Beyond the clinic: Physician presence on social media

By: Maheetha Bharadwaj, MD

“Please help me, doc!”

That was an Instagram DM* I received on a random Tuesday night. The message continued: “I have sudden testicle pain when I was lying in my bed, and I just vomited because the pain was so bad.” As most medical professionals who receive requests for “Instagram diagnoses,” I delivered my standard response: “I’m sorry, I cannot offer medical advice, but if my friend called me with these symptoms, I would urge them to seek emergent medical care.” I did mention that testicular torsion was possible, but that I had no way of diagnosing him from symptoms alone. Two days later, I received another message from him. He was diagnosed with testicular torsion, de-torsed in the emergency department, and underwent a bilateral orchiopexy. When asked how he found my page, he said, “I searched ‘testicles’ on Instagram, and it took me to your videos on testicular rupture and testicular torsion.” The most shocking part of this whole saga: The gentleman lives in Germany. I recounted this story to my department chair the following day. “So, you just helped save a guy’s testicle in Germany, from your apartment in Seattle,” he remarked.

It sounds crazy, but I guess I did.

I started developing a social media presence 4 years ago, when I began posting TikToks as a creative outlet for myself. As a dancer, Tiktok offered a perfect space for me to combine my artistic background with medicine. One of my favorite hobbies is producing dance skits to medically-themed music. For my capstone project in medical school, I choreographed an Indian Classical Dance narrative on a patient going through a cancer diagnosis. From there, I have engaged in many creative works that combine performance arts and medicine. At the same time, I love adapting popular TikTok trends to themes about medicine, urology, and life as a resident physician. I design my skits to be lighthearted and humorous but always with a message. One day as an intern, it happened: my first “viral” video. It was a very short tiktok about have women physicians in urology who can serve as a safe space for urology patients who desired a female provider. The video reached 20,000 views overnight. Not only did I witness the power of visibility, but I understood the power of social media to bring people together through commons points of relatability.

Prior to social media, our health care experiences were largely limited to what we saw in-person, on television, or through painstaking searches online. However, short-form videos (videos less than 3 minutes) have made health care experiences more ubiquitous. The positive impacts of these are often expressed in the comments: women finding comfort in seeing female urologists, medical students finding mentorship, urology applicants feeling less alone in the process, and under-represented minorities gaining exposure to health care careers they may not have otherwise known.

As I started to create more urology-specific content, a critical gap revealed itself. “I wish there was someone like you who explained these concepts to me while I was in the hospital,” said a commenter on a video I made about the different foley catheters. Social media allows the dissemination of information, and this is particularly crucial for a very unique and lesser known field like urology. With such expansive reach came a responsibility, I felt, to educate. Traditionally, this occurs in the clinical setting, but the rise of short-form video offers a broader reach for health education.

However, social media platforms also harbora plethora of inaccurate information. Here lies an opportunity for physicians to combat “fake news” and educate the public on key topics in hopes of harm reduction. Furthermore, as I posted more educational content, a larger theme arose. “Doctors are all paid by big pharma,” said a user in response to a vaccine video from my colleague. This highlights the rising friction between health care and the community. Providers see this pattern on social media daily—from individuals questioning the validity of established vaccines to the perception that doctors serve only as conduits for capitalism.

Social media also provides some room to improve upon this tenuous relationship by humanizing health care workers. “I’m so glad to see passionate doctors care about life outside medicine,” “I want a doctor like you,” “Come work at our hospital!”, are just some of the messages I have received since starting social media platforms. Visualizing doctors embrace life within and outside of medicine has the power to transform public perception of health care from an enigmatic black box to a personable, transparent profession.

Although social media offers many positives, I would be remiss if I did not address the hard truths of growing a social media platform, especially as a trainee. In a world consumed by “rage bait”**, a health care professional must take a principled approach to social media such as avoiding humor directed at patients, HIPAA violations, and jeopardizing the reputation of ourselves and our institutions. To this day, I continue to receive constructive criticism; although hard to appreciate in the moment, such feedback has always helped me be a better doctor and shaped my social media presence positively. I also am very aware that my presence on social media may never be whole-heartedly accepted by my colleagues, who reasonably may see it as a distraction and a liability. Hence, the importance of accuracy has never been more pressing. I cannot risk anyone questioning my priorities. Fully aware that I am still a trainee, my educational videos go through several reviews with faculty and trusted colleagues prior to posting. Honing operative skills, learning from consults, expanding urologic knowledge, and academic productivity will always take priority, even if that means not posting content for weeks. In the end, although social media has given me joy, nothing surmounts the reward I feel from direct patient care. Social media is an adjunct to my career, not a replacement.

Despite these drawbacks, I do believe in the power of social media for the greater good, particularly as a physician.I have been able to network with and absorb knowledge from urologists across the world. I have mentored many pre-med and medical students who have found me online. I’m able to bring joy to my colleagues, who have consistently remarked that my Kardashian skits brighten their day. I have the amazing opportunity to challenge preconceived notions about gender and sex and normalize discussion of “taboo” topics. But most importantly, social media has allowed me to learn from and care for a global community. “I appreciate you more than you know. Thank you for being so patient and supportive,” said a user, who for the past 2 months has been recounting through Instagram messages his father’s recent complicated urologic hospitalization. I offered little more than my ear and reassurance. But it reminded me of something invaluable: the privilege of having the emotional and physical bandwidth to offer kindness and empathy for others no matter where they are in the world. It is humbling and fills me with immense daily gratitude toward my profession, my colleagues, and my patients.

Although social media may not be for every health care worker, I hope that moving forward, more medical content creators will collaborate with the academic medical community to shape the world for the better.

*DM – direct message

**Rage Bait – content that is purposefully controversial, exaggerated, or misleading to increase engagement and viewership

Maheetha Bharadwaj, MD, is a PGY-4 research resident at the University of Washington Department of Urology in Seattle.