Social Media and Digital Strategy For Physicians: Why and How

Physician use of social media, blogs, and other digital platforms for professional purposes have steadily increased. However, many physicians have important questions about the use of social media in health care. Here are just a few:

• Why should physicians bother with social media?
• How does social media work in health care?
• Can busy physicians use social media without investing lots of time and effort?
• How should physicians get started on social media?
• What are best practices for physicians who want to build a successful online presence?
• Isn’t it risky for medical professionals to be active online? What if I do something wrong?

Physicians should use social media for a variety of compelling reasons. First and foremost, they have a professional obligation to be visible online. Aside from the enormous benefits to patients, physicians can leverage social media for career advancement, whether in academics or private practice.

Why should physicians use social media professionally? Here are 5 ways that physician use of social media benefits others:

1.Help patients find quality medical information. You already know that patients search online for medical information. They ask Google about medical procedures, therapeutic risks and benefits, and disease information. You won’t be surprised to know that patients generally are not reading The New England Journal of Medicine. They don’t have a subscription to JAMA. What are they reading? Most likely, they are reading whatever pops up on the first page of their search engine results. What do they find? In the absence of patient-friendly, physician-created content such as blog posts, open-access papers, slideshows, and recorded lectures, patients are likely to face an avalanche of questionable content and misinformation written by nonexperts. Physicians have a professional obligation to enhance health care literacy by helping patients in the space where they are seeking help—on the web.

2.Help the patients right in front of you by keeping up-to-date. I can predict a few eye rolls here. After all, you are keeping up via CME, lectures, meetings, grand rounds, and journal subscriptions, and by engaging in discourse with professional colleagues every day. It is certainly true that media coverage of medical issues can be oversimplified or sensationalized, and medical professionals may be tempted to dismiss such “news” as irrelevant. But here’s the thing: It is not irrelevant if your patients are seeing and hearing and believing it. You have an obligation to keep a finger on the pulse of the public conversation that is relevant to your specialty, and you’ll find this online, just like your patients do. You’ll be a better physician for it by being better prepared to thoughtfully discuss the latest controversy or breaking news with your patients. Of course, with the exponential explosion of scientific information that is generated more rapidly than any of us can reasonably digest, you may even learn a thing or two. Almost every major news organization uses Twitter. The same is true for most academic journals these days. So make it easier on yourself to stay current with news and science, and be a better physician to your patients as a result.

3.Make a bigger difference by disseminating your work. If you are an academic physician, you likely are already creating educational or research content for your own trainees and colleagues. You have dedicated tremendous time and energy already in the service of scientific advancement. You likely wouldn’t be doing so if you thought your work was insignificant. Whatever you are doing in medicine and/or academics, you probably love it—because let’s face it, there are plenty of careers out there that do not require as much school, debt, stress, liability, or night/weekend/holiday hours. If you love it, why not share it with as many people as possible? Sharing your expertise is a service to others. It isn’t spam. No one has to follow your blog or your social media updates if they don’t want to. Come to think of it, you could stop reading this right now. So, share your expertise with more people. Reach learners beyond your own trainees. Accelerate the uptake of the latest research. Make a bigger difference and have a greater influence on the medical community.

4.Engage in professional advocacy. We do important work in a complicated system. Lawmakers look to physicians to provide expert opinion and testimony on many issues, especially those that involve health care delivery. Patient safety is a key priority, but our individual efforts won’t be enough to provide the best care without institutional alignment of policy at the local, regional, and national levels.

5.Enrich your colleagues’ conference experiences. We can’t all be at every meeting we want to attend, and even when we are in attendance, we often can’t be at every session that interests us. Enter “tweeting the meeting”—socially active attendees can share the topline information from sessions, which serves several purposes at once. Late-breaking information is shared more widely; the speaker gets a publicity boost; the disease state or treatment receives more public attention; and the specialty and conference enjoys elevated visibility. Plus, information that is shared widely enjoys immediate peer review as conversations unfold in real time, which is good for researchers and good for the intended readers and ultimate beneficiaries of that research.



Why should physicians use social media professionally? Here are 6 ways that physicians can benefit directly through the use of social media:

1.Find the best partners, faculty, staff, and trainees. When a prospective partner or trainee is considering a position with your group, you can be certain he or she is checking you out online. Your website and your public presence on key platforms (Facebook, LinkedIn, and Twitter) are neutral at best, or possibly harmful to your recruiting efforts unless there is consistent, deliberate activity that paints a glowing picture of your program. Showcase the collegial professional environment, highlight awards and achievements of the group or individuals, and give a taste for the local flavor of your institution and city. You may have a very impressive staff, and your faculty may have incredible curricula vitae, but unless that is reflected in your search results, your prospects won’t see the depth and breadth of what you have to offer. This is true even of well-known powerhouse institutions. Many excellent candidates are turned off by negative reputations and rumors that may mischaracterize the environment in some of the “top” programs. The key recruitment messages you plan to share with candidates during an interview also should be ranking proudly at the top of Google. And this is easy to achieve!

