion-of-innovation curve. Now, baby boomers and laggards alike are using social media to communicate with the world around them. Furthermore, health and healthcare issues are common topics in the social media universe. Eight in 10 Internet users seek health information online and 74% of these health information seekers use social media.^1,2 Additionally, when they look online, they are more likely to trust information from doctors (61%) than from hospitals (55%), insurers (42%), or pharmaceutical companies (37%).³ Therefore, there is tremendous opportunity for physicians to engage patients, policy makers, advocacy groups, and other health care influencers in order to share reliable information. Yet, we must do so responsibly. There is a considerable degree of misinformation circulated in social media and we believe that physicians should help combat this by providing accurate information.

SonerCdem/Thinkstock

In addition, as physicians, we are in a special position to advocate for our patients and our profession. By doing this via social media, we can extend our reach beyond our clinics, endoscopy suites, and research labs and do so much faster than other methods. For example, it is estimated that it would take 38 years for radio to reach 50 million users, 13 years for television to reach 50 million users, but only 1.5 years for Facebook to reach 50 million users.⁴

On a more individual level, social media can help you stay up-to-date on best practices, breakthroughs, and controversies in medicine. It can help you take control of your online reputation rather than letting it be the default Google search results. Social media can also be a vehicle through which you build your offline network of potential colleagues, collaborators, and supporters as well as facilitate speaking, consulting, research, and other professional opportunities.

We that we have convinced you to actively participate in social media professionally. Next, we would like to share our top six best practices for responsible use.


1. Understand and define your goals. We have broadly laid out our rationale but that is different from your specific, desired outcomes. If you do not know what you are trying to accomplish you will have no idea if you are successful or if what you are doing is working versus whether you should try different strategies. Social media does take time; therefore, you should be strategic and goal oriented.

2. Nuture your social media presence. If you explore social media and find it is not for you, it is better to disable your accounts than to simply have a trail of ghost accounts. It looks worse to have a neglected account than no account at all. Caring for your account(s) with regular and deliberate posts drives much of this time commitment. However, there are some ways to be more efficient, such as integrating your social media platforms by linking to your website (i.e., your “landing page”), blog, and other accounts. Use the same photo for all of your accounts and websites and be sure to include “Dr” or “MD” in your username. Also, with a platform such as Hootsuite (https://hootsuite.com), you can schedule tweets – allowing you to upload content at your convenience while still reaching your audience at an optimal time – as well as post the same content to multiple platforms.

3. Share reliable/vetted information in your area of expertise and interest. Do not try to be all things to all people. Focus on content that distinguishes you and meets your goals. On the other hand, this should not be all about you; this can be boring, difficult, and give the impression that all you care about is self-promotion. No more than a quarter to a third of the content should be about you and the rest should be curated content from other reliable sources. Sharing with attribution helps you build your community. Also, people appreciate vetted content in the great web of misinformation available. You can facilitate audience engagement by including graphics, photos, and videos and by engaging and responding to other posts. Importantly, having a disclaimer on your account (e.g., retweets are not endorsements, posts are not medical advice) is never a substitute for knowing/vetting what you are sharing.

4. Exercise caution when responding to medical questions on social media and/or sharing patient information. While we encourage engagement, you should never answer specific medical questions. This develops a doctor-patient relationship and creates legal “duty.” It could even constitute practicing without a license, if the person asking the question lives in another state. Instead, provide general information about a condition, especially as a link to a reliable site (www.gastro.org/patient-care/patientinfo-center) and suggest seeking care from their local medical professional. Along these lines, do not share any potentially identifiable patient information without documented permission. In addition to the obvious (e.g., patient name, photos, medical documents with identifiers), avoid stories of care, complications, rare conditions, or identifiable specimens. With an approximate date and the location of your practice, it may be very easy for someone to determine the patient’s identity.

5. Be careful with all of your social media accounts including any “personal” accounts. While the American College of Physicians (ACP) and the Federation of State Medical Boards (FSMB) recommend maintaining separate personal and professional accounts,⁵ we believe this gives a false sense of security. Once you upload a post to any social media platform you lose control over what others do with that information (photo, etc). We agree with the FSMB recommendation against friending patients on Facebook,⁵ but some platforms, such as Twitter, allow people to follow you without you necessarily following them. In fact, having your patients follow your Twitter account may be a useful way to provide general information about certain conditions (e.g., inflammatory bowel disease) or increase awareness about preventive care (e.g., colorectal cancer screening).

