As one of the 700 official “Tweetiatricians” on the American Academy of Pediatrics (AAP) doctors on Twitter list (follow me @Dr_ScottK), I can personally attest to the good and bad of being engaged on social media. In this month’s Pediatrics, (10.1542/peds.2020-049685) the Committee on Bioethics and the Committee on Medical Liability and Risk Management published the first ever clinical report on the ethical use of social media for pediatricians. This wide-ranging report covers the gamut from why pediatricians should consider using social media to the challenges of confidentiality and reputation targeting. If you are on social media, or considering joining one of the many modalities, this report is a must-read and might help you avoid many of the pitfalls that come with having an active online presence.
If you are not on social media as a pediatrician, I would encourage you to join. While the clinical report offers great guidance, I’ll offer my thoughts on the good, the bad, and the ugly of being a public social media pediatrician. First, the good. With more than 300 million people in the United States using the internet and seeking out health information, it is imperative that pediatricians support, promote, and encourage factual and reliable health information. With targeted and well-funded anti-vaccination and anti-science campaigns garnering millions of “shares” and “likes,” strong pediatric voices need to be part of the discourse and provide good consistent public health messaging. Additionally, the comradery and networking of pediatricians on social media is valuable for both professional and personal growth. And most importantly, the opportunity for advocacy is enormous. Many tweets from pediatricians have led to policy changes, national media attention on key issues to improve the health of children, and have amplified the voices of marginalized communities seeking justice and change from racist and anti-immigrant policies. I cannot stress how valuable it is to follow the social media accounts from our Black, Indigenous, and other People of Color (BIPOC) colleagues and the community organizations on the ground seeking social justice reform. Through their tweets and posts, we can learn from and amplify their voices.
The AAP clinical report highlights many of the “bad” or challenging aspects of social media engagement. I would stress the need to maintain professionalism when posting publicly. The mnemonic THINK before you post is very important: is what I am posting True, Helpful, Inspiring, Necessary and Kind? Are you avoiding posting confidential information, whether from an organization or a patient? Are you attributing someone else’s thoughts/contents appropriately? The answer to all these questions should be “yes” before you post. As one who has overshared and has tweeted too rapidly, these are hard lessons to learn, but are incredibly important. It is sometimes easier to do more harm than good, so slow down and pay attention to what you type before hitting send.
The “ugly” of the internet has been experienced by many people who have been personally attacked online. The medical community is not immune to this from both within the community and from outside. While the internet is very good at policing unacceptable positions, there are times when a physician or one in training isn’t just called out but attacked and reported to supervisors and licensing boards. Clearly, truly unprofessional behavior should be reported, but at times a cancel culture has caused harm. More pertinent to pediatricians in practice are the reputational attacks from afar. Numerous pediatricians have been systematically targeted by anti-vaccine groups with threats, negative reviews, and reports to licensing boards for posting pro-vaccine messages. These attacks are stressful and time consuming, and fortunately a group of pediatricians has banded together to counteract these attacks through the “Shots Heard Round the World” group – “Shots Heard is a rapid-response digital cavalry dedicated to protecting social media pages of health care providers and practices.” If any pediatrician is attacked online, a large group of active pro-vaccine professionals are activated to respond to the attack.
Hopefully I haven’t scared anyone away from joining social media. If you are interested and need a place to start, the AAP offers a social media conference and the members of the Council on Communications and Media can help those new to social media find their niche and voice. If you do join in, you’ll be happily welcomed by the thousands of pediatricians already active on social media.
