Social Media for Medical Professionals: Strategies for Successfully Engaging in an Online World

By David R. Stukus, Michael D. Patrick and Kathryn E. Nuss

Medical professionals are increasingly engaging with social media in an effort to provide credible evidence-based information and combat the misinformation that patients are finding online and bringing to office visits. Medical professionals are uniquely poised to recognize the harm that can come from applying the incorrect information to decisions affecting one’s health, while they are also able to serve as valued and knowledgeable experts online and engage with patients and the public to provide accurate, up-to-date information.

 Social Media for Medical Professionals: Strategies for Successfully Engaging in an Online World is a unique, first-of-its-kind resource, providing specific social media strategies for engagement,  as well as advice regarding best practices for professionals to maintain at all times. Chapters discuss many aspects pertaining to social media, covering the basics, researching and assessing credible medical information online, and best practices for discussing myths and misconceptions with patients. Later chapters cover the benefits of engaging in social media as a medical professional, strategies for increasing engagement and building an audience, various options and platforms for content creation and finding your niche, dos’s and don’ts regarding patient privacy, and strategies for dealing with negative comments online.

A uniquely practical resource, Social Media for Medical Professionals: Strategies for Successfully Engaging in an Online World will be of interest to medical professionals across the spectrum of healthcare, from the student to the seasoned clinician, providing valuable perspective on practicing medicine in an evolving digital world.

 

• Language: English
• Publisher: Springer
• Release date: May 23, 2019
• ISBN: 9783030144395

Book preview

© Springer Nature Switzerland AG 2019

David R. Stukus, Michael D. Patrick and Kathryn E. NussSocial Media for Medical Professionalshttps://doi.org/10.1007/978-3-030-14439-5_1

1. Social Media: Changing the Human Experience

David R. Stukus¹  

(1)

Nationwide Children’s Hospital and The Ohio State University College of Medicine, Columbus, OH, USA

David R. Stukus

Email: [e-mail]

Toto, I’ve a feeling we’re not in Kansas anymore

—Dorothy, Wizard of Oz

Keywords

Social mediaFacebookTwitterInstagramBlogCommunicationMedia

What Is Social Media?

Do you remember what it was like to take a roll of film to get developed? Have you ever returned from a dream vacation to learn weeks later that not only did your pictures get overexposed but also that perfect picture included a wayward thumb? Was your first mobile phone a flip phone? Do you have a Hotmail account? If you answered yes to any of these questions, then you likely remember what life was like before social media. Some would say that was a much simpler time when people relied on actual conversation and human interaction in order to communicate. Others wonder how relationships could exist without instant access to updates from everyone’s lives. Whether you’ve adopted social media and have taken advantage of its many platforms, or you’ve led the resistance for the past decade…love it or hate it, social media is here to stay.

Broadly defined, social media refers to interactive computer-mediated technologies that facilitate the creation and sharing of information [1]. This can take various forms, including opinions, pictures, videos, or long-form written communication. In addition, social media involves the use of networks where individuals and communities can communicate with one another in real time and allow for exchange of ideas and commentary. While different social media platforms exist, they all share common features:

Interactive applications – The Internet allows for rapid connection between anyone with a computer or smartphone.

User-generated content – Each social media account, whether it represents an individual, a company, or an organization, can post their own content and comments. This sharing of ideas is the central element to social media.

Profiles – Each account can establish a unique profile that serves as a representation of that person, organization, or group. The user profile serves as an introduction to the world and allows other users to quickly identify whether they are interested in that user’s content.

Social networks – Social media platforms facilitate the connection of like-minded and similar accounts with one another by connecting a user’s profile with other individuals or groups.

Out with the Old

Traditional media, such as magazines, newspapers, and television broadcasting, serves as a one-way forum to disseminate information. While content delivered in this manner may provoke verbal comments or elicit an emotional response, the consumer is unable to share their opinion with the content originator in real time. That dynamic changed with the advent of social media. Data from Pew Research in 2016 showed that 86% of Americans use the Internet and among those users, 80% use Facebook , 32% use Instagram , and 24% use Twitter [2]. Unlike previous unilateral dissemination of information, we can now communicate with one another in real time by leaving comments, asking questions, or offering opinions surrounding the content disseminated by others through social media. This is a substantial shift in the dynamic of how we each receive, interpret, and process information. In many ways, this elevates the information being shared by making it more interactive, personal, immediate, and intimate. Unfortunately, the ability to rapidly post comments or replies has removed the natural editing capabilities that occur when taking time to offer a thoughtful and measured response. Instead, emotional elephants often dominate the conversation.

