Social Media Quality Control for Physicians

Social media has infiltrated our everyday lives – both personally and professionally. With most people keeping in touch with friends, family, and colleagues and monitoring the news cycle through multiple social media avenues, the question has shifted from if we should be using social media, to how we can make sure we use it to our benefit.

“Everything about how we communicate has changed,” said Mohamad Mohty, MD, PhD (@Mohty_EBMT), professor of hematology at the Clinical Hematology and Cellular Therapy Department at Hôpital Saint-Antoine, Université Pierre & Marie Curie in Paris, France. “Social media is felt to be increasingly important in plenty of things we do in health care, including academic projects, patient interactions, and research collaborations.”

Dr. Mohty was one of the panelists at a special education session at the 2017 ASH Annual Meeting that addressed how hematologists can effectively use social media. The session, titled “Quality Conversations on Social Media: Achieving Credibility and Efficiency Together” and chaired by Joseph Mikhael, MD, MEd (@jmikhaelmd), chair of the ASH Committee on Communications, featured Dr. Mohty and other panelists who discussed “best practices” for starting and maintaining conversations relevant to hematology on Twitter and other social media platforms.

A Double-Edged Sword

As Dr. Mohty and fellow panelists John P. Leonard, MD (@JohnPLeonardMD), and Elaine Schattner, MD, MA (@ESchattner), outlined, health care practitioners can use social media to their advantage in a number of ways.

In addition to enabling conversations with international collaborators, it can also open up new ways to help patients around the world. “It’s a tool for freedom,” Dr. Mohty said. “You don’t need a visa, you don’t need pre-authorization – it’s communication without borders that brings stakeholders in the community together to share experiences, to agree, to disagree, to comment,” Dr. Mohty said. “It’s a true added value.”

That immediacy, though, creates a demand for instant engagement that contradicts physicians’ roots in thoughtful consideration of evidence-based medicine. Also, when measured, considerate, and balanced ruminations about recently posted research findings are condensed into 280-character tweets, much can get lost in translation.

“With instant communication, you think less,” he said. “Your reaction needs to be matured before answering.” To avoid getting involved in “tweetstorms” or fruitless arguments on social media, Dr. Mohty applies a lesson he learned from replying to upsetting emails: “Embargo yourself.”

“Sometimes it’s hard to resist [responding immediately], because you want to attack,” he said. “But, if you want to do the right thing on social media, you need to create your own rules. There is no universal way to interact on social media – you need to decide what is most important to you.”

With so much of our daily lives moved online, people can lose sight of the consequences of these online interactions and of the value of “face-to-face” interactions, which would be a mistake, Dr. Mohty said. “Social media will never replace in-person interactions, because we need these close human relationships,” he said. “My advice is to be aware of the minuses and inconveniences [of this new technology]. Sometimes, they can hurt.”

The Rules of Engagement

Dr. Schattner, a journalist, patient advocate, and clinical associate professor of Medicine at Weill Cornell Medicine in New York, emphasized the value of social media in empowering patients.

“When patients go online, they are usually searching for information about a health condition,” she said. “The reality is that patients have less and less time with their doctors, and doctors increasingly may not be [an] expert in the particular issues that their patients ask them about. The need for information is extreme.”

Patients also use the internet to gather information on clinical trials or treatments that might not have been offered by their local physicians, and to look for other opinions altogether. “People used to go to other doctors. Now they go to other websites, follow certain disease-specific hashtags, and ask other patients online about where to go for more information.”

Social media also opens new avenues of communication between physicians and introduces the risk of oversharing – a tricky area to navigate because of legal issues surrounding doctor-patient confidentiality and professionalism.

Dr. Schattner said she believes patients understand and respect these issues, and doctors should in turn respect patients’ inquiries. “Most educated patients are not looking for specific answers to their medical problems online,” she said. “That said, I admire doctors who treat patients with respect. Some doctors only follow doctors – not patients or people who identify as patients. Whether or not you choose to follow people who are not physicians, I think if you acknowledge the legitimacy of their questions, that can go a long way.”

Social media platforms also invite informality, but Dr. Schattner advised the audience to keep it professional. “If doctors use words or phrases like ‘LOL’ or ‘garbage’ when referring to clinical trial results, for example, that can be hurtful to patients who are on those trials.” Patients are savvy enough to find and follow conversations about topics of interest to them, she said, adding “[physicians] should be careful, because patients may be paying closer attention than [doctors] realize.”

Maintaining privacy and safety online should also be of paramount concern, because some unwanted followers might be too close for comfort, Dr. Schattner noted. “There are creeps on the internet,” she said bluntly, “and because I have a significant following, at this point I have learned that directly.” Blocking and reporting spammers or users who employ hateful language or share violent images is a must for any doctor who wants to seriously use social media.

Dr. Schattner advised audience members to be careful about divulging details about their personal lives (such as their location or family, events they attend, etc.). “When I’m here, it’s useful for me professionally to reveal that I am in Atlanta for the ASH annual meeting,” she said, “but I’m not going to publish my family vacation plans on the internet.”

Tips and Tricks

According to Dr. Leonard, Richard T. Silver Distinguished Professor of Medicine and associate dean for clinical research at Weill Cornell Medicine and New York Presbyterian Hospital in New York, deciding what to put on the internet is half the battle. He discussed best practices for taking full advantage of the connectivity and exposure inherent to social media.

Twitter can be helpful for shining a light on your institution, programs, work, and the work of colleagues, he said. Retweeting colleagues’ presentations or achievements to your followers – and providing your opinions – can be a great engagement tool.

For better engagement, Dr. Leonard noted, try to keep your posts interactive and, when possible, entertaining. Some doctors will use a lot of jargon, or will only post links to articles, and “that’s fine if you just want to talk to your colleagues on the internet,” Dr. Schattner agreed. “To make your Twitter feed or any social media feed interesting, though, it’s helpful to have a hobby. For me, it makes Twitter more fun.”

The back-and-forth comments and camaraderie that builds between users and followers is an essential aspect of social media. But Dr. Leonard warned, “Comment, don’t vent. It’s okay to comment and be excited about something you are posting, but be mindful of your language and reactions.”

And, of course, realize that not everyone online is following these same rules of engagement. In response to an audience member’s question about frustrating interactions on social media, Dr. Schattner advised that sometimes it’s best to just walk away from the situation. When conversations become argumentative, ignore them. “[These interactions] can be  hurtful to both sides – they are not helpful to patients, and they are not helpful to the people who tweet,” Dr. Schattner said.

The most important thing to remember is that social media is supposed to be informative and fun – not a burden professionally or personally. “Do it as much as you like,” Dr. Mohty said, “but it is not an obligation.”

An audience member noted that in the era of “alternative facts,” constantly correcting misinformation on the internet can be a burden. While the internet is rife with misinformation, “we are not in a position to police … Facebook or … what is said on Twitter, or in The New York Times for that matter,” Dr. Schattner said. “Conventional and new media all have some truths and some fallacies. My attitude is you can’t correct it all. I think patients, through better education, will gradually gravitate to people who prove to be reliable.”

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