Low points in social media use

An internet-famous US doctor lamented this week that health professionals creating TikToks was the low point of 2019. She wasn’t entirely wrong. TikTok, a video sharing app, changed the social media landscape in 2019. Along with the usual slew of young people dancing on camera and making funny memes, health professionals have also taken to the platform. Some have created accounts for sharing information on topics like birth control and health screening practices, taking advantage of the engagement of young people on the app. We also have doctors, nurses and other ancillary health professionals dancing in uniforms while at work — perhaps not strictly professional, but at least fairly innocuous. Then there are others. Edgy videos parodying encounters with patients gain enough traction as to be worrisome. The patients are portrayed to be either exaggerating, or stupid, or exacerbating an already full workload with negligible complaints. Think of health workers making fun of patients who consult “Doctor Google”; think of a nurse dancing to the beat of a patient’s distressed breaths during a heart attack. It’s relatable to some, but never appropriate. TikTok is just another platform where health professionals can make hits or misses on social media, and these parody videos really may have just embodied the low point of our profession.

The way health professionals engage on social media now — with levity, often with efforts at public education, and sometimes with glimpses on how challenging, rewarding, tiring and thankless the job can be — is a far cry from how doctors were perceived early in the last century.

Since the birth of formal training in medicine there has been an expectation of imperturbability, something the famous Sir William Osler deemed an irreplaceable quality. It allows physicians to work competently and objectively, almost unemotionally, with grace under pressure. This stoicism is supposed to be reassuring to those at the receiving end of their treatment. With this expectation of cool grace comes the belief that doctors should be able to rise above the slings and arrows of the profession’s daily challenges—or that if they are affected by tiredness, loneliness, grief, or mental exhaustion, these feelings should be kept to themselves. Social media has changed this expectation of equanimity by allowing a better look at what health workers and their families endure, painting the former as more human and vulnerable. It was only in recent years that “doctor-shaming” became a household word, as health professionals reacted against those who would shame them for sleeping, for taking breaks, or for appearing as anything other than service industry robots.

Medicine is changing, and while doctors are still expected to be competent and work under pressure, the unreasonable expectation of equanimity — the expectation that doctors should maintain 24/7 a persona that is cool yet approachable yet commanding, immune to tiredness and any emotion other than empathy — is hopefully coming to its end, and the internet has had a huge role to play in this change.

The young doctors of today, who grew up at the turn of the century when social media was born, easily share their experiences online, and tread a fine line between just venting and outright complaining. They always run the risk of undermining patient confidence and allowing the other things they share — sexual orientation, political beliefs, religion — to color interactions with patients who may have seen them online. Those recent videos making fun of patient encounters are another thing altogether. They might just be the cautionary tale that we need, showing that we have become far, far too comfortable in using social media, and extremely reckless in trying to get laughs out of relatable content. The ethics of social media use among health workers is ever changing, and need to adapt with every new platform. The benefits of a human online presence and the use of the internet as educational tool are undeniable, but here’s hoping that in 2020 our online personae will be more cautious.

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