Social Media: A Friend or Foe for Healthcare Professionals?

Dr Chapa:
The use of social media has become a way of life around the world. And many use social media tools to stay in touch with friends or share life experiences. Others may use these platforms for more professional reasons, including medical education. But in the digital age where online posts have the potential to spread like wildfire, even some well-intentioned professional posts may have some unexpected consequences.

Welcome to Clinician’s Roundtable on ReachMD. I'm your host Dr. Hector Chapa. And here to discuss the use of social media for physicians is Dr. Mikaela Rush. Dr. Rush is a board certified OB/GYN physician in Cedar Park, Texas, with a sizable following on social media, including TikTok, where recent posts took an unexpected viral turn. Dr. Rush, welcome to the program.

Dr. Rush:
Thank you so much for having me. I'm excited to be here today.

Dr Chapa:
Well, of course, it's always great to hear from you. And we'll get into how we know each other a little bit later on into the program. But I want to concentrate on the message at hand here. Now Dr. Rush, you're no stranger, of course, to social media, and I do follow you actually on one of your platforms. Can you tell me a little bit about why you chose to have a social media presence to begin with?

Dr. Rush:
Yeah, so it pretty much started on Facebook for education from my office and for my patients. And then I added on Instagram to reach a larger audience. Now that Instagram and Facebook are linked together, you can easily post to one and cross over to the other. So it's easy to post on both. And then I decided to add on to TikTok to reach an even larger audience. It's a very different audience I've discovered but it's overall been fun. And it's a new way to educate and to get medical information out there to a new audience.

Dr Chapa:
Well, as we said a little while ago, we definitely know social media is not going anywhere. It's actually growing. And there's pros and cons, as you know, Dr. Rush, to everything. And I know that you recently posted a little brief video regarding a very common OB/GYN procedure, which is placement of an implantable contraceptive device into the arm. That post went viral, but maybe not how you expected it to. So tell us a little bit about this post and just what happened here and the reactions it drew.

Dr. Rush:
So the post itself is probably only maybe nine seconds, but it was just a quick video, an insertion video of the subdermal implant contraceptive in the arm, and it was just meant to show how quick and easy the insertion was. But the comments started pouring in. And once it goes viral, when it gets into the millions, your comments are getting into the thousands. And basically everyone can post about how much they hate it or all the side effects and how terrible it is. And you get a lot of negative comments. And then the more concerning ones were coming through about how long you can leave this device in. So this specific device was FDA approved for three years, and comments were pouring in about how I was wrong and how it's five years, they were told five years.

Dr Chapa:
Well, now, let’s back up there for a minute. What were they saying that you were wrong about? What did you say? We know that you posted a video about an implantable contraceptive device. We do that a lot in OB/GYN practice. But  what did you say that caused the spark – to cause this thing to catch fire? Was it the video itself? Or was it something that you said?

Dr. Rush:
So in the video, there were titles in the video just describing the actual device and how long it lasts and what it is. In the video, there was a notation about how it's good for three years. So it was just more factual, just information about the device itself. But the comments would roll in about how it was incorrect and how I was wrong. It's not three years, it's five years. Their doctor told them five years, it's not three years, and then there would be debates going on in the comment section about the length of time that this device is good for, which was baffling to me because that's not debatable in my mind.

Dr Chapa:
So let's clarify this for non-women's healthcare providers. So this contraceptive implant that was implanted into the arm is available in the United States and is FDA approved right now for three years. Now having said that, there is medication in that device that extends its use outside the United States because remember, every country has their own regulation; some countries outside of here in the United States use it by their approval for up to four and, at times, five years. So just to clarify that the controversy was nothing really controversial because what Dr. Rush stated – Dr. Rush, tell me if this is correct, is that the device here is approved for three, and that made people flip. So go on a little bit more about this. What were those posts like?

