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Cataract Surgery | Jun 2011

The Ins and Outs of Social Media

Physicians can benefit from two-way interaction through these networking outlets.

When I created my blog, www.KevinMD.com, I was unsure what kind of following I would have. At that time, in 2004, I was one of less than 100 physician bloggers, most of whom blogged about what it was like to practice medicine. My aspirations were different—I created a forum for health-related breaking news. Little did I know that 7 years later I would have a total of 47,687 people reading my blog, more than 34,000 followers on Twitter, and 7,280 “likes” on Facebook.

It is safe to say that blogging is no longer the lone social media outlet. There are now countless professional and personal networking channels. Within the medical community, many of my colleagues have joined the ranks of physician-bloggers because they understand the power behind this medium. Social media could very well be the best outlet to communicate with our patients.


There are a number of reasons why I started using social media, the principal one being to provide my patients with dynamic physician commentary—a context that I felt was missing from mainstream health news stories. I was used to my patients asking, “Dr. Pho, what does this latest health news mean for me?” and I wanted to be able to provide more than just a verbal answer the next time the patient was in my office. With social media, I can provide health-related context, almost in real-time, for patients to apply to their own lives.

I have evolved as a blogger, using my Web site as both my foundation for social media and a stepping-stone to other networking outlets including Facebook and Twitter, thus increasing my exposure. I realize that people often rely on Twitter and Facebook for breaking news, and adding these to my repertoire means that more people will read my posts when they are searching for health in the news.


There are so many social media platforms that one cannot possibly use them all. I have chosen to concentrate on my blog and on Facebook and Twitter as my three main social media outlets. What I like is that these social media venues are complementary. I think of Twitter as the headline, and I use it to catch the reader’s eye. I use my blog as the actual article, providing readers with in-depth information. Facebook is kind of the inbetween medium, and I typically use it to guide readers to a more complete source, which may be my blog or a link to a detailed article. Each platform has its strengths and weaknesses.

Blogs. Most if not all of my patients know that I blog, and I think they appreciate hearing what it is like practicing medicine from someone behind the curtain. Physician blogs provide a window into the health care industry; it is a view and a perspective that patients do not often get.

Twitter. I always say that Twitter is “blogging on steroids,” because its real-time concept is tremendously helpful to disseminate breaking news. For example, during the H1N1 influenza epidemic of 2009, when the news was changing rapidly, I was able to guide patients to good sources of information almost in real time. However, Twitter posts are limited to 140 characters, so I could not provide readers with more than a lead to these other resources.

Twitter is also one of the most conversational of the social media, and feedback—both positive and negative—can be seen almost instantaneously. I prefer to use Twitter to curate the Web, which is achieved by following individuals and groups and reading what they have to say. Often I click through the links of what is being posted on Twitter to stay abreast of the current news. I think Twitter is a great medium for learning.

Facebook. With more than 600 million users worldwide, Facebook acts as its own ecosystem. Users log on daily to see what their friends are posting and to brush up on local and world news, including health headlines. Some of these sources are not trustworthy, and without some type of physician presence patients are less likely to know whether they can believe what they see online. Therefore, it is important for doctors to be present on Facebook to guide patients to better sources of information or to confirm that a source is useful.


Professionally, the social media are a great way for physicians to reach out to patients, and today eight in 10 Internet users look for health information online.1 In fact, it is the third most popular activity online after e-mail and use of a search engine. However, according to a survey conducted in the first quarter of 2011, only 25% of patients check the source of what they read online.2 These two statistics go hand-in-hand, because what patients are reading may be of questionable quality. If more physicians maintain blogs or use other social media outlets, we can help to increase the amount of valid information on the Web. There is plenty of room for us to connect patients to reputable sources.

Personally, social media have given me ample opportunities to speak on larger platforms. I now regularly contribute op-ed pieces to USA Today, and I write for CNN.com. These are platforms that I might not have had a chance to reach if it were not for my social media presence. Lately, I have been speaking about health care reform, and connecting with the mainstream media has given me the platform to speak to a larger group of people.

