These Are the Perks and Pitfalls of Physicians Posting on Social Media

Last year, the Journal of Vascular Surgery published an article in which the authors evaluated the professionalism of the social media posts of young vascular surgeons. The authors considered several types of posts—including those involving slander and drug use —to be inappropriate or unprofessional. But what caused a fierce backlash was that they also considered photos of female doctors in bikinis to be unprofessional.

Who were the authors to decide that posting these moments of leisure was out of bounds, commenters wondered? Right on cue, the hashtag #medbikini blossomed on Twitter in opposition to what was considered excessively judgmental oversight, and even an invasion of privacy. Journal editors retracted the article.

The episode was mentioned by panelists in a Triological Society session on April 9 at the virtual Combined Otolaryngology Spring Meetings as they discussed the benefits and risks of social media for physicians and otolaryngologists. Panelists examined whether social media posts should be assessed when evaluating applicants for residency and other positions.

The Journal of Vascular Surgery story, they said, shows the perils that such evaluations could entail. “It really highlights the unconscious biases that we all have. Even if there was a process by which people looked up the social media of their applicants, there would have to be some really active process to mitigate those unconscious biases that we bring to the situation,” said Hayley Born, MD, a laryngology fellow at the Weill Cornell Medicine Sean Parker Institute for the Voice in New York City, who is active on social media.

With the potential for unanticipated problems always looming, panelists acknowledged that it’s easy to wonder whether physicians should even bother with social media, especially with patient care, teaching, conferences, and other duties already keeping doctors busy.

“Sometimes, with the internet, you’re just screaming into the void, and it’s unpredictable who’s going to scream back and in what way,” said Jennifer Villwock, MD, associate professor of rhinology and skull base surgery at the University of Kansas Medical Center and chief of otolaryngology at the Kansas City Veterans Affairs Hospital. But she also suggested that to not have a social media presence would be a wasted opportunity.

If you’re trying to make things better in your hometown or provide more education about X, Y, or Z specific pathology, those posts might not ever go viral, but they might help educate that one person who was looking for an answer and will now get the care they need. —Jennifer Villwock, MD

“We’re uniquely poised as physicians and surgeons to really contribute meaningfully to the health conversation with accurate, evidence-based information,” she said.

The beauty of social media is that physicians can match their usage with their goals by using different platforms that target different audiences. For instance, ResearchGate is a platform designed for purely academic purposes, connecting researchers who want to share papers, ask questions, and find collaborators. Publons offers a way for physicians to track their research impact and maximize that impact, said Dr. Villwock.

Social media gives physicians a chance to tell their story, draw people in, insert science into the dialogue, and protect the public from erroneous information, said Dr. Villwock. It can also be a platform for social activism, allowing users to call out actions that aren’t appropriate or are discriminatory, she said.

“You can be serious, you can be funny, you can be whomever you’d like to be, and I think that we can all make it work for us, regardless of whether that involves a lot of effort and a lot of posts or just staying current with the conversation and networking among colleagues,” said Dr. Villwock.

Being Cautious

Michael Johns, III, MD, director of the University of Southern California Voice Center in Los Angeles and Social Media Committee chair for the Triological Society, defined social media this way: “Microbits of information presented publicly, with limited context, that have the potential for wide dissemination.”

Each element of this definition, he said, says something about the potentially perilous nature of social media. “Microbits of information” means readers get only a small amount of information, not an in-depth report. “Limited context” raises the prospect for a post to be misconstrued or misrepresented. “Potential for wide dissemination” means that this misunderstanding or misrepresentation could spread far and wide. So as content producers or content consumers on social media, users have to be cautious.

“Just because you can put something into the written word, that doesn’t mean it’s true,” he said. “The information source does matter, and on social media it can come from anybody.”

While social media has the veneer of being casual, a casual approach to posting can lead to problems, he said. “When you’re writing posts, it looks and feels a lot like texting,” Dr. Johns said. “Don’t look at it that way—look at it more like poetry, where you need to be very thoughtful in how you craft what you want to say.”

“Everything that gets on the internet is forever, so remember that just because you delete a picture or post, it doesn’t mean that it goes away,” added Dr. Born. “And what you think is funny when you’re 18 isn’t necessarily funny when you’re 35.”

Romaine Johnson, MD, MPH, the panel’s moderator and associate professor of otolaryngology–head and neck surgery at University of Texas Southwestern Medical Center in Dallas, put it this way: “One of the things that I always tell the residents and fellows is that anything you say can and will be used against you in a court of public opinion, so you should be mindful of what you say. And I think that’s true for social media.”

Everything that gets on the internet is forever. —Hayley Born, MD

Social Media Impact

Dr. Born said that social media has benefited her in her young career. “It can really help make you feel a part of the community and help you learn about the different people who are involved in your field,” she said. “I feel like I’ve gotten to know several people over the last year who I can’t wait to meet in person at the next Triological meeting.”

Dr. Villwock said a social media presence can have big impact without viral posts. “You don’t need a few million followers,” she said. “If you’re trying to make things better in your hometown or provide more education about X, Y, or Z specific pathology, those posts might not ever go viral, but they might help educate that one person who was looking for an answer and will now get the care they need.”

Dr. Villwock did add a caveat, however. “You might also want to consider setting a timer before you visit a social media site, because there are a thousand rabbit holes you can go down that aren’t productive.”

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Thomas R. Collins is a freelance medical writer based in Florida.