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News Without Gatekeepers: Social Media and Medicine


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Grand Rounds, Weill Cornell Medicine, Department of Medicine, November 2017

Published in: Health & Medicine
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News Without Gatekeepers: Social Media and Medicine

  1. 1. source unknown
  2. 2. News Without Gatekeepers: Social Media and Medicine - by Elaine Schattner, MD, MA @ESchattner
  3. 3. How Did We Get Here? 1983 2017 Women’s health story, when I entered medical school: Woman speaking about health, via Twitter: Binghamton Press and Sun-Bulletin, April 14, 1983. p.4 Schattner, Elaine (ESchattner). “Beth Caldwell's impact on metastatic breast cancer, @fredhutch...” Nov 6, 2017, 9:30 am. Tweet. @ESchattner
  4. 4. Pre-www (1993): support groups, telephone hotlines 1994-5: first patient list-serves 1997: weblogs (blogs), for health: ~ 2003 2004: Facebook 2005: Reddit, YouTube 2006: Twitter 2010 Future? A Brief History of Social Media For Health @ESchattner
  5. 5. Social Media For Health Is Not So New Schlesinger Library, Harvard Univ. (Our Bodies Ourselves) 1971 Yale Cancer Center image: launch of the NCI Cancer Information Service (1976) @ESchattner
  6. 6. Newspaper Readership Is Declining 0 10,000,000 20,000,000 30,000,000 40,000,000 50,000,000 60,000,000 70,000,000 1930 1940 1950 1960 1970 1980 1990 2000 2010 2020 Total estimated circulation for U.S. daily newspapers (print and digital) Weekday Sunday data source: Editor & Publisher (through 2014); 2015-2016 estimation based on Pew analysis of Alliance for Audited Media data, PEW RESEARCH CENTER, 2017. estimated (2015 – 16) @ESchattner
  7. 7. Where Do People “Go” On Social Media? @ESchattner
  8. 8. • To advertise their practices and hospitals • To promote their research • To draw patients for care including clinical trials • To connect with peers • To educate and to learn • To express themselves • Curiosity, procrastination… • Narcissism, psych issues & needs Why Do Doctors Use Social Media? #hcsm @ESchattner (Adobe stock photo, licensed)
  9. 9. Doctors on Social Media @ESchattner (There’s a range.)
  10. 10. The Mayo Clinic on Social Media @ESchattner
  11. 11. Tweeting at Medical Conferences? @ESchattner Tweets can be measured. Not everyone thinks it’s a good idea.
  12. 12. “The Doctors” onYouTube @ESchattner
  13. 13. The NCI is on Facebook @ESchattner
  14. 14. Pathologists Use FacebookTo Share and Discuss Clinical Results @ESchattner
  15. 15. #Telepathology @ESchattner
  16. 16. Pathologists UseTwitter to Discuss Clinical Findings @ESchattner
  17. 17. Doctors Use Social Media to Recruit Patients for ClinicalTrials @ESchattner
  18. 18. Dr. Nikhil Wagle Shares An Update on the Metastatic Breast Cancer Project @ESchattner
  19. 19. • Search for information about a health condition • Learn about clinical trials and treatments not offered by local physicians • Want second (and third…) opinions • Seek camaraderie and support among peer patients, advocates and others • Express viewpoints • Curiosity, boredom, procrastination, etc. • Narcissism, anger, joy, psych issues & unknown needs Why Do Patients Go Online? (Adobe stock, licensed) #hcsm@ESchattner
  20. 20. Why Do Patients & Caregivers Go Online for Health Info? @ESchattner My answer (ES): 1. Doctors lack time to answer Q’s 2. ↓ patient-doctor relationship 3. ↑ information access (web, etc.)
  21. 21. Tweeting for Platelets @ESchattner
  22. 22. 2011 @ESchattner
  23. 23. Lisa Bonchek Adams (1969 – 2015) @ESchattner
  24. 24. Sharing Health Stories Exposes Patients to Journalists (among others) January, 2014 – controversy overTweeting @ESchattner
  25. 25. COLONTOWN is a Facebook Community for CRC Patients, Survivors & Caregivers
  26. 26. Patients Use FacebookTo Discuss Their Conditions @ESchattner
  27. 27. My Online Profile (“Presence”) @ESchattner One profile, mix of personal and private posts Many followers, loose ties – journalism, health Strictly professional (including SlideShare) Mainly for fun, filing of posts by topic
