ASCO 2018: Risks versus Benefits: Using Social Media Safely

Chicago, IL ( At ASCO 2018, Dr. Matthew Katz, a radiation oncologist, gave an engaging presentation discussing the risks and benefits of using social media from a medical professional platform. Dr. Katz notes that social media isn’t worth your time unless (i) it complements or improves your clinical practice of medicine, and (ii) it maintains or builds trust between you and your patients.

A diagram of the patient-doctor dyad with regards to social media summarizes this concept nicely: 
Screen Shot 2018 06 02 at 1.47.21 PM

With regards to social media and established patients, Dr. Katz notes that there are several “no fly” zones: 

  • Connecting on any platform – this risks violating trust. Physicians should have no personal account Facebook or LinkedIn friends with their established patients. For Twitter and Instagram, patients may follow you, but you should not follow them back 
  • Searching for patients online 
  • Public sharing on social media (or physician review websites) 
Dr. Katz highlights that there are several risks for not being on social media, including (i) that patients may find health information online, (ii) others will define your professional reputation online, (iii) patients finds providers that are more accessible online, and (iv) there may be a malpractice risk for no public affirmation for your quality as a physician. When a medical professional is considering signing up for social media, one should consider the platform. For instance, Facebook, LinkedIn, and Twitter are public domains, which loses privacy, but also may establish your presence as trustworthy. Additionally, an important point is that having these public profiles competes with physician rating sites in search engines such as Google. Other platforms, such as Doximity and Sermo, are more private and avoids crossover with patients, however there is more of a HIPAA violation risk with these sites compared to more public sites. When signing up for social media, it is important to not import your contacts, as this may expose private links to family and patients, as well as create connections between trusted colleagues and industry that may not be desired. It is important to note, anyone can follow you on Twitter with a public account, however this is not the case with Facebook and LinkedIn. 

There are certainly benefits and risks for obtaining information on social media: 
Potential benefits: 
  • Learn how people discuss disease processes and treatment in plain language 
  • Keep up on new health information with regards to publications, academic meetings, and policies affecting patients and practice 
  • Affirm accurate information over ‘fake news’ 
Potential risks: 
  • Potential for distraction 
  • Exposure to misinformation 
  • Malware 
  • Tracking 
Dr. Katz defines what he calls a ‘smartphone addiction” which is addictive social media use linked to age, gender, education and income. There is an estimated ‘at risk’ or ‘problematic’ use in 20.5% of adults, with high frequency use linked to sleep disturbance and symptoms of depression. The average person touches their phone 2,617 times and 2.42 hours/day! Furthermore, pertaining to direct patient care, there is an estimated 38% of viral pathogens transmitted through smartphones, with 74-98% of smartphones colonized by bacteria. Indeed, 59% of medical students report smartphone use while using the restroom. 

When deciding when/what to post, Dr. Katz highlights the 4Rs that he has developed [1]: 
  • Reflective – be thoughtful and humble and ‘agree to disagree’ 
  • Responsive – be an active listener with timely responses 
  • Relevant – be focused on the current topic 
  • Rigorous – share valid information based on experience and evidence, and don’t be afraid to acknowledge what you don’t know 
Dr. Katz concluded his presentation with several important take-home messages: (i) opting out of social media has risks for you and your patients, (ii) participation brings increasing risks and benefits, (iii) social media use is a learnable skill, and (iv) set limits and keep content clean and transparent. 

Presented By: Matthew Katz, Department of Radiation Medicine, Lowell General Hospital, Lowell, MA

Written by: Zachary Klaassen, MD, Urologic Oncology Fellow, University of Toronto, Princess Margaret Cancer Centre, Twitter: @zklaassen_md  at the 2018 ASCO Annual Meeting - June 1-5, 2018 – Chicago, IL USA

1. Bibault JE, Katz MS, Motwani S. Social media for radiation oncologists: A practical primer. Adv Radiat Oncol 2017;2(3):277-280.