Risks versus Benefits: Using Social Media Safely

Risks versus Benefits
Using Social Media Safely
1MATTHEW KATZ, M.D. http://bit.ly/MSKSlideshare

Disclosures
• Stock: Dr. Reddy Laboratories, U.S. Physical Therapy, Mazor
Robotics, Healthcare Services Group, Inc.
• No other financial disclosures for healthcare or social media
companies

Social media isn’t worth your time unless
• It complements or improves
your clinical practice of
medicine
• Maintains or builds trust
between you and your
patients
3MATTHEW KATZ, M.D.
Patient-Doctor Dyad
http://bit.ly/MSKSlideshare

Our Roles as Doctors*
4MATTHEW KATZ, M.D.
Clinician
Educator
Administrator
Researcher
* Applies to other health professionals
Citizen
PRIVATE PUBLICPRIVATE?
Advocate

Denial is futile, Competence in not
• Social media are powerful
communications tools
• We can learn to use them safely and
effectively*
5
* Introverts can do great on social media
MATTHEW KATZ, M.D. http://bit.ly/MSKSlideshare

6MATTHEW KATZ, M.D.
Digital ‘Snapshot’
Risks & Benefits
of Social Media

7MATTHEW KATZ, M.D.
Risks & Benefits
of Social Media
Passive Receptive Creative Interactive

“No Fly” Zone: Established Patients
• Connecting on any platform
• Risks violation of trust
• No Facebook friends, LinkedIn to your personal accounts
• Separate account for your practice/department okay
• Twitter, Instagram: they may follow you, but don’t follow back
• Searching for patients online
• Public sharing on social media (or physician review websites)

Risks of Opting Out
• Patients find health misinformation online
• Others define your professional reputation
• Patients find providers more accessible online
• ? Malpractice risk for no public affirmation your quality

Dangers of Misinformation
• False news spreads farther,
faster than the truth
• Online ads undercut patient
confidence in treating oncologist
10MATTHEW KATZ, M.D.
Vosoughi et al, Science 2018
Abel et al, J Clin Oncol 2009
CCDF = fraction of rumors with certain #
of cascades

Signing Up
• Give information about
• Yourself
• Who you know [usually email]
• Details about professional self

Signing Up
12
• Avoids crossover with patients
• Risks ‘silo syndrome’
• ? HIPAA risk vs. more public sites
• More public, lose some privacy
• Establish your public presence as trustworthy
• Competes with physician ratings sites in search
engines

• Don’t import contacts
• May expose private links to family, patients
• May create connections between trusted
colleagues and industry
• Non-anonymous, use full name
• Anyone can follow you on Twitter but not
Facebook, LinkedIn
13
Consider link to COI
if you have them

Obtaining information
Benefits
• Learn how people discuss
disease, care
• Plain language, not ‘medical-ese’
• Keep up on new health
information
• Publications
• Academic meetings
• Policy affecting patients, practice
• Affirm accurate information over
‘fake news’
Risks
• Potential for distraction
• Exposure to misinformation
• Malware
• Tracking

Smartphone Addiction
• Addictive social media use linked to age, gender, education, income
• Some links of addictive use to narcissism, low self-esteem
• Estimated ‘At risk’ or ‘problematic’ use in 20.5% of adults
• High frequency use linked to sleep disturbance, symptoms of depression
• Social networking linked to problematic internet use in 26-55 year olds
• Average person touches phone 2617 times, 2.42 hours/day*
15
Andreassen et al, Addictive Behaviors 2017
De-Sola et al, PLOS One 2017
Thomée et al, BMC Public Health 2011
Ioannidis et al, Addictive Behaviors 2018
* blog.dscout.com/mobile-touches

Time Management
• Avoid multitasking
• Limit/Budget time online
• Put mobile phone away from
where you sleep
• Consider turning color ‘off’
* blog.dscout.com/mobile-touches

Misinformation, Malware: Think Before You Link
Pew Research, December 2016
• Only 61% believe they can identify false information online
• 23% have shared ‘fake news’ – 7% on purpose
• Restrict who you follow for health information to reliable sources
• Avoid clicking on hyperlinked material for strange URLs or bit.ly links
for possible malware

Tracking, Online or Off
• https://www.facebook.com/s
ettings and download a copy
•
https://takeout.google.com/s
ettings/takeout
• 50-75 URLs from browser
history enough to de-
anonymize with >80%
success rate
18
Su et al, World Wide Web conference 2017
CBS News, April 24 2018

Mobile Phones Going Viral – or Bacterial
‘Dirty’ Phones in Healthcare
• Viral pathogens 38%
• Bacterial colonization 74-98%
• Nosocomial 5-28%
• More common with smartphones
• 59% of medical students report bathroom
smartphone use
19
Pillet et al, Clin Microbiol Infect 2016
Zakai et al, J Microscopy Ultrastruct 2015
Lee et al, J Hosp Med 2013

Creative and Interactive Social Media
• You are what you
• Like
• Tweet
• Post
• Nurses, pharmacists and doctors are the three most trusted
professions*
• Be the best version yourself online
20
*Gallup, December 2016

What the public and our patients expect of us
• Confident
• Reliable
• Composed
• Accountable
• Dedicated
21
Chandratilake et al, Clin Med 2010

The 4Rs will take you far
Reflective
• Thoughtful, humble
• Agree to disagree; don’t try to ‘win’ an argument by
disrespecting others
Responsive • Active listening, timely response
Relevant • Focused on the current topic
Rigorous
• Shared valid information based upon experience, evidence
• Acknowledging what we don’t know
Bibault et al, Adv Radiat Oncol 2017

What you share is discoverable
Sarcasm, superiority, and
sharp wit may
• attract followers more quickly
• increase volume of engagement
• be used against you in court
Humility, integrity, and empathy
may
• attract similar people, more slowly
• increase quality of engagement
• provide favorable evidence of your
character

Define & Maintain Boundaries
Goal Method
Protect my patients Don’t acknowledge in public directly
Suggest privately (DM, Message) they contact you
by telephone, email
Avoid establishing therapeutic relationship Don’t give medical advice
Don’t establish/maintain connect with people
seeking more than you’re comfortable sharing
Learn/share with patients (not mine) Validate-Reference-Direct
Promote your practice/hospital Let that entity do the promotion, not you

Avoid Medical Advice, Maintain Trust
• Validate the person sharing her/his medical issue through
active, reflective listening
• Reference publicly available resources that are relevant but
generalized (guidelines, websites, articles)
• Direct her/him to discuss the issue with own doctor

Legal Tips
• Social media policy
• Know if your employer or hospital has one
• Read it
• Copyright
• Don’t take post figures/tables from articles without permission
• Defamation
• Comment, debate without using personal attacks
• Speak the truth, back it up with hyperlinks/data
• Remain silent if you can’t back it up

Risks & Benefits
of Social Media

Safe Use Snapshot
Risks & Benefits
of Social Media

Conclusions
• Opting out has risks for you and your patients
• Participation brings increasing risks and
benefits
• Social media use is a learnable skill
• Set limits, keep it clean and transparent
• Use digital tools, don’t be one

Thank you
• Questions? Contact me at @subatomicdoc

Risks versus Benefits: Using Social Media Safely

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