  28. 28. ES onTwitter @ESchattner
  29. 29. ES on Pinterest @ESchattner
  30. 30. •Treating people with respect goes far. •Twitter’s not a place for dispensing medical advice. •Be informal, but keep it professional! •Consider the old rules for physician behavior in hospital cafeterias and elevators: Patient-Doctor Engagement on Social Media GetsTricky chatting in a hospital cafeteria (Adobe stock, licensed image) • Patients and caregivers on Twitter are often watching, listening and reading; • A careless remark can be hurtful. @ESchattner
  31. 31. A Good Example of Not Answering a Clinical Question onTwitter @ESchattner
  32. 32. Informational Chaos Schattner, E. “Can Cancer Truths Be Told? Challenges for Medical Journalism” ASCO Educ Book 2017;37:3-11 “ @ESchattner
  33. 33. “Old” News is Imperfect,Too Scott Pelley CBS Evening News May 12, 2016 (screenshot) Schattner, E. Am Soc Clin Oncol Educ Book 2017;37:3-11 @ESchattner
  34. 34. WhoTurnsTo Social Media for News? @ESchattner
  35. 35. Fake News is Real (and Contagious) @ESchattner
  36. 36. @ESchattner Social Media Spreads Fake Health News
  37. 37. @ESchattner Is Fake Health News Easy to Spot?
  38. 38. 1. Newsrooms reduce staff for reporting and editing. 2. Many outlets lack fact-checkers. 3. To keep their jobs, reporters need file articles quickly. 4. Most journalists lack time or knowledge to critically evaluate reports about medicine, science, technology and drug development. 5. Income depends on web traffic (clicks) 6. Editors may favor sensational stories to drive traffic. Pressures on the Quality of Medical Journalism Adapted from: Schattner, E. “Can Cancer Truths Be Told? Challenges for Medical Journalism” ASCO Educ Book 2017;37:3-11 @ESchattner
  39. 39. Sensational Stories Sell More USA Today (screenshot, Nov 2017) @ESchattner
  40. 40. News Has the PowerTo Influence Public Health @ESchattner Angelina Jolie’s op-ed on BRCA testing and her decision for bilateral mastectomy
  41. 41. 1. Seek input from varied sources. 2. Transparency about COIs at all levels of reporting: doctors & scientists, patients, reporters, publishers 3. Better education 4. Foundations to support in-depth medical coverage 5. Patient-driven “advocacy journalism” to distribute critical information. 6. Open access to real-time and anonymized clinical data 7. Innovative systems of weighted commentary culled from social media and elsewhere Health News Fixes? Adapted from: Schattner, E. “Can Cancer Truths Be Told? Challenges for Medical Journalism” ASCO Educ Book 2017;37:3-11 @ESchattner
  42. 42. Digital Data Might Boost Health @ESchattner
  43. 43. Search is Social! J Oncology Practice 2016 12:8, 737-744 @ESchattner
  44. 44. Search Data Reveal HealthTrends @ESchattner
  45. 45. Date of download: 11/27/2017 Copyright 2017 American Medical Association. All Rights Reserved. From: Internet Searches for Suicide Following the Release of 13 Reasons Why JAMA Intern Med. 2017;177(10):1527-1529. doi:10.1001/jamainternmed.2017.3333 Internet Searches Following the Release of 13 Reasons Figure Legend: @ESchattner
  46. 46. Security Issues: • Stalkers exist and may be following you. • Think before sharing details: family, location, vacation, events • Block pornographers, spammers, and individuals displaying hateful language or violent images. • Boringness can kill a social media feed; consider divulging safe-yet-interesting aspects of your life. • Know yourself. Establish limits about what you’re comfortable sharing, and stick to those limits. Yes, you are being watched. Flickr, CC attribution: Kristina Alexanderson @ESchattner
  47. 47. • Doctors no longer control conversations about health. • Traditional journalism is fading. • Social media is not going away. • Information about health will emerge from new sources, more from patients • Public access to data and patients’ engagement in decisions will grow. • Artificial Intelligence What Does the Future Hold? @ESchattner
  48. 48. The Future of Medical Media Will Be Amazing Thank you!