The Doctor Will Tweet You Now

WHEN YOU THINK of social media and healthcare, you might not automatically see an obvious connection. While social media is focused on sharing information, many aspects of the healthcare industry are characterized by a need for privacy rules and HIPAA guidelines. But the fact remains: Social media has increasingly influenced and, in some ways, dramatically changed how healthcare is managed. As the world becomes more and more digitally connected, the healthcare industry has had to evolve to meet changing patient preferences and demographics, especially as younger patients who depend on social media become young adults with their own healthcare needs. In 2020 alone, telehealth, once a debated and somewhat fringe idea, went mainstream overnight in the face of a global pandemic. And as more and more people get comfortable with remote access to care, social media healthcare platforms seem poised to become even more prolific.

Extending the Doctor-Patient Relationship

The Journal of Medical Internet Research reports 99 percent of hospitals in the U.S. have an active Facebook page, and the use of other social media platforms like Twitter and Instagram is also on the rise.¹ From a provider perspective, perhaps the biggest benefit of social media in healthcare is information dissemination, which provides physicians and healthcare institutions a platform to share research data, health tips and lifestyle recommendations with patients. Social media can also help build trust between patients and providers; when providers share up-to-date health research and stories on their accounts, patients may feel more confident they are receiving leading-edge care. Not only does this build confidence with existing patients, it also increases the opportunity for patient referrals as people begin reposting information in their own social media feeds.

“Social media is merely an extension of the doctor-patient relationship,” says Kevin Campbell, MD, FACC, an internationally recognized cardiologist who specializes in the diagnosis and treatment of heart rhythm disorders. “When physicians are active on social media sites, it affords them with an additional opportunity to reach patients and impact the daily choices that patients make. Lifestyle changes are much more likely to be implemented with regular reinforcement, and social media is a simple way to reach hundreds of thousands of patients — and it only takes minutes.”²

Dr. Campbell adds that social media provides patients an opportunity to easily interact with physicians, nurses and other patients, noting that blogging sites offer the opportunity to express opinions and share common experiences. “These often provide patients with a great source of information about a particular physician, hospital or procedure. Twitter is another platform that allows patients to interact and discuss conditions and experiences in real time,” he says. “It is a great place for debate, and these discussions lead to better patient engagement.”

Social Media as a Decision Influencer

Millions of people use social media on a daily basis to select a restaurant, find a hair salon or review a travel destination. And, in a similar fashion, people are increasingly turning to social media when it comes to choosing a healthcare provider. A Pew research study showed 83 percent of Internet users have searched for health-related information online, with search topics ranging from mental health and disease management to immunizations. Moreover, the study found 60 percent of social media users trust the information shared by doctors and other health professionals.³

According to a PricewaterhouseCoopers (PwC) report, 41 percent of patients interviewed said social media content impacted their choice of hospital or physician.⁴ The ability to read reviews from other patients not only offers patients peace of mind, it creates a level of transparency for physicians. In fact, online reviews of individual physicians and group practices can also help to improve the quality of care. If a significant number of individuals leave feedback about poor or unacceptable levels of care, changes are likely to be made to improve them. On the flip side, healthcare providers can also use social media to their advantage by utilizing online polls and surveys to obtain feedback from their patients and then use this data to make changes to improve their services.

The PwC report also noted that by using social media for research and information gathering, patients are able to come more prepared to consultations and may even ask better questions. In addition, social media has become a popular tool for patients to expand their knowledge about their condition and treatment options. For example, 29 percent of patients peruse social media to view other patients’ experience with their disease, and 42 percent browse social media platforms to discover health-related consumer reviews, according to the report.⁴

“Social media usage makes patients more inclined to actively communicate with their doctor during the medical consults in the first place,” says Kevin Meuret, CEO of Mantality Health, a healthcare practice that performs testosterone replacement therapy on men who qualify. “Growing conversations on social media about ‘stigmatized’ conditions such as low testosterone levels or psoriasis send a powerful message to other sufferers and encourage their willingness to seek medical attention.”⁵

The Power of Online Patient Communities

The proliferation of self-organized online communities of patients, often focused on a particular disease, is a healthcare trend worth noting. Patient-led sites that serve as virtual support groups are the most well-known platforms and often provide features such as a moderated forum, blogs, advice, support, academic references and a retail page selling relevant products. These sites provide a sense of connection and community while giving patients an opportunity to share ideas, treatment plans and approaches, and they provide access to others who share similar healthcare experiences. It’s these types of connections that can positively influence healthcare outcomes.