As recently as 10 years ago, many of us received our political, scientific, or world news solely through reading newspapers or watching the evening news. By natural extension of the editorial process and production timeline, the information shared in this manner originated during the previous day or days, was limited in scope, and was subject to biases of the reporting agency. Today, if an important news story breaks, social media and websites afford instant access to multiple sources of information and opinions, including video, written description, and commentary. The way Americans receive their news has also changed, with 62% receiving it from social media [3]. Today, news cycles occur in a matter of minutes, not days, and reading the newspaper in many ways reflects a long-form reporting of old news that occurred days or weeks beforehand.

This paradigm shift has many benefits, as well as unintended consequences. Previously, reporters were afforded more time to cultivate stories, gather essential facts, and could wait until they had a more complete understanding of the subject matter before disseminating their findings. Today, media outlets are racing one another to provide the fastest reporting, which often does not allow for dissemination of complete or necessarily accurate information. Likewise, consumers are more apt to form rapid opinions based upon how the information is presented and their own internal biases…and can now share those opinions with the entire world within a matter of seconds. In addition, we are all too familiar with the knee-jerk claims of fake news by politicians and pundits when information counters their narrative or agenda. All of these factors have fundamentally changed how information is disseminated and obtained throughout the world.

Leave a Message: LOL

This dramatic shift in how we all receive and share information has resulted in changes in how we communicate with one another. Instead of taking the time to call someone on the telephone to have a conversation, the majority of people, particularly younger generations, prefer to use text messaging to communicate. Smartphone users in the United States send and receive five times as many texts compared with the number of phone calls each day, which averages about 26 minutes a day spent texting [4]. This is certainly much faster and efficient, but also makes it easier for ideas to be poorly communicated and misunderstood. Teenagers, in particular, can become withdrawn, have higher levels of stress, or feel socially isolated if they are not receiving a constant stream of text messages from their friends [5]. Regardless of whether someone is busy actually experiencing life through social engagements or travel, they are now expected to instantly share their story on any number of social media accounts. A catastrophic unintended consequence of the ubiquitous nature of smartphones and desire to capture photos of every human experience involves deaths that occur while taking selfies [6]. A study published in 2018 identified 259 deaths between October 2011 and November 2017 that occurred, while people were attempting to take selfies while visiting dangerous locations, partaking in risky activities, or deliberately ignoring warning signs. These findings were so alarming that the authors declared a need to post signs stating No selfie zones at tourist areas located near bodies of water, mountain peaks, and tall buildings.

Concerns about frequent social media usage and depression have been raised in recent years. An increasing number of research studies are attempting to characterize the prevalence of social media addiction, which occurs when online activities interfere with daily life, especially with functioning at work or school (Table 1.1). Online harassment, or cyberbullying, is a real problem that can dramatically impact someone’s mood and quality of life. Previously, if someone wished to insult or offend another person, they had to confront them face to face or at least leave a menacing voice mail message. Now, users can spew hatred and offensive language from behind a wall of anonymity on social media, but the intended consequences are very real and felt by the recipient. While the dark side of social media has received increased attention in recent years, there is currently little that can be done to prevent or eliminate these negative aspects.

Table 1.1

Signs of social media addiction

Social Media Platforms

It is challenging to define the evolving social media services, but there is some agreement among experts regarding the distinct types of social media, which are highlighted in Table 1.2. In 2016, Merriam-Webster defined social media as forms of electronic communication (such as websites) through which people create online content communities to share information, ideas, personal messages, etc. Initial social media platforms included features such as instant messaging but have since expanded their reach and capabilities through incorporation of more engaging features.

Table 1.2

Various types of social media

Ultimately, social media is used to document and share memories, learn about new concepts, advertise oneself or business, form friendships, and grow ideas through content creation. Individuals can now build expansive networks in collaboration with other networks to help create and manage content.

It’s Gone Viral!

Some social media platforms allow for rapid sharing of content to a large number of users. Going viral is a term that stems from viral infections, which spread rapidly from person to person. A social media post or site that goes viral is shared with large numbers of users very rapidly, which increases exposure of that account and can generate large numbers of new followers. Twitter ’s retweet option, Pinterest ’s pin function, and Facebook ’s share option all allow for rapid sharing and resharing of ideas to a large number of users.

My Example

I have had Twitter posts go viral on a few occasions, but my first experience is the most memorable. In 2014, the largest Ebola outbreak in history occurred in West Africa and garnered significant media attention [7]. Ebola first appeared in 1976 and epidemics have occurred sporadically over the past several decades. The epidemic in 2014 became the most widespread and deadly on record, resulting in more than 28,000 cases and over 11,000 deaths. Infection from Ebola causes rapid onset fever, severe headache, muscle pain, and weakness and kills almost half of individuals who become infected. Infection is spread very easily from contact with any infected person’s bodily fluids. It often originates in underdeveloped parts of the world and can cause massive infection and deaths throughout a community. There is no cure for Ebola, and the only treatment is supportive care to try and keep someone alive as their organs fail and then hopefully recover. Given the rural nature of these outbreaks and limited healthcare in these low socioeconomic communities, many people do not receive effective treatment.

