Nearly everyone knows Facebook, it and other social media platforms have grown to be an integral part of life in the modern world. With nearly 2 billion active users monthly (Facebook) – a large portion of the human race is engaged in some way or another on Social Media. Doctors and health professionals being no exception.
For me personally I’ve gone through ups and downs on using Facebook and other social media. For those who remember these: I started off on Friends reunited and myspace, and before that I used to use Geocities. I got onto Facebook around 2006 I think, a friend got me onto it when we were trying to organise a school reunion. But over the last decade – like most people – I’ve had a love hate relationship with the blue icon with that ‘f’ symbol.
So what effect has social media had on our modern lives?
Some can be positive, some negative, and today we’ll discuss some of these dual aspects.
With the use of social media, there tends to be a slight divide in doctors who use and those who don’t use social media. Part of it is generational differences, with those in my age group and younger (30-40s) having grown up with it and comfortable with using it. Then there are an older generation of doctors who may not be as comfortable with using social media. This isn’t a clear divide, as doctors in general tend to be early adopters of technology in some form or another, and I know of many older GPs and doctors embracing Social Media and the opportunities it presents for ongoing education and health promotion as well as peer networking.
Then there are differences in specialities and also geographic settings. The Royal Australian College of General Practitioners (RACGP) did a Technology Survey (2016) and found that of the surveyed group (1718 responders):
65% of GPs were confident in using new technology, of these –
- 75% were new grads
- 60% were GPs with 5-20 years experience
- 36% of GPs with 20-30 years experience
With specific reference to Social Media:
1 in 5 use social media for work purposes, with barriers to use being :
- Time concerns of managing and using social media
- Patient/Doctor boundaries
Different types of social media personalities.
1.28 billion people use Facebook daily, of these the average user spends at 35mins a day on it. A recent study from Brigham Young university  found that there are 4 distinct personality or types of users of Facebook (Fb):
- Relationship Builders – use Fb as an extension of their real world life, to build relationships, they post, share photos, information, use additional features, and respond to posts from those in their network.
- Town Criers – Aren’t interested in sharing personal information or stories/photos, they mainly want to ‘push’ information and be the first to share out latest news and trends.
- Selfies – promote themselves, they post photos and text – but their main focus is getting attention and likes/comments, and the more they recieve the more approved they feel.
- Window shoppers – are the voyeuristic ones, who feel some obligation or interest in being on Fb, but tend not to post or comment on the things that they see – the people watchers.
Reading through the above, I’m sure we can recognise some of those personality types either in ourselves or in our friends and family.
So what are some of the negatives of using Social Media?
There have been numerous studies [2,3] linking social media use to depressions, anxiety, self-esteem, and internet addiction. To put it simply its expanding the high school experience to a larger scale where you have groups, factions, and you have positive reinforcements of use (Likes) and it can become an exercise in popularity. As this goes on you can become dependant on feedback from those in your network or groups. It’s human nature to appreciate and even earn for approval and praise, through evolution, through our education system, and upbringing. These words of encouragement also promote and reinforce certain behaviours. Most cultures, and indeed religions have this system as part of the make up. With social media this has been amplified to another level. When you post or share something you do so with a certain fear or anxiety as you’re exposing that particular aspect of your life or personal thought to the world and your peers. But when the thing you shared is met with appreciation and generates “Likes” it provides a positive feedback as with most things that give positive feedback this can become addictive.
You post a picture of your dog or cat and you have so many “likes” or positive comments from people in your network – this makes you feel good. This also makes you feel connected and a part of a community, these people who have liked your picture like something you share, and by extension like you. As this grows your confidence and self-value can grow – but the risk is that your self-value and self worth has become dependent on other’s impression of a social media persona/profile that you have built. This online profile no matter how in depth can never be a full picture of you, but it can translate and even magnify damage, mainly in the form of perceived loss of social standing/value/popularity from that social media profile to the real person.
This is just a brief snapshot of some of the negatives, and doesn’t delve into the addictive nature, anxiety, depression among other side effects of use.
There be Trolls!
Recently Dr.Jan Orman posted a useful post on the Black Dog institute’s blog – Managing the Dark Side (of Social Media). Her post discusses some of the personality traits of trolls including some of the dark tetrad of psychology – Machiavellianism (willingness to deceive and manipulate others), narcissism (self-obsession and egotism), psychopathy (lack of empathy and remorse) and, more recently, has gained sadism (deriving pleasure from others’ pain). For those unaware “Trolls” is a term for those pleasant people on social media who make it a point to post destructive, divisive and disruptive comments or posts – purely to antagonise others.
The blog post by Jan also mentions a couple of useful tips that we should all remember when responding to posts on Social Media :
- Wait until you feel calm before you respond.
- Think about what else they might have been meaning to say as opposed to the thing you first thought.
- Talk to them rather than respond on social media or by text – this allows you to clarify the meaning of their message and prevent them from misinterpreting your response.