6. Know and adhere to the social media policies of your practice, institution, organization, or employer. Most academic institutions have social media policies and they are becoming more widely adapted to other settings. While you may just get a metaphorical slap on the wrist for not following the rules, I think we all would agree that it would be a tragedy to get fired over a social media post.

However, none of the above best practices are a substitute for being intentional and mindful when sharing information on social media, whether it be Facebook, Twitter, Instagram, Youtube, or another platform. What does being intentional and mindful on social media mean? Absolutely avoid commenting/posting about patients, colleagues, or your workplace in any way that could be perceived to be negative. Declare conflicts of interest where applicable (i.e., if you’re a consultant for a pharma company, avoid endorsing a drug without declaring your conflict). Above all else, don’t post anything that you wouldn’t mind being on a billboard or mainstream news.

Participation is an investment of your most valuable resource: time. Therefore, know your goals and revisit these goals and your success in reaching them regularly. Start small and expand as your time and interest allows. Finally, minimize your exposure to risk by keeping our guidance and your institutional policies in mind and always pause before you post.

You can find out more about the AGA, its programs, and publications via our social media outlets, including:
 

 

Twitter:

@amergastroassn

@AGA_CGH

@AGA_CMGH

@AGA_Gastro


Facebook:

@AmerGastroAssn

@cghjournal

@cmghjournal

@gastrojournal

Dr. Fisher is associate professor in the department of medicine, division of gastroenterology, Duke University, Durham, N.C. VA Medical Center. Twitter: @DrDeborahFisher. Dr. Gray is assistant professor, department of medicine, division of gastroenterology, hepatology and nutrition, Ohio State University College of Medicine. Twitter: @DMGrayMD.

This information was presented at a Meet-the-Professor Luncheon at DDW® 2017. More for in-depth details than are described in this article, refer to this session on DDW on Demand (http://www.ddw.org/education/session-recordings).

References

1 Von Muhlen M., Ohno-Machado L. J Am Med Inform Assoc. 2012;19(5):777-81.

2 Childs L.M., Martin C.Y. Am J Health System Pharm. 2012;69(23):2044-50.

3. Social media “likes” healthcare. From marketing to social business – 2012 Report

https://www.pwc.com/us/en/health-industries/health-research-institute/publications/health-care-social-media.html.

4. www.martinsights.com/social-media-marketing/social-media-strategy/new-global-social-media-research/.

5. Online Medical Professionalism: Patient and Public Relationships: Policy Statement From the American College of Physicians and the Federation of State Medical Boards. Ann Intern Med. 2013;158(8):620-7.

 

Gone are the days when social media was primarily used by millennials and those early adopters on the diffusion-of-innovation curve. Now, baby boomers and laggards alike are using social media to communicate with the world around them. Furthermore, health and healthcare issues are common topics in the social media universe. Eight in 10 Internet users seek health information online and 74% of these health information seekers use social media.^1,2 Additionally, when they look online, they are more likely to trust information from doctors (61%) than from hospitals (55%), insurers (42%), or pharmaceutical companies (37%).³ Therefore, there is tremendous opportunity for physicians to engage patients, policy makers, advocacy groups, and other health care influencers in order to share reliable information. Yet, we must do so responsibly. There is a considerable degree of misinformation circulated in social media and we believe that physicians should help combat this by providing accurate information.

SonerCdem/Thinkstock

In addition, as physicians, we are in a special position to advocate for our patients and our profession. By doing this via social media, we can extend our reach beyond our clinics, endoscopy suites, and research labs and do so much faster than other methods. For example, it is estimated that it would take 38 years for radio to reach 50 million users, 13 years for television to reach 50 million users, but only 1.5 years for Facebook to reach 50 million users.⁴

On a more individual level, social media can help you stay up-to-date on best practices, breakthroughs, and controversies in medicine. It can help you take control of your online reputation rather than letting it be the default Google search results. Social media can also be a vehicle through which you build your offline network of potential colleagues, collaborators, and supporters as well as facilitate speaking, consulting, research, and other professional opportunities.