Dr. Rush:
Well, most patients or other people would post that they would just be disagreeing with the three years. But when it comes to my side of it as an educator and as a physician and on the social media side of things, you want to educate people, but you can't get into the storm and the snowball effect of commenting back and forth. Right? So you can't comment on other comments without it -

Dr Chapa:
-taking a life of itself.

Dr. Rush:
Yeah, and it just grows out of control. So when you actually post on your own post, it labels it as a creator is commenting on this, and it actually makes it more visible. So then that post would be even more visible, then more comments would roll in on top of that. So you have to refrain from posting onto it. So you don't want to respond necessarily to negative posts or other posts, but you want to educate. So usually what I would do is if I need to clarify something or educate, I would make a separate comment post on my own, just a single post not responding to another comment.

Dr Chapa:
Understood. Now to be very clear, your intention was never to cause some kind of debate about the longevity or use of this device; it was just to show what the procedure look like. But that's what it turned out to be. It turned out to be a discussion and/or argument about the use. And did some comments say that you were wrong?

Dr. Rush:
Oh, of course. I mean, people were telling me that it wasn't three years, it was five, you know, and so comments would roll around saying that I was incorrect, which obviously I know I'm correct. So then you wonder what country are they in? Is it a different device that they're thinking of or some of them are in the U.S., and they were told by their doctors here in the U.S. that it was five years. So then there's a whole different debate in regards to that.

Dr Chapa:
And I think that's one thing, and this is a good lesson for any healthcare provider, from a nurse to a midwife to a physician who think about social media, is things that we take for granted as understanding may have to be said out loud in an overt way to prevent confusion. So for example, in the United States, device, X, Y, or Z is approved for this amount of time, but it may be used for an extended amount of time based on the conversations with you and your provider. And that's something that I learned from that, Dr. Rush. Wouldn't you agree with that?

Dr. Rush:
Yeah, I totally agree. And that's exactly the comment that I placed onto my own video was that in the U.S., this device is FDA approved for three years, and I just left it at that. It was a fact, it just is, I made the comment to clarify because that's all you can do is just clarify; in this country, this device is FDA approved for three years. And just leave it at that.

Dr Chapa:
Once you saw that this post literally went viral, which a lot of people want things to go viral, but maybe in a different way. What was your initial response? Was it happiness? Was it shock? Was it worry? What did you feel when this thing went viral?

Dr. Rush:
So you know this one was surprising to me just because it wasn't a post I thought would go viral in any means. And I think any of my viral posts always shock me because it's just not one that I would expect. The first time I ever had a post go viral, it was very stressful to me and you kind of feel like you lose control and it spirals out of control very quickly. You just can't control the comments that start rolling in. But you kind of learn that after you've been through it a little bit, you just kind of have to learn to just back off, maybe not even look at the comments, don't even read them, you just gotta let it roll. Because otherwise you stress out. It'll stress you out and then you want to start blocking some of them but then you start blocking and then you actually get blocked by that platform itself. So in TikTok, I would get blocked if I deleted a very negative comment that surely shouldn't be on there. I would actually get blocked or banned for certain things for about 24 hours on TikTok. So you can't really block or delete comments without facing consequences. So you just have to let it roll and play out. And then you can't really control all the comments, especially when you're dealing with thousands of comments. You just have to just let it go.

Another thing I would say, if you let it go long enough, other educated people will start to chime in and start defending it. They will try to re-educate the other people who are potentially incorrect. And sometimes they get into their own debates, but it is kind of nice, where you can kind of sit back and watch some other people come in and defend you a little bit and try to help the other person understand what they're not understanding. So sometimes you can see some of the people come into your rescue.

Dr Chapa:
For those just tuning in, you're listening to Clinician’s Roundtable on ReachMD, and I'm your host, Dr. Hector Chapa. And I'm speaking with Dr. Mikaela Rush about her recent experience on social media as a practicing OB/GYN physician.

