Open TikTok, Instagram, or other social media sites, and chances are you’ll come across a physician “influencer.” These physicians use visual medical images and videos to educate their followers and debunk medical myths, as well as charismatic “doctor next door” personalities and medical humor while they work to destigmatize the embarrassment or shame behind various ailments. However, medicine comes first: physicians even with large social media presences and influence have a responsibility to share credible, educational information and adhere to medical license regulations and laws.
“I do have patients that will consent to allow me to use their image or talk about their stories a little bit, but we have a unique consent form in the office that's specifically for social media,” Dr. Dustin Portela, a dermatologist, said. “I make it clear, we'll record this video and it'll probably be used on TikTok and YouTube and oftentimes even in those situations we're certainly not naming the patient and [we] avoid showing their face.”
Dr. Portela had joined a new practice after a residency mismatch and had the thought to use social media for advertising. He got lucky, and had a few viral videos related to skincare. “After a viral video, I did a deep dive to try to learn the algorithms and learn what kind of content would perform well,” Dr. Portela said. “And while it did start to bring people into the clinic, it also became its own thing where I could speak to people nationally to educate them on their skin health and a lot of people may not have easy access to a dermatologist. But it initially started with just trying to get people in the door.”
Dermatology, a more visually oriented specialty, seems to lend itself to social media. Another dermatologist, Dr. Muneeb Shah, or “DermDoctor” as his 17.6 million TikTok followers know him, uses his videos to debunk skin care myths. Dr. Shah has a mentor of his to thank for his TikTok presence.
“I was in residency at the time and my program director who was training me in dermatology went home and watched my videos and he actually told me, ‘You need to take this seriously because you have an opportunity to educate people in a way that's never been done before,” Dr. Shah recalled. “You can reach millions of people in one video that would take you [a] lifetime in the clinic to reach.”
Navigating the production of content for a large audience while also operating as a medical professional with a responsibility to their patients is something both Drs. Shah and Portela work to balance. While consumers enjoy visual content featuring real people, laws like HIPAA prohibit sharing patient’s information.
Upholding HIPAA laws is just one part of a bigger responsibility that physicians creating content on social media must contend with. Medical influencers both have to make sure everything they are doing adheres to their medical license regulations while also holding themselves accountable by sharing factual information with their viewers, which creates trust.
Dr. Shah found that his platform came with an audience of people that respected his opinion on skin products, to the extent that they would buy things or potentially discontinue using something based on his medical opinion. “People were telling me, ‘I bought what you recommended,’” Dr. Shah said. “And that is a huge responsibility to make good recommendations because someone's going to spend their hard earned money. And it might be the only product that they can afford to buy.”
He avoids giving medical advice and instead focuses on sharing education on the ingredients of skincare so that users can make smart decisions for themselves. “When I first started making content, I focused entirely on ingredients,” Dr. Shah recalled. “But then people would ask for recommendations of specific skincare products since that audience didn’t want to do the research but wanted to know what was safe and effective.”
Dr. Portela also believes in this approach to educating without prescribing or diagnosing anyone. “I don't see any of [the viewers] as patients,” Dr. Portela said. “We certainly can't treat people through social media. And so I'm very cautious about even wading into video requests that I get tagged in that are asking for help to diagnose a unique problem or a medical condition. And also, with the medical licensing system, it's often illegal if they're not residing in my state to offer them any medical advice. So when people send direct messages and ask personal questions, my staff and I are very clear that we cannot provide medical advice.”
On social media, doctors have unearthed a unique opportunity not only to educate, but also to fact-check information being spread online. “TikTok has been the best platform for educators because there's now more accountability,” Dr. Shah explained. On the app, users can “duet” another person’s video which allows them to post a video in direct reply to someone else’s and they appear side by side. “So it's good to have doctors there, to kind of create checks and balances, but doctors are wrong too,” Dr. Shah said. “So that's why it's good to have the public checking doctors back.”
Digital footprints are forever and these physicians are well aware of the long-term impact their social media presences may hold. When asked what his long-term plan for his social media status was, Dr. Shah shared that he wants to eventually become obsolete: “My idea was that there should be a point where I am no longer needed on social media because I want to educate people so that they could then make good decisions for their own skin health.”
Social media has proven to be a convenient side hustle for physicians as well, including Dr. Portela. “As a kid, you would hear of people that did really well on YouTube and you're like, ‘Oh, that's cool, but that'll never be me,’” he said. “I initially went to medical school with the thought of becoming an emergency physician, and I thought that that was a very fun specialty but ultimately I thought that over the course of my career having a stable kind of nine to five would be much more conducive to the type of life that I wanted to live, where I didn't always want to work nights and weekends and shift work and maybe miss a birthday or a holiday here and there.”
When asked what advice he would offer other physicians considering using social media to reach a larger audience, Dr. Portela said: “First, you don't have to be perfect, but you do have to start. People might think I don't know how to do it, or I need to get a better camera … But the reality is you have to just get started and then you'll get better over time. Second, exercise caution but also experiment. I love to talk about skincare, but I'm also very passionate about physical fitness and nutrition. And so I incorporate some of that and I talk about my kids a little bit too. People need to know that you're a human.”
Illustration by Jennifer Bogartz