We that we have convinced you to actively participate in social media professionally. Next, we would like to share our top six best practices for responsible use.


1. Understand and define your goals. We have broadly laid out our rationale but that is different from your specific, desired outcomes. If you do not know what you are trying to accomplish you will have no idea if you are successful or if what you are doing is working versus whether you should try different strategies. Social media does take time; therefore, you should be strategic and goal oriented.

2. Nuture your social media presence. If you explore social media and find it is not for you, it is better to disable your accounts than to simply have a trail of ghost accounts. It looks worse to have a neglected account than no account at all. Caring for your account(s) with regular and deliberate posts drives much of this time commitment. However, there are some ways to be more efficient, such as integrating your social media platforms by linking to your website (i.e., your “landing page”), blog, and other accounts. Use the same photo for all of your accounts and websites and be sure to include “Dr” or “MD” in your username. Also, with a platform such as Hootsuite (https://hootsuite.com), you can schedule tweets – allowing you to upload content at your convenience while still reaching your audience at an optimal time – as well as post the same content to multiple platforms.

3. Share reliable/vetted information in your area of expertise and interest. Do not try to be all things to all people. Focus on content that distinguishes you and meets your goals. On the other hand, this should not be all about you; this can be boring, difficult, and give the impression that all you care about is self-promotion. No more than a quarter to a third of the content should be about you and the rest should be curated content from other reliable sources. Sharing with attribution helps you build your community. Also, people appreciate vetted content in the great web of misinformation available. You can facilitate audience engagement by including graphics, photos, and videos and by engaging and responding to other posts. Importantly, having a disclaimer on your account (e.g., retweets are not endorsements, posts are not medical advice) is never a substitute for knowing/vetting what you are sharing.

4. Exercise caution when responding to medical questions on social media and/or sharing patient information. While we encourage engagement, you should never answer specific medical questions. This develops a doctor-patient relationship and creates legal “duty.” It could even constitute practicing without a license, if the person asking the question lives in another state. Instead, provide general information about a condition, especially as a link to a reliable site (www.gastro.org/patient-care/patientinfo-center) and suggest seeking care from their local medical professional. Along these lines, do not share any potentially identifiable patient information without documented permission. In addition to the obvious (e.g., patient name, photos, medical documents with identifiers), avoid stories of care, complications, rare conditions, or identifiable specimens. With an approximate date and the location of your practice, it may be very easy for someone to determine the patient’s identity.

5. Be careful with all of your social media accounts including any “personal” accounts. While the American College of Physicians (ACP) and the Federation of State Medical Boards (FSMB) recommend maintaining separate personal and professional accounts,⁵ we believe this gives a false sense of security. Once you upload a post to any social media platform you lose control over what others do with that information (photo, etc). We agree with the FSMB recommendation against friending patients on Facebook,⁵ but some platforms, such as Twitter, allow people to follow you without you necessarily following them. In fact, having your patients follow your Twitter account may be a useful way to provide general information about certain conditions (e.g., inflammatory bowel disease) or increase awareness about preventive care (e.g., colorectal cancer screening).

6. Know and adhere to the social media policies of your practice, institution, organization, or employer. Most academic institutions have social media policies and they are becoming more widely adapted to other settings. While you may just get a metaphorical slap on the wrist for not following the rules, I think we all would agree that it would be a tragedy to get fired over a social media post.

However, none of the above best practices are a substitute for being intentional and mindful when sharing information on social media, whether it be Facebook, Twitter, Instagram, Youtube, or another platform. What does being intentional and mindful on social media mean? Absolutely avoid commenting/posting about patients, colleagues, or your workplace in any way that could be perceived to be negative. Declare conflicts of interest where applicable (i.e., if you’re a consultant for a pharma company, avoid endorsing a drug without declaring your conflict). Above all else, don’t post anything that you wouldn’t mind being on a billboard or mainstream news.

Participation is an investment of your most valuable resource: time. Therefore, know your goals and revisit these goals and your success in reaching them regularly. Start small and expand as your time and interest allows. Finally, minimize your exposure to risk by keeping our guidance and your institutional policies in mind and always pause before you post.