Participating in social media is one of the best ways to control what is said about you on the Web. Not only are more patients looking for health information online, but they are also researching doctors and hospitals. It is best to be in control of the information that comes up on the search engine. You do not want to have a negative news story or negative online ratings as the first hit. Even worse, you do not want false information to surface. Social media sites—whether a Google profile, LinkedIn, Facebook, or Twitter—are indexed with your name. Being present in these venues puts the individual doctor proactively in control of his or her own online digital footprint.


Doctors do not have to do all that I do. I am obviously on one end of the spectrum with my use of social media. However, I think that all physicians should consider maintaining a simple profile on Google or LinkedIn. For physicians who are just tiptoeing into social media, this professional page can be the start of their digital outpost on the Web. Once the physician is comfortable being online and having personal information online, the next step is to introduce an interactive site, such as a Facebook page for the practice or a Twitter profile.

One simple way for a physician to grow his or her use of social media is to follow the blogs and the Twitter and Facebook accounts of a few influential people. Reading what the thought leaders are posting usually leads to greater comfort in conversing and sharing more information with the public.

It is important for physicians to adhere to the strictest lines of professionalism when sharing information on the Web. The social media are outlets to millions of people across the world, and anything that is posted becomes a part of the public domain. Consider adopting professional guidelines, such as the American Medical Association’s Policy on Professionalism in the Use of Social Media (Table 1), to ensure that all posts honor the patient-physician relationship.

Also keep in mind that patient privacy comes first. Under the US Health Insurance Portability and Accountability Act (HIPAA) of 1996, patient health information must remain confidential.3 Patient privacy should be the physician-blogger’s first priority, and therefore it is best to avoid sharing personal accounts of specific cases. If images or videos are posted, all patient information must be removed.


Participating in the two-way medium that social media are famous for is exciting. But not every physician has the same comfort level with social media as I do. Starting off incrementally allows the skeptical physician to build a digital footprint that he or she can be comfortable with.

Following these simple rules, I have created a social media presence that I can truly be proud of. Patients continue to tune in to my blog, read my tweets, and check my status on Facebook to find out about breaking health care news. I know that my use of social media has strengthened my practice as well as my relationship with patients. I encourage my colleagues to start incrementally building their online presence to share the same successes.

Kevin Pho, MD, is a primary care physician practicing in Nashua, New Hampshire, and founder and editor of www.KevinMD.com.

  1. Pew Internet and American Life Project Web site.http://www.pewinternet.org/topics/Health.aspx.Accessed May 11,2011.
  2. BUPA Web site.Health and Wellbeing.http://www.bupa.com/mediacentre/healthpulse/healthandwellbeing. Accessed May 11,2011.
  3. US Department of Health and Human Services Web site.Health Information Privacy. http://www.hhs.gov/ocr/privacy/hipaa/understanding/index.html.Accessed May 10,2011.



  • Physicians should be cognizant of standards of patient privacy and confidentiality that must be maintained in all environments, including online, and must refrain from posting identifiable patient information online.
  • When using the Internet for social networking, physicians should use privacy settings to safeguard personal information and content to the extent possible, but should realize that privacy settings are not absolute and that once on the Internet, content is likely there permanently. Thus, physicians should routinely monitor their own Internet presence to ensure that the personal and professional information on their own sites and, to the extent possible, content posted about them by others, is accurate and appropriate.
  • If they interact with patients on the Internet, physicians must maintain appropriate boundaries of the patientphysician relationship in accordance with professional ethical guidelines, just as they would in any other context.
  • To maintain appropriate professional boundaries, physicians should consider separating personal and professional content online.
  • When physicians see content posted by colleagues that appears unprofessional, they have a responsibility to bring that content to the attention of the individual, so that he or she can remove it and/or take other appropriate actions. If the behavior significantly violates professional norms and the individual does not take appropriate action to resolve the situation, the physician should report the matter to appropriate authorities.
  • Physicians must recognize that actions online and content posted may negatively affect their reputations among patients and colleagues, may have consequences for their medical careers (particularly for physicians-in-training and medical students), and can undermine public trust in the medical profession.


Available at: http://www.ama-assn.org/ama/pub/meeting/ professionalism-social-media.shtml