2.Grow your practice by helping patients find you. When someone searches “best [your specialty] in [your area],” does your name or your practice group appear at the top? If not, a little bit of web presence can go a long way toward influencing the way Google ranks you. Search engine algorithms are complex and ever-evolving, but it really is easier than you think to exert influence over your own rank, and therefore make it easier for patients who need your expertise to find you. Similarly, if you are an academic physician, these same strategies can make you much more visible when a meeting organizer is seeking a speaker, or an editor is seeking an author, or the media is seeking a subject matter expert.

3.Analytics are an evolving academic currency. Academics place high value on being a primary author published in a major journal. But what if you could show the number of times your papers have been read or cited, and how you rank compared with your colleagues in that regard? Tools like Altmetric track your publications in the traditional measures as well as by influence measures, such as news coverage, and social media engagement, such as sharing by third parties. What if you think your work is the most talked about presentation at a major academic meeting? Websites like ResearchGate.com and symplur.comcan give you the proof to back up the claim. And I’ve already touched on the career benefits of publically establishing your expertise so that you are easily found when an expert is needed. On that note, if you think of social media and other online activities as unsavory self-promotion, stop! For one thing, a successful academic career depends on people recognizing your work and your name. For another, sharing your ideas with as many people who might possibly benefit—even if that is by challenging you or taking another view—is a good thing. Disseminating knowledge and advancing science are core reasons we publish in journals. Even the best academic journals have a ridiculously low readership compared with the web. Do both.

4.Reputation management. You already know that patients and prospective employers or partners are looking on the web for information about you. With the massive flood of health care reviews and rating websites—which rank very highly on Google—you can be sure that a search of your name will yield a lot of digital noise. That is, the first few pages of search results are likely to contain a variety of prepopulated profiles of you on the top-ranking websites. Within those profiles, there may be sparse, incorrect, or outdated information. This is neutral at best, and may be harmful if the profiles prevent important opportunities from finding you, and even worse if they contain negative reviews. But there’s good news! Just a few strategic activities can shift the order of these search results so that your best information—on sites over which you have at least some control—appears first. Professional reputation companies will charge you thousands of dollars for this, but assuming you do not have a serious problem (eg, highly publicized lawsuit), you have more influence on Google than you think.

5.Connect with collaborators. Your professional endeavors need not be limited to the small circle of colleagues in your department, institution, and specialty organization, and those you encounter at regional or even national meetings. There’s a wide world of untapped connections that share your scientific interests. A few clicks will connect you with a pool of like-minded and similarly motivated potential collaborators across the globe, and perhaps in a totally different domain. You may find connections that foster multi-institutional collaborations, or explore synergies with experts in domains other than your own.

6.Save time. That’s right. Social media platforms and online activities can actually save you time in the long run. Social media platforms offer extremely convenient ways to curate libraries of relevant articles, list your favorite publications and experts, and categorize conversations. Posting links to news articles, journal articles, online resources, and academic meeting proceedings or abstracts is an extremely easy way to track content that interests you. As a bonus, these same posts offer a practically effortless way to share the information with others who are interested. Most platforms also offer easy bookmarking (via a “like” or “save”), which makes it easy to return to interesting content that you do not wish to post or share on your own public timeline. These features make social media a powerful tool for collecting resources and ideas that may be the basis of your next professional presentation or writing project. Similarly, providing links to digital content that you’ve created, or that is in the public domain, can answer the most common questions from patients, preparing them in advance for more informed and more efficient “informed consent” conversation. For the advanced user, there is a plethora of simple dashboards that allow you to manage more than one social media account (eg, Twitter, Facebook, and LinkedIn) from a single dashboard. These management systems also offer time-saving features, like the ability to save lists of your favorite accounts or hashtags, displayed in their own feed, and to schedule your content so you can create a variety of posts at one time and have them released into your feed throughout the day or week in a prearranged pattern.

Are there risks for physicians who are on social media or other digital platforms? Of course! In fact, fear of liability or misstep is the No. 1 reason physicians cite for their lack of engagement online. These concerns are legitimate, but are easily mitigated. Physicians can stay out of trouble on social media by following a few simple, commonsense rules.

5 Tips to Minimize Risk for Physicians on Social Media

1. Many interactions online are conversational—you’ll respond to others and they will respond to you. While sharing your expertise, be clear that you are providing general educational information and not specific medical advice to any individual, nor are you initiating a patient–physician relationship. This can typically be done with a simple disclaimer in your bio on the platforms you choose to use, and by avoiding language that suggests you are recommending a particular therapy.
2. Be mindful of HIPAA rules and patient privacy. Do not post information that could identify a patient, whether directly or indirectly. Physicians can get into trouble by posting real patient information under the guise of a “hypothetical” case, but the patient may be identifiable to readers who know the physician’s practice location and the date or time of the post.
3. Never be distracted by social media during patient care. This should be obvious, but warrants a quick mention because such activity is not only a safety hazard but also represents a permanent time-stamped record that will surely be scrutinized if any untoward events occur. Absolutely everything that is posted online—even in “private” or “secret” forums—should be considered both permanent and potentially public.
4. Always use a professional tone. Never post negative content about your employer, partners, colleagues, or institution. Be sure that you are aware of and following your institution’s social media policy, if one exists. And of course, ensure that your bio and messages do not appear to speak on behalf of your organization unless you are specifically authorized to do so.
5. Conflicts of interest must be disclosed if you are posting about a device, medication, or service for which you receive compensation in any way. This is required not only by professional standards but also by the Federal Trade Commission.

