Social media is a frequent topic of heated discussions over whether the phenomenon’s effect on society and the human condition itself—including the ability to separate fact from fiction—is more harmful than good. One undebatable fact about social media, however, is that it isn’t going anywhere.
The explosive growth of its use, particularly among U.S. consumers, shows no sign of slowing: Recent market data indicate that use of social media services is a daily activity for most people, with 65% of consumers engaging with at least one of these services several times each day. (Westcott K, et al. Streaming video on demand, social media, and gaming trends. Deloitte Insights. Accessed Nov. 23, 2021).
Terminology notwithstanding, social media platforms expanded beyond the “social” realm a long time ago. They’re now an essential tool for professionals of all stripes, including physicians, in professional networking, recruitment, information sharing, research, public education, and, of course, self-promotion.
“Specialties like dermatology and plastic surgery have been using these platforms to promote their practices for years,” said Steven Gold, MD, an otolaryngology–head and neck surgeon with ENT and Allergy Associates in Hackensack, N.J. Dr. Gold opened his Instagram account in 2017 and has since established a rewarding online presence. “I see the same for us in otolaryngology.”
The Benefits of Being Social
Although many otolaryngologists are beginning to appreciate the business potential of social media, the idea is far from fully embraced in the field. “It’s surprising how little ENT presence there is on social media, given that it’s such a lifestyle-forward specialty,” said Hayley Born, MD, a laryngology fellow at the Sean Parker Institute for the Voice at Weill Cornell Medicine in New York City, who has taken a leadership role in educating her colleagues on the subject—specifically on its benefits.
It started a few years ago when she served on the American Academy of Otolaryngology–Head and Neck Surgery’s Women in Otolaryngology Communications Committee. “I was at a meeting where none of the women in the room knew how to log in to Instagram or TikTok, or even Twitter,” recalled Dr. Born. “And it occurred to me that this was an area where ENT was very behind, with the possible exception of our facial plastics colleagues.” After the meeting, she approached some of the women to discuss a future panel introducing the basics of social media. She has since repeated that panel three times in an official capacity.
Inna Husain, MD, section head of laryngology and director of the Voice, Airway, and Swallowing Disorders Program at Rush University Medical Group in Chicago, also believes that today’s otolaryngologists could benefit from a bigger presence on social media. “We have a lot to offer, especially to patients, and we need to be more accessible,” she said, noting that social media can be a great tool for educating the public on otolaryngology issues that are important but haven’t gone mainstream. “For example, I created a TikTok video on why throat clearing isn’t good for you, and it went viral with more than 5 million views. It was a starting point to educate on good laryngeal hygiene and bring to attention that laryngeal specialists exist. My content has allowed a lot of patients to get the help they need.”
I created a TikTok video on why throat clearing isn’t good for you, and it went viral with more than 5 million views. It was a starting point to educate on good laryngeal hygiene and bring to attention that laryngeal specialists exist. —Inna Husain, MD
Dr. Gold’s entry to social media was inspired by a lighthearted conversation with one of his patients. “At the time, Dr. Pimple Popper had gained significant popularity,” he explained. “I joked with a patient that I wanted to start an account called Dr. Booger—and the rest is history.” Today, Dr. Gold’s ear wax removal videos on TikTok have garnered more than 1 million followers and 12 million likes, while his Instagram has amassed more 71,000 followers. “My intent was to engage people with some of the interesting things that otolaryngologists do,” he said. “My patients have always been fascinated by video images, and they help to reinforce their diagnosis. We can demonstrate and teach so much with endoscopes, but I never expected the response I’ve received.”
As Dr. Gold’s social media presence grew, he was able to reach many new patients and colleagues with his content. “By using these platforms, your information is hitting a much wider audience than you would normally reach. The exposure added growth to my practice in ways I never imagined,” he said.
Physicians with a social media presence effectively place themselves at the center of the conversation and, sometimes, in the right place at the right time. Dr. Born happened to be checking her Instagram one night when she noticed a post by one of her favorite comedians. “She was in New York City, having trouble with her voice, and was asking if anyone knew a voice professional. I responded that I would be happy to see her, and she ended up coming in the next day—and then posting all about it!” she said.
