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It was the first week of medical school, and we were both thrilled and horrified. Wearing our starched white coats, we filed into the lecture hall and took our seats. A white-haired physician in a tweed blazer came to the front of the room to talk to us about social media.
He projected a video of medical students drinking beer on a boat with an elderly professor that has been posted to Youtube. He explained that this was unprofessional and told us that we should not have social media. We were entering the hallowed halls of academic medicine, and we needed to fit an image of a physician: short hair, unpainted nails, and quiet. Apparently, Osler once said, “The best doctor is the one of whom the public hears the least.” Not just our social lives, but our opinions needed to be hidden.
It was horrible advice.
Without doctors on social media, people scrolling through cyberspaces like Twitter get their medical information from unreliable sources. Companies like Goop promote coffee enemas to purify oneself of toxins and tell women to use $60 jade eggs for their vaginas.
As doctors, we know that the liver purifies the body naturally. Not only is a coffee enema unnecessary, but it can lead to rectal burns and even death. While Goop tells people that queens used to sleep with jade eggs in their vaginas to impress emperors, we know that these eggs can get filled with bacteria and cause health problems.
Twitter is also a favorite platform for non-doctor politicians. They’ve used the site to spread the idea that gun violence would stop if we had more mental health access. They leave out the fact that people with mental illness are far more likely to be victims of violence than perpetrators of violence. They also fail to mention that doctors cannot reliably predict who is going to be a mass shooter. While expanding mental health care would be helpful for a range of situations, ending mass shootings isn’t one of them.
Politicians, however, love this narrative, as it distracts from the need to have more gun control legislation. They use their hundreds of thousands of followers to amplify false narratives on reproductive health, transgender health issues, health care access, and immigration. Without physician voices who can help contradict them with scientific evidence, patients and families believe what they are presented, not what is actual scientific fact. Who could really blame them?
Automated “robot accounts” and Russian troll accounts also cover the platform with messages designed to confuse the public and sow conflict. While this has been observed for racial and political purposes, they have also had tangible health consequences. These strategies have led to widespread fear around vaccines causing autism, for instance, despite broad scientific consensus that vaccines are safe and one of the most effective public health interventions ever to be developed. As a result, measles, a once eradicated illness, has had a large resurgence.
Luckily, there is a small team of physicians on Twitter fighting the companies, politicians, and bots that spread misinformation. Obstetrician Jennifer Gunter, who has over 200,000 followers, has told people the harms of coffee enemas and putting jade eggs in your vagina. Psychiatrists have started to disseminate the literature showing that expanded mental health access won’t stop gun violence. Physicians have confronted politicians on Twitter who spread misinformation about dangerous practices like conversion therapy. Pediatricians have disseminated papers and their expertise about the safety of vaccines. And reproductive health experts have taken on politicians head-on when it comes to issues related to their patients.
But it’s not enough. We’re drastically outnumbered. While there are doctors on Twitter, and that number has been growing, there are thousands of people spreading medical misinformation. It is a tragedy that physicians tell young medical students and residents not to use their voices on social media for public advocacy. As a result, generations of doctors still think it’s not a good place for them to be.
But it is not a choice to be on social media or not; it is a need. We need help fighting for the public to have safe, accurate, health information. We need to protect patients from harm. That is, after all, the most critical part of our oath, of our job.
For non-physicians reading this: Please check the sources of your health information and the conflicts (money, political gain) they posses. If you’re not sure about something, ask your doctor. Go on one of the healthcare organization websites. But always question it.
And for physicians reading this: Get in the ring. Not only should you be on Twitter, but it is part of your professional responsibility. You don’t need to post a picture of yourself drinking, but you do need to provide accurate information to save lives. The health of thousands depends on it.
Jack Turban MD (@jack_turban) is a resident physician in psychiatry at The Massachusetts General Hospital (Harvard Medical School). Jessica Gold MD MS (@drjessigold) is an assistant professor of psychiatry at Washington University in St. Louis.