Dr. Campbell says when patients are involved in online discussions, they are more aware of their disease process, more likely to make lifestyle changes and more compliant with their medicines. “Twitter chats are a great way to create ‘virtual support groups,’” he explains, “and these often breed communities of patients with similar medical problems. These communities are a fantastic way to connect patients (when patients connect, they are able to support one another and hold each other accountable). Just as with an exercise buddy at the gym, this accountability and buddy system works well for improving compliance.”²

Providers are also using online communities and social media platforms to promote access to care. For example, the Psoriasis Association launched an awareness campaign on Instagram that encourages users to share images of their condition using #getyourskinout and #psoriasiscommunity. Dominic Urmston, digital communications officer at the charity, says, “Users can find people who share similar experiences who they can chat to and support one another. Also, it empowers them so they can share images of their psoriasis and post about their experiences, too. As a result, the condition becomes less stigmatized, and more people are encouraged to weigh in on various treatment options and speak about them with their healthcare providers.³

The AMA Journal of Ethics notes that online health communities offer numerous benefits of participation and access to an abundance of information for patients and their caregivers, family members and friends. More than half of members on the popular PatientsLikeMe site said the site was either moderately or very helpful for learning about their symptoms, and it helped them manage symptoms and understand treatments, and almost half said they connected with another member who helped them learn more about a medical treatment.⁶

Social Media and Public Health

Social media has the advantage of reaching more people worldwide than any other forms of media. This reach is especially useful during a global health crisis, since it provides a platform for sharing important information quickly and in real time. The Zika outbreak in Brazil in 2016 provides an instructive example. The virus, spread through mosquito bites, began to circulate right before thousands of tourists were due to arrive in the country for the Rio Summer Olympics. Using social media, healthcare providers, news outlets and charities were able to disseminate important information about the virus such as how to prevent it from spreading, how to avoid mosquito bites when traveling to the infected area, risks for vulnerable individuals such as pregnant women, and symptoms to look out for. In fact, the Centers for Disease Control and Prevention (CDC) earned a Social Media Campaign award from Ragan Communications for its campaign effectiveness.⁷

Of course, as with any platform that gives communication access to the masses, the opportunity for spreading misinformation increases exponentially as more and more users log on, consume and share social posts. This proliferation of misinformation was displayed widely during the early days of the COVID-19 pandemic, despite efforts by leading social platforms to “control the narrative.” For example, Facebook established a COVID-19 information center to share information about the virus from vetted government sources and credible media outlets. Unfortunately, this center was promoted alongside a plethora of other pandemic-related posts, including misleading ones. Other outlets also led the charge to share accurate COVID-19 information with the general public. YouTube started directing people to coronavirus-related videos from official sources like the World Health Organization. And Twitter, Instagram and TikTok took similar approaches. Despite these efforts, one of the identified challenges came from the way people consume information online; inflammatory and misleading headlines are more likely to get attention and clicks than straightforward news bullets from a government-sponsored site.

Even with these drawbacks, in times of crisis, the use of social media offers many benefits, including minute-by-minute realtime information. Through social media, hospitals and other organizations are able to deliver updates on hospital capacity, operation status and emergency room access. Having an active social media presence also allows healthcare professionals to pass along information shared by organizations such as the Red Cross and CDC or communicate with news outlets.

From a public health perspective, social media can also offer helpful data that might otherwise be challenging to gather. People post about everything online, including their health, and simply tracking something like #flu can reveal when and where a virus is spreading. In their book Social Monitoring for Public Health, professors Michael Paul and Mark Dredze explain, “Social media offers advantages over traditional data sources, including real-time data availability, ease of access and reduced cost. Social media allows us to ask and answer questions we never thought possible.”⁸

The Future of Social Media and Healthcare

For providers looking to navigate the numerous potential pitfalls of social media, whether for practice promotion, networking or to connect with patients, ample resources are available to make the prospect less risky. The Association for Healthcare Social Media is a 501(c)(3) nonprofit created to support healthcare providers on social media. The organization provides resources to help physicians who use social media comply with HIPAA concerns, as well as how to disclose conflicts of interest, how to navigate industry relationships and how to cite medical literature so patients and others can easily understand it.⁸

In addition, the American Medical Association (AMA) has developed a code of medical ethics relating to professionalism in social media use.⁸ AMA encourages physicians who use social media to:

• Be cognizant of standards of patient privacy and confidentiality, and refrain from posting identifiable patient information online.
• Follow ethics guidance regarding confidentiality, privacy and informed consent.
• Use privacy settings to safeguard personal information when using the Internet for social networking, keeping in mind privacy settings are not absolute.
• Maintain appropriate boundaries of the patient-physician relationship in accordance with professional ethics guidance.
• Consider separating personal and professional content.
• Bring unprofessional content posted by colleagues to their attention, or report the matter to appropriate authorities.
• Recognize that actions online may negatively affect their reputations among patients and colleagues, may have consequences for their medical careers and can undermine public trust in the medical profession.

As social media trends continue to expand and evolve, the healthcare community will undoubtedly have to remain flexible and open to innovation. And, as both younger patients and younger physicians who have grown up with social media begin to incorporate online platforms into the foundations of their doctor/patient interactions, social media use may become the rule rather than the exception.

The AMA Journal of Ethics summarizes it this way: “There are many positive social media uses for healthcare professionals. As technology advances, social media guidelines will be modified, and yet the underlying principles of professionalism will remain. Best practices will emerge and outpace the guidelines, but if they are ‘best,’ they should maintain — and even enhance — the public’s trust in healthcare professionals.”⁹