You can find out more about the AGA, its programs, and publications via our social media outlets, including:
 

 

Twitter:

@amergastroassn

@AGA_CGH

@AGA_CMGH

@AGA_Gastro


Facebook:

@AmerGastroAssn

@cghjournal

@cmghjournal

@gastrojournal

Dr. Fisher is associate professor in the department of medicine, division of gastroenterology, Duke University, Durham, N.C. VA Medical Center. Twitter: @DrDeborahFisher. Dr. Gray is assistant professor, department of medicine, division of gastroenterology, hepatology and nutrition, Ohio State University College of Medicine. Twitter: @DMGrayMD.

This information was presented at a Meet-the-Professor Luncheon at DDW® 2017. More for in-depth details than are described in this article, refer to this session on DDW on Demand (http://www.ddw.org/education/session-recordings).

References

1 Von Muhlen M., Ohno-Machado L. J Am Med Inform Assoc. 2012;19(5):777-81.

2 Childs L.M., Martin C.Y. Am J Health System Pharm. 2012;69(23):2044-50.

3. Social media “likes” healthcare. From marketing to social business – 2012 Report

https://www.pwc.com/us/en/health-industries/health-research-institute/publications/health-care-social-media.html.

4. www.martinsights.com/social-media-marketing/social-media-strategy/new-global-social-media-research/.

5. Online Medical Professionalism: Patient and Public Relationships: Policy Statement From the American College of Physicians and the Federation of State Medical Boards. Ann Intern Med. 2013;158(8):620-7.

 

Gone are the days when social media was primarily used by millennials and those early adopters on the diffusion-of-innovation curve. Now, baby boomers and laggards alike are using social media to communicate with the world around them. Furthermore, health and healthcare issues are common topics in the social media universe. Eight in 10 Internet users seek health information online and 74% of these health information seekers use social media.^1,2 Additionally, when they look online, they are more likely to trust information from doctors (61%) than from hospitals (55%), insurers (42%), or pharmaceutical companies (37%).³ Therefore, there is tremendous opportunity for physicians to engage patients, policy makers, advocacy groups, and other health care influencers in order to share reliable information. Yet, we must do so responsibly. There is a considerable degree of misinformation circulated in social media and we believe that physicians should help combat this by providing accurate information.

SonerCdem/Thinkstock

In addition, as physicians, we are in a special position to advocate for our patients and our profession. By doing this via social media, we can extend our reach beyond our clinics, endoscopy suites, and research labs and do so much faster than other methods. For example, it is estimated that it would take 38 years for radio to reach 50 million users, 13 years for television to reach 50 million users, but only 1.5 years for Facebook to reach 50 million users.⁴

On a more individual level, social media can help you stay up-to-date on best practices, breakthroughs, and controversies in medicine. It can help you take control of your online reputation rather than letting it be the default Google search results. Social media can also be a vehicle through which you build your offline network of potential colleagues, collaborators, and supporters as well as facilitate speaking, consulting, research, and other professional opportunities.

We that we have convinced you to actively participate in social media professionally. Next, we would like to share our top six best practices for responsible use.


1. Understand and define your goals. We have broadly laid out our rationale but that is different from your specific, desired outcomes. If you do not know what you are trying to accomplish you will have no idea if you are successful or if what you are doing is working versus whether you should try different strategies. Social media does take time; therefore, you should be strategic and goal oriented.

2. Nuture your social media presence. If you explore social media and find it is not for you, it is better to disable your accounts than to simply have a trail of ghost accounts. It looks worse to have a neglected account than no account at all. Caring for your account(s) with regular and deliberate posts drives much of this time commitment. However, there are some ways to be more efficient, such as integrating your social media platforms by linking to your website (i.e., your “landing page”), blog, and other accounts. Use the same photo for all of your accounts and websites and be sure to include “Dr” or “MD” in your username. Also, with a platform such as Hootsuite (https://hootsuite.com), you can schedule tweets – allowing you to upload content at your convenience while still reaching your audience at an optimal time – as well as post the same content to multiple platforms.

3. Share reliable/vetted information in your area of expertise and interest. Do not try to be all things to all people. Focus on content that distinguishes you and meets your goals. On the other hand, this should not be all about you; this can be boring, difficult, and give the impression that all you care about is self-promotion. No more than a quarter to a third of the content should be about you and the rest should be curated content from other reliable sources. Sharing with attribution helps you build your community. Also, people appreciate vetted content in the great web of misinformation available. You can facilitate audience engagement by including graphics, photos, and videos and by engaging and responding to other posts. Importantly, having a disclaimer on your account (e.g., retweets are not endorsements, posts are not medical advice) is never a substitute for knowing/vetting what you are sharing.

