Even though our professional lives are so much intertwined with society, it has taken a pandemic for the physician workforce to enter the parallel universe of social media and digital socialism. Despite the exponential growth in popularity of social media in the last decade, most doctors have practised social distancing from Facebook and even microblogging sites such as Twitter. Privacy concerns about patient-doctor relationships, potential medicolegal consequences of social media behavior, and lack of intellectual and meaningful content on such platforms are touted as excuses to stay out of these virtual arenas. The professional vacuum created due to physician experts shying away from social media has spearheaded a negative campaign blaming modern medicine and its exponents as pro-Big Pharma and corrupt.
In March 2020, during the early days of the pandemic, social media was dominated by influencers pedaling unproven remedies, immune boosters, and fake products with doubtful preventive and therapeutic effects on COVID-19. The deluge of misinformation on COVID-19 compelled many responsible physicians to claim their well-deserved spot in the field of knowledge dissemination. The lockdown era forced medical experts from all over the world to shed their social media aversion, anxiety, and inertia overnight! Not only that, we suddenly witnessed doctors from around the world flocking to Twitter and Facebook to gather updates on medical information about COVID-19. In fact, during the early phase of the pandemic, many of us were heavily reliant on real-time medical updates exchanged between doctors from China, Italy, Spain, France, and the US.
Facing huge gaps in our knowledge about the novel virus, many private groups were launched on Facebook by physician volunteers to educate and prepare the planet’s physician army to lead the epic fight against the virus and the infodemic. Several of these physician groups now have up to 75 000 members and continue to engage and educate members in a constructive manner. They are also involved in physician advocacy on various issues including shortage of PPE, spread of misinformation, cyberbullying, and workplace harassment. Community Facebook groups made up of thousands of members and run by the general public in major Canadian cities have been successful in conducting interactive webinars hosted by physician experts in order to clear COVID-19 misinformation. There is also a Facebook group named “COVID-19 Physicians Memorial” created as a tribute to physicians who have died while fighting COVID-19. The group shares information and obituaries of physician warriors from North America. As an emerging trend, we see physician celebrities with thousands of Facebook followers engage in debunking COVID-19 myths generated by Dr Google, WhatsApp university, and YouTube academy. A Facebook post from 5 March 2020 by Canadian infectious disease specialist Dr Abdu Sharkawy has been shared by over 1 million Facebook users so far.
Twitterati physicians are able to engage in day-to-day interactive learning through regular updates from leading epidemiologists, eminent researchers, infectious disease and critical care specialists, policymakers, physician leaders, hospital CEOs, and even prominent media personnel covering the pandemic. Twitter took the extra measure of promoting credible COVID-19 information by verifying the accounts of physician experts with its blue checkmark badge. This was done in consultation with global public health authorities.
Almost all high-impact journals now have Twitter handles, tweeting regular updates on cutting edge research on SARS-CoV-2. Virtual journal clubs, medical case discussions, and even graduations happen on a daily basis via Twitter.
Health care workers have also been resorting to mobile applications such as WhatsApp for real-time professional communication and knowledge exchange. Facebook, WhatsApp, and Twitter have thus evolved into a virtual front line for knowledge translation and dissemination related to the pandemic.
Zoom is another phenomenon that has been imposed on us due to COVID-19. This year many organizations held their international conferences virtually on Zoom and similar web applications.
Recognizing the need to capitalize on social media popularity, some universities have appointed chief medical social media officers to consolidate their digital footprint. Thanks to the infodemic mess, infodemiology is now a popular area for medical research. The World Health Organization recently conducted an online conference on infodemiology as part of its fight against misinformation and disinformation. Non-profit organizations and groups like the Association for Healthcare Social Media are being launched to help promote positive social media engagement by doctors.
Although the number of social media physicians is growing fast, the lack of professionalism in engagement is a rising concern. Unfortunately, there have been instances where the public has witnessed fierce debates between doctors on social media, exposing the professional divide around various aspects of COVID-19 lockdown and treatment. Receiving billions of views, COVID-19 misinformation is not only putting lives at stake but has also led to many influential physician researchers and front-line doctors facing character assassination and even receiving hate messages and death threats from social media mobs.
Sadly, some of these hate campaigns are triggered by the lack of consensus of opinion among physicians dealing with the pandemic. The emerging trend of individual physicians trying to spread awareness on various COVID-19 topics may end up creating chaos and confusion owing to the mixed tone of messaging. Since social media is where the public consumes scientific information, it is crucial that we as physicians, collectively, direct the public toward the credible sources of information. It is high time we ourselves became familiar with the perils and pitfalls of evidence-based medicine.
Moving forward, CME activities should include sessions to empower physicians with the skillsets required for critical evaluation of scientific literature. Dissemination of anecdotal data on COVID-19 should be discouraged as we are starting to see emerging high-quality evidence on many aspects of the disease. Also, we have to be sure our inferences and conclusions are not based or influenced by that of the echo-chambers that we knowingly or unknowingly are a part of. Many doctors use social media for self-branding and to promote academic activities and their clinical practice. Some even engage in political discussions and digital health care marketing. Doctors should be aware of social media etiquette as carving an online identity is serious business. We need to be mindful of when to tag someone on our posts, try not to violate the privacy of our patients, and prevent falling for click-bait. Let us be cautious of online hackers, phishing scams, and disinformation campaigns. Drunk tweets are a big no. It also helps to be cognizant of our employer’s regulations and expectations around professional behaviors on social media. Also, be careful not to share personal information in large Facebook groups. Finally, we must always verify the source and credibility of the information we share.
Although we have seen specific guidelines and toolsets developed in the last decade by health care institutions and physician organizations, such resources seem to be inadequate to empower doctors to combat the deluge of COVID-19 misinformation and quickly become outdated. We need better information channels to familiarize physicians with new concepts around social media monitoring tools, data analytics, Facebook algorithms, content creation, and influencer marketing tips.
“The life so short, the craft so long to learn.”―Hippocrates
—Nisha Nigil Haroon, MD, DipNB, MSc, DM
Assistant Professor, Internal Medicine and Endocrinology, Northern Ontario School of Medicine
This post has not been peer reviewed by the BCMJ Editorial Board.
An earlier version of this post was published by the Canadian Healthcare Network