As horrific as an outbreak such as this can be for those living in remote parts of the world, attention and concern grew in 2014 when a few individuals with exposure on the front lines and/or acute symptoms traveled to the United States. Suddenly, Ebola was no longer a disease affecting people living in remote areas on a different continent, but it was now in the backyard of every American (or so the media made it seem). As discussed earlier in this chapter, in this instance, social media helped fuel rapid dissemination of information that was incomplete, incorrect, or created with the intent to garner a fear-based emotional response in the name of more website clicks.

During the same time frame, anti-vaccine sentiments were growing in increasing numbers among concerned parents. Vaccines have a long track record of safety and efficacy through use in millions of children and well conducted and numerous research studies. There is no debate regarding the dramatic reduction in serious infectious diseases such as polio, pertussis, rotavirus, and measles, among children across the world who have received vaccines. While anti-vaccine sentiments have been present since the origin of vaccine development in the late 1700s, social media has allowed a new platform for a well-organized and vocal anti-vaccine contingent to disseminate their views. In 2000, measles was declared eliminated from the United States. However, in recent years, as more and more parents have elected to not vaccinate their children due to unfounded concerns that vaccines cause autism or contain large amounts of toxic substances, measles outbreaks have occurred in various parts of the United States. Needless to say, the misinformation surrounding vaccines is rampant online and through social media, and this topic can generate an emotional response.

As a pediatric allergist and immunologist, I have received specialized training in regard to the immune system and am often asked to evaluate children with suspected immune deficiency. In the midst of the Ebola outbreak in 2014, one of my colleagues relayed a story of their interaction with a parent surrounding the influenza vaccine . I thought this was an interesting and timely commentary and formulated this tweet, shown in Fig. 1.1. At the time, I had approximately 1000 followers and was very careful to not violate any patient privacy laws or relay any identifiable information (see Chap. 9 for more information regarding the protection of patient privacy on social media).

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Fig. 1.1

My first viral tweet. (Adapted from https://​twitter.​com/​AllergyKidsDoc)

I sent this out on a Wednesday morning, around 11 am EST. I checked my account around noon and noticed a few dozen retweets and several comments. By 3 pm, I received a notification from Twitter that my account, @AllergyKidsDoc was trending in Toronto. This meant that the algorithm used by Twitter at the time determined my profile was being mentioned, retweeted, or commented on more than almost all other accounts or hashtags in a specified time frame. Within the hour, my tweet had been retweeted or commented on over 1000 times. I then received notifications that I was trending in New York, followed by Washington DC, and ultimately, across the United States.

I suddenly became very nervous and actually starting sweating and feeling my heart race. I had no control over and little understanding of what was happening at the time. I was worried that my employer would be upset or that people would start posting negative comments toward me (yes, doctors get cyberbullied, too). After 48 hours, and over 10,000 retweets, things settled down. My number of followers almost doubled, and I was contacted by several media outlets to discuss Ebola, influenza, and vaccines. Ultimately, Forbes magazine named my tweet one of the Top 10 Healthcare Tweets of 2014.

With experience, I have a better sense of why that particular tweet went viral and have since experimented with a similar approach to find less prolific, but similar, results (Fig. 1.2). My Ebola viral tweet included a popular hashtag, addressed two timely and emotional topics (Ebola and vaccines), and framed it in a way that relayed my observation from the viewpoint of a healthcare professional. In addition to thousands of accounts sharing that tweet with their own followers, there were hundreds of comments…and comments to the comments. This combination kept my Twitter handle as part of the overall impressions, which is what triggered the algorithm that determined I was trending. See Table 1.3 for additional elements that are common among viral tweets. I learned a valuable lesson as well: Always think before hitting send because once it’s out there, it’s out there.

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Fig. 1.2

Additional examples of viral tweets . (Adapted from https://​twitter.​com/​AllergyKidsDoc)

Table 1.3

Elements of a viral tweet

Bots and the Rise of Fake News

An interesting phenomenon has accompanied the increased use of social media. Companies or individuals have developed ways to generate wide spread dissemination through the creation of bots. These are automated programs that can post content through multiple accounts and with great frequency, in a sense inundating users with their information and agenda. Chatbots and social bots are programmed in a manner that mimics natural human interactions. Their profiles often contain pictures of real people (frequently very attractive men or women, who may be scantily clad) and appear to be human. The bot accounts then function in a manner similar to individual accounts and can like, comment, follow, or unfollow other users. At first glance, they are very difficult to tell apart from real people. However, careful review of these accounts can reveal some features that make it less likely to be human in origin, including long account names that appear computer generated, misspelled words, and high volume of messages with little interaction. See Fig. 1.3 for one example of my encounter with a bot that generated a response directed at my account after I posted information surrounding Himalayan salts.