4. Exercise caution when responding to medical questions on social media and/or sharing patient information. While we encourage engagement, you should never answer specific medical questions. This develops a doctor-patient relationship and creates legal “duty.” It could even constitute practicing without a license, if the person asking the question lives in another state. Instead, provide general information about a condition, especially as a link to a reliable site (www.gastro.org/patient-care/patientinfo-center) and suggest seeking care from their local medical professional. Along these lines, do not share any potentially identifiable patient information without documented permission. In addition to the obvious (e.g., patient name, photos, medical documents with identifiers), avoid stories of care, complications, rare conditions, or identifiable specimens. With an approximate date and the location of your practice, it may be very easy for someone to determine the patient’s identity.

5. Be careful with all of your social media accounts including any “personal” accounts. While the American College of Physicians (ACP) and the Federation of State Medical Boards (FSMB) recommend maintaining separate personal and professional accounts,⁵ we believe this gives a false sense of security. Once you upload a post to any social media platform you lose control over what others do with that information (photo, etc). We agree with the FSMB recommendation against friending patients on Facebook,⁵ but some platforms, such as Twitter, allow people to follow you without you necessarily following them. In fact, having your patients follow your Twitter account may be a useful way to provide general information about certain conditions (e.g., inflammatory bowel disease) or increase awareness about preventive care (e.g., colorectal cancer screening).

6. Know and adhere to the social media policies of your practice, institution, organization, or employer. Most academic institutions have social media policies and they are becoming more widely adapted to other settings. While you may just get a metaphorical slap on the wrist for not following the rules, I think we all would agree that it would be a tragedy to get fired over a social media post.

However, none of the above best practices are a substitute for being intentional and mindful when sharing information on social media, whether it be Facebook, Twitter, Instagram, Youtube, or another platform. What does being intentional and mindful on social media mean? Absolutely avoid commenting/posting about patients, colleagues, or your workplace in any way that could be perceived to be negative. Declare conflicts of interest where applicable (i.e., if you’re a consultant for a pharma company, avoid endorsing a drug without declaring your conflict). Above all else, don’t post anything that you wouldn’t mind being on a billboard or mainstream news.

Participation is an investment of your most valuable resource: time. Therefore, know your goals and revisit these goals and your success in reaching them regularly. Start small and expand as your time and interest allows. Finally, minimize your exposure to risk by keeping our guidance and your institutional policies in mind and always pause before you post.

You can find out more about the AGA, its programs, and publications via our social media outlets, including:
 

 

Twitter:

@amergastroassn

@AGA_CGH

@AGA_CMGH

@AGA_Gastro


Facebook:

@AmerGastroAssn

@cghjournal

@cmghjournal

@gastrojournal

Dr. Fisher is associate professor in the department of medicine, division of gastroenterology, Duke University, Durham, N.C. VA Medical Center. Twitter: @DrDeborahFisher. Dr. Gray is assistant professor, department of medicine, division of gastroenterology, hepatology and nutrition, Ohio State University College of Medicine. Twitter: @DMGrayMD.

This information was presented at a Meet-the-Professor Luncheon at DDW® 2017. More for in-depth details than are described in this article, refer to this session on DDW on Demand (http://www.ddw.org/education/session-recordings).

References

1 Von Muhlen M., Ohno-Machado L. J Am Med Inform Assoc. 2012;19(5):777-81.

2 Childs L.M., Martin C.Y. Am J Health System Pharm. 2012;69(23):2044-50.

3. Social media “likes” healthcare. From marketing to social business – 2012 Report

https://www.pwc.com/us/en/health-industries/health-research-institute/publications/health-care-social-media.html.

4. www.martinsights.com/social-media-marketing/social-media-strategy/new-global-social-media-research/.

5. Online Medical Professionalism: Patient and Public Relationships: Policy Statement From the American College of Physicians and the Federation of State Medical Boards. Ann Intern Med. 2013;158(8):620-7.