Patient education and outreach are compelling enough reasons to embrace social media, but they’re by no means the only ones. Some of the platforms can significantly bolster professional recruitment and networking efforts. “Because of COVID, social media has assumed a much bigger role in ENT, specifically as a recruitment tool for the residency programs,” explained Dr. Born. “Since the pandemic began, none of the students or residency applicants were able to travel, so the expansion of social media has been centered on outreach to applicants for residency and fellowship programs.”
Beyond residency and fellowship years, otolaryngologists can continue to connect with past, present, and future colleagues in exciting ways. “Social media provides us the opportunity to collaborate and network much more freely, and can open more doors,” said Dr. Gold. “I’ve been approached by many colleagues in my area—specifically, I’ve developed relationships with several oral surgeons regarding sinus-related issues with implant dentistry.” Dr. Born has met at least 10 people socially online who “have put me up for job opportunities or involved me in their research. I think that aspect of social media is often underrecognized.”
Identifying the Right Platforms
Of course, benefitting from social media requires more than opening an account, writing a post or two, and waiting for something to happen. Otolaryngologists who aim to optimize the vast reach of social media need to develop a strategy. That starts with understanding what they want to accomplish and determining which specific social media platforms are best suited to their content and goals.
“I like TikTok for the sheer volume for users; plus, it can be a creative way to spread education and include your voice in the narrative with trending music,” said Dr. Husain. “I like Instagram for its well-established community of physicians, and Twitter for sharing my more academic pursuits. Also, by being involved in each, I can diversify the content I create and educate in the form of images/photos, videos, and thought/resharing.”
At the time, Dr. Pimple Popper had gained significant popularity,” he explained. “I joked with a patient that I wanted to start an account called Dr. Booger—and the rest is history. —Steven Gold, MD
Although all the commonly used social media platforms have the potential to reach lots of people, each has its particular strengths, said Dr. Born:
Doximity: a site for medical professionals. “Doximity is essentially LinkedIn for physicians. It has some great resources, like HIPAA-compliant messaging and anonymous phone calling, that many of our colleagues use.”
Facebook: an older platform that’s community oriented. “While my millennial counterparts will say that Facebook is going the way of the dinosaurs, it is very useful for patient support groups. There’s a very large community of different support groups for specific conditions—such as spasmodic dysphonia, for example—without which these people would never otherwise find another affected person. Even for something as general as thyroid cancer, to have such an easily accessible community is highly valuable.”
Instagram: advertiser-friendly, visually oriented. “Unlike Twitter, where you can’t really put yourself out there as an expert, on Instagram you can put out a video explaining what subglottic stenosis is and how you treat it. You can put up pictures and information and links to resources. These are very powerful tools.”
LinkedIn: for general professional networking. “LinkedIn is far more popular in the business world than it is in medicine. However, it’s a good place to go to find CV-type details. Otherwise, I haven’t heard of or seen many doctors, much less otolaryngologists, using the site in a proactive way.”
TikTok: newest of the platforms, featuring 15-second videos. “Like Instagram, TikTok is advertising friendly. Personally, I’m not as comfortable on video, so it isn’t for me, but some people love making those little videos, and they’re pretty easy to produce.”
Twitter: heavy on commentary. “Twitter has become part of the political landscape. I think that if you want to have a dialogue with your colleagues or patients about hot topics, this is probably the place to be.”
YouTube: for instruction and demonstration with video content. “YouTube is an awesome educational tool. A resident or fellow can go on YouTube and look up a surgical video to get a sense of the steps and anatomy. From a trainee’s side of things, that’s invaluable.”
Dr. Gold recommends that physicians focus on one or two social media platforms. “Trying to keep up with posting regularly on multiple platforms takes plenty of work and time,” he said. “Stay focused. Most importantly, it should be fun and shouldn’t add any stress.”
Avoiding Pitfalls
Given the notorious news coverage dedicated to social media users (famous and otherwise) who find themselves in the public’s crosshairs over a posted comment, image, or video, it’s understandable that a nonuser might tend to stay that way. After all, why risk becoming public enemy No. 1 over something that can be so easily avoided? The fact is that it’s easy to steer clear of social media landmines by following a few basic principles.
“The main pitfalls with social media resolve around this very sticky term of ‘professionalism,’” said Dr. Born. The issue, she explained, is the notion of having an online “professional identity,” both in terms of patients and of job prospects. “If a patient goes online and sees you goofing off or doing something even mildly offensive, that can change their idea of you,” she noted. “Is it wrong to post certain opinions or jokes online? Maybe not, but the question is, is it worth the consequences? I think you need to balance the idea of being yourself with putting yourself out there as a professional.”