So Dr. Rush, one thing that you've kind of alluded to already, and you've already given some  pearls of wisdom, if you will, for physicians, or any healthcare provider, who is looking to go into social media to have a presence. What are some key facts or some guiding points or just some tips that you would give in addition to what you've already stated?

Dr. Rush:
Well, first, I would say if you are not on any social media and starting out from scratch, you just have to know your audience, who you're actually trying to reach, whether it's just for your work or for your physician page, or whether it's a work page or personal, and then which platforms you choose to work on. They're all a bit different. And they have a different audiences. So you need to know who your audience is that you're looking for. But also, I think it's a great tool for networking, especially Instagram. Instagram has been fantastic for networking for other physicians and other providers in your field. And it's great for patient education. You learn little nuances about it over time, but if you can find current users, they can kind of show you the ropes and help you out. But you can also hire specific people that are great at social media, and they can take over social media for your practice if you don't have the time. But you have to kind of plan your own content and know what you plan to educate about or what you want to actually post.

Dr Chapa:
Now as another tip for our listeners, I would like to put this out. It doesn't matter who you are, if you put yourself out there and, Dr. Rush, I want to see if you agree with this, you've got to be able to expect the unexpected. So Dr. Rush, I'll tell you it was this had to be about 10 years ago, and I was so excited, I had signed up to be a trial investigator for the FDA for a new birth control device. And so in joy, right, and excitement, I did a two-sentence post on  Facebook that I'm doing a new trial about a contraceptive device for women, you know, looking forward to next advances or something similar to that. And I was bombarded by comments. But again, people I didn't know said that this device was barbaric. Mind you, it's an FDA trial, you know, how can I sleep at night and I gotta be honest, it took my breath away. I felt hurt. I felt disappointed because that's the last thing that I wanted to relay as who I am. And so would you agree, Dr. Rush, you have to be able to have a certain thickness of skin, and mine got thick really quick from that, if you're going to get yourself out there, you've got to be able to expect the unexpected. Would you agree? 

Dr. Rush:
I completely agree. And it's almost like how people say if you're famous, any news or media is good media, right? So any news is good news. So if you're out there, whether it be negative press or good press, I mean, at least you're out there and your name is getting out there. So the way I look at it is even if I'm getting negative comments or people are confused or whatnot, the more comments that go on there, the more people start to see it, and maybe I'm educating someone out there. But also I'm gathering more followers at the same time, which means I can still educate more people in the future. So the more people that follow, the more I can still educate. So you know, there's got to be a silver lining somewhere.

Dr Chapa:
Absolutely. And I think that's great advice as we get to the end of the program. I heard it once said, and it's something I teach my children and even teach our medical students and our residents is, “Listen, if you hear someone talking negative about you, then consider this and say, ‘Well look, at least I'm interesting enough where people are talking about me.’” At least you've got to have a way to spin it and as long as it doesn't tear you down, hopefully you can build you up.

Last question, Dr. Rush: do you consider social media then, with your recent experience both as pros and cons, as an ally to a physician or as an adversary?

Dr. Rush:
Oh, definitely an ally. I still think it's an ally. It's a great way to get medical information out to people on multiple platforms. We use that to keep trying and keep educating as best you can. But I definitely think it's a good ally.

Dr Chapa:
And I would agree with you. There's nothing perfect; even the best shiny car gets a little mud on it at some point, it doesn't take away the joy of the car.

Dr. Rush:
Exactly.

Dr Chapa:
Well, it's clear that social media isn't going anywhere anytime soon. And in an increasingly tech-reliant world, I want to thank my guest, Dr. Mikaela Rush, for joining me to discuss social media as an ally or adversary. Dr. Rush, it was great having you on the program. 

Dr. Rush:
Thank you so much for having me on. Maybe I can help you set up a TikTok account and you can make some videos. 

Dr Chapa:
I'm Dr. Hector Chapa. To access this and other episodes in our series, visit ReachMD.com/CliniciansRoundtable, where you can Be Part of the Knowledge. Thanks for listening.