The above is great advice, and something we tend to forget, when responding to posts that may anger or annoy us. One thing to always remember is that once you posted or shared something onto social media or the internet – its out there, and you can’t take it back easily.
Professional Risks of Social Media use for Doctors
Finally we also have some specific risks for Doctors and medical students, that some of the regulatory bodies (Colleges/APHRA etc..) have specifically pointed out. These include but not limited to :
Breaches of confidentiality – this can be from discussing cases or sharing information/photos on Social Media.
Defamation of colleagues or employers – defamation lawas extend to the internet and social media, and you have to be careful that by venting your frustration about a colleague or employer you don’t open yourself to risk of defamation laws. Always have that rule that: “You don’t post or say something online that you would not be say infront of a judge”
Violation of doctor–patient boundaries. – This can be from patients stalking you, to a blurring of the personal/professional boundaries.
Professional integrity – of doctors and medical students can also be damaged through problematic interprofessional online relationships, and unintended exposure of personal information to the public, employers or universities.
Benefits of Social Media for Doctors
We’ve talked about some of the different groups and types of people who use social media, and some of the negative aspects of it – but there are a number of positives as well. At the heart of the core values of Social Media is the aim to connect people. This is the key concepts that makes it a useful tool in medicine. Some of you reading this would have found this via social media. Through Facebook where there are groups restricted and private, for doctors to share information, debrief and learn from each other.
GPs Down Under – seen as a self styled ‘National Park’ has a large group of GPs from australia (4,500 odd and growing). With members including senior members of the RACGP and ACCRM (the main colleges for GPS in Australia) and other influential and learned members, it provides a wealth of information and experience to draw from. At times it has been a sounding board for some of the policies being proposed, other times its a place to vent and debrief from the daily stressors of GP life. Another recent group Business for Doctors (BFD) has grown quickly and has about 8,500 members and growing (disclosure I’m an admin on that group). Business for Doctors focuses on an often neglected aspect of medical work – the financial side. The advice in these and other groups allows a form of peer support and networking that was not possible in times past.
FOAMed (Free Open Access Meducation ) – This is another important evolution of social media in the medical field – the concept that we can keep uptodate and educate one another, and through time and effort from those involved a treasure trove of information can be found online – openly shared, discussed and educating peers.
Other social media platforms:
Twitter – has become a trendsetter, and often campaigns and movements like #MH4Docs, and #Socks4Docs started out in the twittersphere. Admittedly I’m a newbie on Twitter and getting to grips with it, but its a popular stream for FOAMed, and also for use in conferences.
LinkedIn – This is a platform to present your professional persona, increasingly companies and employers search for your online footprint, and will ask for your LinkedIn profile. If you haven’t already it’s worthwhile setting up and maintaining a professional looking profile on LinkedIn.
I won’t go into the other Social Media platforms like Instagram, SnapChat etc… but worth mentioning blogging … yes you are reading a blog, but in a way it is also considered a form of social media. Blogs can be a great way of sharing information, and a lot of articles, views and news are presented through blogs.
Use it or unplug?
The above gave a brief snapshot of some of the factors related to Social Media, but doesn’t list every pitfall or use. As with most tools it can be used for “good” or “bad”, its up to you how you use it. Be aware of the risks, and the pitfalls, and don’t fall for the illusion of glamour and virtual life that it can offer – ground yourself in reality and the life that you already have. At the same time, be open to the opportunities it can offer, and the networking opportunities if can open up, there is a lot of ways if can be used, especially in the area of education and peer support. So use it, but remember to unplug now and then.
Useful Links and Resources
FOAMed – https://lifeinthefastlane.com/foam/
Business for Doctors , Facebook Group – https://www.facebook.com/groups/businessfordoctors/
GPs Down Under, Facebook Group – https://www.facebook.com/groups/gpsdownunder/
ShareGP, RACGP Social Media platform – https://sharegp.racgp.org.au/
Black Dog Institute – Managing the Dark side of Social media
 Robinson, Tom, Clark Callahan, Kristoffer Boyle, Erica Rivera and Janice K. Cho. “I ♥ FB: A Q-Methodology Analysis of Why People ‘Like’ Facebook.” IJVCSN 9.2 (2017): 46-61. Web. 20 Aug. 2017. doi:10.4018/IJVCSN.2017040103
Edson C. Tandoc, Patrick Ferrucci, Margaret Duffy, Facebook use, envy, and depression among college students: Is facebooking depressing?, Computers in Human Behavior, Volume 43, 2015, Pages 139-146, ISSN 0747-5632
Nikolina Banjanin, Nikola Banjanin, Ivan Dimitrijevic, Igor Pantic, Relationship between internet use and depression: Focus on physiological mood oscillations, social networking and online addictive behavior, Computers in Human Behavior, Volume 43, 2015, Pages 308-312, ISSN 0747-5632,