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Fig. 1.3

Example of a bot promoting use of Himalayan salt. (Adapted from https://​twitter.​com/​AbellaA44881364)

To make things more confusing, cyborgs are a combination of a human and a bot and are also used to spread fake news or create marketing buzz. Cyborgs can be bot-assisted humans or human-assisted bots. An example is a human who creates an account, sets automated posts and will interact from time to time with other users or comments. This allows the human to cover their tracks and prove that there is a real person behind the account, should it come into question.

These social bots, chatbots and cyborgs have made it difficult for companies to utilize data from their social media accounts to assist their marketing. Bots also have helped give rise to the rapid and pervasive dissemination of misinformation, particularly surrounding emotional topics such as vaccines, politics, and health-related information. Some of these bots have been traced to individuals or organizations that intend to influence voting strategies or purchasing habits among the general population or may be specifically targeted to social media accounts that have keywords or phrases in their profiles. Other bots seem to exist with the sole purpose of promoting chaos. Either way, every person who utilizes social media must now become savvy in regard to these bots or risk falling victim to their influence.

Social Networks

There are many networks people utilize, all of which share the central features discussed earlier, but differ in unique ways that attract different demographics. Figure 1.4 shows popular social networks according to number of active users in 2018 [8]. The following section will briefly discuss some of the most popular social networks but will not be all inclusive. Inevitably, given the rapid evolution of social media, some of these platforms may become obsolete in future years, and new ones will undoubtedly be developed.

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Fig. 1.4

Number of active users for various social media networks

Facebook

Initially launched in 2004, Facebook is the king of social media platforms. With over 2 billion active monthly users, Facebook was not only one of the earliest to arrive at the party, but its popularity has withstood both the test of time and competition from new social media sites. Each registered Facebook user can establish their own personal profile that reveals their posts and content. In 2011, the format of each user page was changed and became known as their Timeline. The Timeline serves as a chronological feed of a user’s stories, status updates, photos, interactions with other social media sites, and events. Users can add and edit at any time a larger photo/header at the top of their Timeline (Fig. 1.5).

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Fig. 1.5

Facebook home page for Nationwide Children’s Hospital. (Adapted from https://​www.​facebook.​com/​NationwideChildr​ensHospital/​)

The News Feed feature of Facebook appears on every user’s home page and highlights information such as profile changes, upcoming events, and birthdays of the user’s friends. The News Feed has been revamped over the past decade to remove unwanted features such as clutter or undesirable information and users can now control the type of information automatically shared with their Facebook friends.

Facebook connects users through the friend feature. Users can send requests for others to become their friend. Once accepted, friends can see all posts and information in the other user’s Timeline . Users can also subscribe to a Facebook page, which allows access to that page’s posts without becoming friends, i.e., posts from the account that does the subscribing will not show up in the Timeline of the account they have subscribed to – this is akin to one-way dissemination. The like button on Facebook was first enabled in 2009 and allows users to easily interact with status updates, comments, photos and videos, links, and advertisements. When the like button is clicked, that content appears in the News Feed of that user’s friends and also displays the number of other users who liked the content. Instant messaging can occur through use of Facebook Messenger, which allows users to send messages to each other and chat without leaving the site. New features such as voice calls, video calls, and group conversations have been incorporated over recent years.

Facebook is used by individuals, businesses, organizations, and groups to provide information pertaining to the user’s interests and also disseminate information from others. Privacy settings can be set to allow for sharing albums with only certain group members or for all Facebook users to have access. The tag feature allows users to label other Facebook users in the photo, which sends a notification to the friend that they have been tagged, along with a link to see the photo. In 2015, Facebook launched the Instant Articles program to provide articles from media and news organizations. This enables users to have access to articles without having to leave the Facebook site. This feature has been controversial as Facebook curators can suppress or promote news that supports various political agendas.

Facebook has significantly changed how families, friends, professional colleagues, and the world at large interact with one another. There are many positive aspects to this social media giant, including the ability to maintain a personal connection with friends, relatives, and acquaintances despite living long distances apart, to generate interest and income for businesses, and for rapid dissemination of information on a wide scale. However, Facebook has been subject to many criticisms and controversies over the past decade as well. Issues surrounding user’s privacy, sharing user information with third-party trackers, facial recognition software, and its role in suppressing workplace and personal productivity are a few areas that have raised concern. Facebook has also received significant attention and criticism for providing a platform for conspiracy theorists, hate groups, and disruption of America’s political process through dissemination of fake news and misinformation. Whether the impact has been good or bad, no one can dispute the enormous impact Facebook has had on the world.

Facebook for Healthcare Professionals

There are many ways healthcare professionals can use Facebook to disseminate information, interact with patients and the general public, grow their online presence, and