Here are a few more frequent questions and practical tips for understanding and getting started on social media:
How do algorithms influence social media? There are ever-evolving rules in social media software, just as in search engines. It the early days, social media feeds displayed posts from accounts and hashtags in chronological order. Today, there are sophisticated algorithms that determine which content we see first, and by extension, due to the large volume of social media content, these algorithms may determine whether you ever see certain content at all. For example, your Facebook feed no longer shows every status update and every photo from every one of your friends in reverse chronological order. Instead, it displays an algorithmically curated set of content that Facebook thinks is most relevant to you and your interests, as measured by your behavior: what topics or accounts you interact with most via your like, share, and comment activities. Therefore, social media algorithms have a massive effect on the visibility of your shared content, underscoring the importance of interesting writing, use of links, and use of images if your goals include increasing the number of people who follow your content.

What is a hashtag, and how is it used? A social media “hashtag” is a word or phrase preceded by the “#” sign, which is used to mark and track topics for the purpose of making them discoverable to people with shared interests who are not necessarily otherwise connected. On most social networks, clicking a hashtag will reveal all the public and recently published messages that also contain that hashtag. For example, if you are interested in checking out posts about medical education, you could start by following #meded. If you are interested in patient safety, #ptsafety is a great place to start. You’ll find conversations on those topics, as well as the profiles of others who are posting on those topics, any of whom might be good connections. By way of social media history, hashtags originated as a user-created phenomenon on Twitter, and are now used on most of the major social media platforms, often in a formal way (eg, a hashtag for an academic conference or online journal club conversation).

What’s the difference between a tweet and “RT” or “MT”? A tweet is your own content, posted to your own account feed and shared with your followers only. It is still potentially visible to anyone, but will not show up in their feeds, unless it contains a hashtag or “@” mentioning other accounts specifically. For this reason, hashtags and tagging other users are particularly effective ways to amplify the visibility of your posts. A retweet (RT) is the sharing of someone else’s post on your feed, thereby making content from another user account visible to all of your followers. This is analogous to the “share” function on Facebook. A so-called “modified tweet” (MT) is an RT that you have modified in some way, typically for brevity, and calls out explicitly that the original tweet has been altered. This is good etiquette, although not required. The “quote tweet” function allows you to share the full content of another account’s twitter post, while preserving more character space for you to add your commentary.

What should I know about “live tweeting” a medical conference or presentation?This is a particularly controversial topic recently, with some presenters believing strongly that their presentation is intellectual property that they control, and others believing that they and their audiences are best served by the viral dissemination of their information. Similarly, audiences vary on their perspectives. Some are distracted by the widespread use of phones and photography during sessions, whereas others are pleased to have the virtual experience of attending more than one session concurrently or having digital notes preserved via the twitter stream. Regardless of your view, “tweeting the meeting” is increasing rapidly, and most conferences are encouraging this via promotion of an official conference hashtag. This phenomenon will only grow.

Tips for speakers:

1. Establish a social media account if you do not already have one! Assuming you have a compelling presentation, you can be assured that people will be photographing and sharing your slides. They will be doing a modern form of real-time peer review. There are numerous benefits to you!
2. First, you can use audience feedback to improve your presentations. What was powerful? What fell flat? What is most controversial? Is there an alternative perspective you’d like to include next time?
3. Second, you can monitor the discussion to correct any misperceptions, or elaborate on key areas that resonate most with the audience. This might even include sharing links to your publications or other scholarly work.
4. Third, you’ll likely find future speaking invitations (or committee nominations, etc) come from someone who found you on Twitter.
5. Finally, the discussion surrounding your presentation may make you aware of research, points of view, and experts who will be new to you, enriching your understanding of your area of interest.
6. Mark your slides with your name (even better, your Twitter handle) as a footnote or watermark. Make it easy for them to give you credit by identifying yourself and your social media accounts directly on the slide.
7. Invite the audience to tweet your presentation, if you are so inclined. Respond to the conversation (later, of course).
8. If you really want certain messages shared or nuances captured correctly, consider having a colleague tweet your presentation, or using a scheduling software to release your own tweets during your talk. Think of this as supplemental digital content that enriches your presentation.

Tips for audience members:

1. Remember that etiquette dictates that you give credit by identifying the speaker, using his or her Twitter handle to do so if you can. Ideally, also identify the conference/session.
2. Use caution when paraphrasing a speaker—which is tempting given the brevity constraints of social media—to be sure you have preserved his or her intent.
3. Be considerate of other audience members and of the speaker. If you plan to take photos, choose a seat that will give you line of sight without obstructing others.
4. Realize that while you may consider presentations to be in the public domain, it is certainly possible that not all speakers or venues share that view. Further, it is not impossible to violate intellectual property laws.

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