1. Twitter 103
Trolls, Malware & Spam
A Tutorial for Oncologists
Matthew Katz, MD
May 2014

2. Overview
 Trolls
 Definition
 Types
 How to respond
 Malware & Spam
 Definitions
 Magnitude
 How to minimize it

3. Troll
 Wikipedia: “Creation of any content that
targets anther person.”
 Mostly intentional, but in healthcare there
are new variants that may be unintentional

4. Who is a troll?
Troublemaking
Ridicules
Objectionable content
Lying
Lead astray

5. Reality Check
 Trolls are not people who disagree with you
 Expect debate on Twitter
 Be open to being wrong
 When conversations get heated and emotional,
show respect so you aren’t considered the troll

6. Troll Types in Social Media
 “Calling Out” Troll*
 Taunts you about your achievements, position
 Mainly affects self-promoters
 “Public Shaming” Troll*
 Keeps pestering you, repeated tweets
 May alternate between email, tweet, FB post
 May try to make you look unresponsive
 “Freeloader” Troll*
 People following others to obtain free materials
* Mitch Joel, TwistImage.com, http://bit.ly/1iNVm3C

7. The 5 R’s of Responding to Trolls
 Read, then walk around the block
 Trolls love emotional reactions
 Respectfully ask for them to clarify
 Give benefit of the doubt since it’s only 140 characters
 Reserve and humility are key
 Neutralize, de-escalate the hostile tone
 Redirect topic after making your point
 Indicate you have moved on
 Reject baiting if troll persists
 Don’t give trolls the attention they crave

8. “Help Me Doctor”
 Patient/caregiver
 Request for medical advice
 May share symptoms, problems
 May want treatment recommendations
 Complain about actual real-life providers
 Request for medical assistance
 Money for tests, medical procedures or medication
 Public support for raising awareness without full
disclosure, information

9. “Help Me Doctor”
 Different types
 Honest (unintentional)
 Fake (intentional)
 Don’t believe you can tell the difference!
 Contacting you
 Public tweet or DM
 Email or LinkedIn, Facebook message

10. Troll or not?
 Reasonable to consider trying to get medical
advice “objectionable”
 Not good medical practice
 Patient/caregiver may not know that, though
 Assume it’s someone truly in need
 Even if it ends up being someone who’s baiting you,
you’ll be judged by how you treat that person
 Empathy and professional

11. Handling “Help Me Doctor”
 Expressing sympathy is fine
 Identify the boundary
 “Sorry, I can’t address that for you”
 “That sounds like something to discuss with
your doctor”
 If the issue is pertinent to your field:
 “Twitter isn’t the place for direct medical care. Call
my office to make an appointment.”
 Direct to Cancer.net to find doctor near him/her
http://www.cancer.net/find-cancer-doctor

12. For Persistent Trolls

13. Block or Report?
 Block is more appropriate for trolls
 Caveat: You won’t see what they say about you
anymore
 Generally recommend ignoring, unfollowing if
applicable
 If it’s on a topic you care about, consider
checking in on them instead
 Don’t follow; lends credence to true trolls
 Report is more for spam

14. Malware and Spam
 Malware = “malicious software”
 Access private information
 Disrupt computer/website
 Mostly for financial gain
 Spam = unsolicited messages for advertising,
other messages
Source: Wikipedia Malware: http://bit.ly/Sqjlva
Spam: http://bit.ly/1kD6uxe

15. Malware in 2014
 Breaches and malware may cost $491B from
malware in pirated software alone
 1.2 B hours spent dealing with malware
from pirated software
 On Twitter and other platforms, fraudulent
accounts can be sold to be used for malware
or spam
Source: IDC/NUS, http://bit.ly/RfAXJj
UC Berkeley, http://bit.ly/1mtodNa

16. Mobile = computers
Source: Cisco Systems, http://bit.ly/1ig9xZp
Forbes.com, http://onforb.es/1msRrY0
Android = 70-97% of malware

17. Social Spam
 0.5% of all social content is spam
 355% increase in 1st
half of 2013
 Facebook+YouTube for 99% of content
 15% provide link/URL to spam, porn or
malware
Source: Nexgate, http://bit.ly/1msQcbs

18. Twitter Spam
 May use bit.ly or tinyurl.com shortlinks to
mask the URL
 Twitter banned such links in Direct Messages
(DM) in October 2013
 Social [ro]bots can autoreply to certain tweet
content to share spam with you

19. A Hint: Account Activity
Source: Nexgate, http://bit.ly/1msQcbs

20. Beware of friends, too
 Your account, or those of your
friends/followers may be taken over
 Spam may also come from legitimate
accounts
 If you notice it happen, notify the person
with a DM
 If no response, open message in case spammer
has disabled notifications or deleted the DM

21. Ways to Avoid Malware & Spam
 Strong password
 Follow with care
 No autofollow (using 3rd
party apps)
 Minimize 3rd
party software linked to Twitter
 Don’t share your email on Twitter openly (DM
only)
 Don’t click on links from folks you don’t know
Source: Social Media Examiner, http://bit.ly/1g1E9xU
eHow.com, http://bit.ly/Q4NKgv

22. For Spammers: Block & Report

23. Summary
 Trolls will test you
 Medical professionalism = take the high road
 Protect your brand from malware and spam
 Strong password
 Value = quality not number of followers
 Limit 3rd
party apps to essentials
 Look before you click

24. Questions?
 Contact me
 Twitter @subatomicdoc
 Website http://www.subatomicdoc.com/social-media.html