Social Media in Surgery

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Some thoughts for Social Media Panel at the American Academy of Otolaryngology Head & Neck Surgery Meeting 2019, New Orleans.

Social Media is here to stay. The lines between traditional media, digital media and social media are blurred. Contents of traditional media are presented on social media platforms. Social media has become an acceptable entry point to digital and traditional media. The difference between social media and other forms of media is the social element. It is a two-way engagement with the information presented. The reader can engage directly with the content creator. In the past, a journal is published and passively read subsequently with significant time gaps in between. Today, an article can be presented at a meeting, brought up on social media and then discussed by various different experts from different countries each engaging in real time with the topic at hand.

How do you use social media in your practice?

In my mind I see 3 levels of social media use:

  1. Entertainment. This is where most people are and where the misconception is. Many people think that social media is a Weapon of Mass Distraction. And it’s true to a certain extent. This is where we watch cat videos, watch others getting pranked, and enjoy pictures of other people’s lunches. It’s a 2-way street. I get entertained, and I try to provide entertainment too, by adding terrible dad jokes and interesting pictures of my travels.
  2. Education. This is when we start to leverage the use of social media as an information highway. I read news, journal articles, opinions and thoughts. I curate who I listen to. Less of Justin Bieber or Kim Kardashian, more of ENT Journals and ENT News. I get educated, but I also educate by adding contents of value.
  1. Engagement. This is the part where you use Social Media as a platform for engagement, change and advocacy. Tweets can alter the reputation of others. Social Media articles can influence thoughts. The #MeToo movement was born from social media impetus. Several organisations, book publishers, medical conference panels have been brought down by tweets and status updates. You get engaged by topics you are passionate about, and you engage others in that area too.

My day to day use of social media is for those benefits. Notice that marketing or advertising is not part of my daily use. As an individual or corporate entity, you can use social media for those marketing purposes. The metrics and tools are different and there’s a whole professional industry group now established for that purpose. There would be many social media professionals available to help you with that.

How do you separate personal and professional social media?

Separating personal and professional social media is an individual preference. You can share as much private aspect of your life as you like. Totally up to you, but bearing in mind the issues with personal information and safety. I know that friends, colleagues, patients and strangers see my social media updates. I need to be careful not to overshare personal things. I have my private Facebook and official Facebook page separate.

How do I get started in professional social media?

Just do it. It’s going to get bigger and become more mainstream. Get your real estate address and slowly build up your property and presence over time. Grab hold of the 5 most common platforms: Twitter, Facebook, Instagram, LinkedIn & a website. Grab an easy handle on all, and create a similar content on all of them. I started off being an anonymous user during my residency training. I set up a WordPress blog and a Twitter account. I blogged my experiences as a surgical trainee. I linked the contents to twitter and engage twitter friendships. I learned quietly as an anonymous how to do it well. What to do and what not to do. Overtime it got big. So when I became an attending, I closed my anonymous account and set up my professional accounts. I use a similar content across all platforms and linked it to each other so it becomes a connected presence.

Some studies show that the vast majority of our patients have smart phones. They would have done their research prior to seeing you in your clinic. Many patients have researched their condition, their physician and they may even have found other patients with the same conditions. Our patients are coming to us engaged with both good and bad information. To me, having a social media presence allows my patients to get a feel for my expertise prior to them even seeing me face to face. I think it helps build rapport.

Common pitfalls?
A common pitfall would be wanting to go big too quickly. Social Media is social. It takes time to build relationships and presence. Another common pitfall is poor tone. Communication on social media is not the same as communication face to face. Lots of nuanced information is lost in social media. Misinterpretation, misunderstandings occur. Sarcasm and jokes don’t work too well. Be wary of engaging in heated discussions over social media. That’s another pitfall, engaging in long discussions over complex controversial topics. There are some topics that just don’t go well in social media. I have personally drawn some lines over religion and politics. Other things like gender equality and immigration are controversial yet I feel strongly about it so I engage in it. Just be aware and be careful of the tone you use in these discussions. You do not want to ever sound patronising or holier-than-thou. Much safer to ask questions than to make statements. Also, do not engage trolls or negative comments. There will just be a lot of to and fro shouting over social media. Lots of these negative heated discussions will fizzle out and be forgotten pretty quickly.

Legally speaking, there are rules around social media use in our professional practice. You are bound by HIPAA, I am bound by the Australian regulations. There are 5 things that we cannot do in Australia on social media:

  1. No false or misleading claims.
  2. No enticing of services with gifts
  3. No testimonials
  4. No claims of unreasonable expectation.
  5. No encouragement of unnecessary servicing.

I can talk about conditions, but I can’t talk about patients. I can talk about what I do, but I can’t say that I’m the best. I cannot entice them to come to my practice with gifts. No matter how good my patients think I am, I can’t put their reviews on my website. I can’t say “2 for 1 get two tonsils out for the price of one”. If your goal is to entertain, educate and engage positively, there are no rules around that. If your goal is advertising, then there are rules around that. I am also very careful about engaging patients on social media. The moment you identify as a doctor, you are immediately held to a higher standard. In fact, if a patient wrote on your Facebook page and you replied, you’ve already broken confidentiality rules as you’ve suddenly identified him or her as a patient of your practice. Be careful.

Pearls from your experience?

Be authentic and be respectful. If you’re likeable in real life, you’re probably likeable on social media.

You already have the content. You are the content expert. There’s no repetition of work, you put on social media the stuff you say regularly on a day to day basis. Re-write your abstract in lay terms and you’ve got a blogpost. Summarise your grand round presentation into a tweet or blogpost. Write down the controversies around your subspecialty are and you’ve got a discussion started.

Start small, and do it slowly over time. Watch, listen, ask questions, be funny, be human. The techniques of using twitter, facebook, Instagram are all slightly different.

Do I need to use social media?

It depends on what you’re using it for. It depends on your practice patterns. The short answer is no you do not need to use social media, but personally, social media has accelerated my career and opened up numerous opportunities that I did not plan for. There are bonuses of having social media. I am not using it for advertising, but I can report that I have had many patients referred to me through social media. I have had speaking invitations, collaborative projects, and international friendships made rapidly though social media. Social media breaks down the walls and silos that restrict communication channels.

Can you please explain what it means to be an influencer?

It’s not about the number of followers you have. It’s the value-added impact you have on others. Hard to measure. Perhaps you should ask an influencer.

Pick 3 topics close to your heart and tweet/write about it. Engage in that discussion. My 3 advocacy areas are social media in health behaviours, clinician wellbeing and leadership/cultural change. I try to engage in these topics in the hope of influencing the trend and discussion around these issues.