Many social media users separate their personal and professional social media accounts, as both Dr. Born and Dr. Gold have done. Others decide to keep them as one but avoid sharing too many personal comments, pictures, or videos. Dr. Born admits that this balancing act comes more naturally to her generation of millennials than to previous, less content-ingrained generations, who tend to be much warier of social media in general.
Reputation management is an essential part of maintaining a safe and robust social media presence. A lawyer on one of Dr. Born’s panels emphasized the difference between a proactive social media presence and a reactive one. “He talked about the importance of taking charge of your name,” she recalled. “He told the story of a doctor who had been reported by a patient as falsifying his identity because he hadn’t updated his LinkedIn profile that said he was the head of an emergency department of a certain hospital, which he no longer was.”
In another instance, a well-known facial plastic surgeon with an enviable social media presence continues to find herself regularly dealing with imitation accounts created by people trying to capitalize on her identity. “She has had to be very proactive in getting those account names and having them taken down,” said Dr. Born. “It’s better to counter them than to just let it happen to you.”
Dr. Gold urges colleagues on social media to avoid giving medical advice regarding a specific treatment or diagnosis on any platform. “I’m cautious to not answer direct messages that are related to specific patient issues,” he said. “Remember that any followers, including your own patients, have an ability to communicate directly through social media, so you must maintain clear boundaries. Most importantly, be careful about posting information that could be a HIPAA violation, which is accompanied by significant fines and penalties.
A Changing Landscape
Thanks to the unique circumstances of the past two years, medicine has been in the headlines every day. In a time of public health crisis, information sharing tools such as social media have proven invaluable. “It’s shown us that we, as physicians, can play a really big role in helping people through these social media platforms that reach so many people,” said Dr. Born. “I think it’s important for us to be involved.”
While many otolaryngologists remain resistant to the idea of social media as a professional tool, Dr. Born is noticing changes. “For a while I was getting a lot of eyerolls when I would bring up social media, and I still have a lot of colleagues who think of it as a game—a time waster,” she acknowledged. “But a lot of us are starting to realize that, if you do it right, you can get quite bit back from the time that you put in, which isn’t a lot once you’re experienced with the platforms. I think part of the resistance comes from being unfamiliar with the tools.”
Dr. Born also believes it has something to do with the unique nature and circumstances of the otolaryngologist. “We’re all very Type A individuals who have spent a lot of time moving in one particular direction,” she said. “Also, our issues are so universal that we don’t have to do a lot of advertising the way that perhaps our facial plastics or dermatologist colleagues do. We ENTs are pretty in demand and pretty busy, so we haven’t had to think much about it. But if we’re not part of the conversation, then the conversation gets away from us.”
Linda Kossoff is a freelance medical writer based in Woodland Hills, Calif.
TikTok Boom: Tonsil Stones
Over the past four years, TikTok has grown into a social media engagement behemoth. By the end of 2021, the short-form video-sharing app is expected to surpass 1 billion monthly active users worldwide, approximately 80% of them under 40 years old.
Although at first blush TikTok might not seem to impact the practice of medicine in a significant way, recent evidence indicates that the contrary is true. In a report published in Ear, Nose & Throat Journal (doi:10.1177/01455613211038340), otolaryngologists Anita Sulibhavi, MD, and Glenn Isaacson, MD, in the department of otolaryngology at the Lewis Katz School of Medicine at Temple University in Philadelphia, discussed the role that the social media app has played in the dramatically increased number of disproportionately female and teenage patients they’ve seen visit their clinic complaining of tonsil stones.
The physicians were mystified until one of the patient’s parents suggested that the phenomenon could be related to TikTok. After conducting a search for “tonsil stones” on several social media databases, including TikTok, they found “a plethora of videos,” viewed by millions, mostly of teenagers’ intraoral selfies showing “large tonsillar concretions or debris-filled tonsillar crypt with do-it-yourself techniques for management,” they said. The popularity of the videos was compounded by the isolation and protracted social media exposure during the COVID-19 pandemic, said the doctors, who reported that the use of those suggested remedies for tonsil stones have led to injury and unnecessary surgery.