#dr Austin chiang

[bookquotesfrombooks]

“Much of the remedial work performed by gastroenterologists is like household plumbing – removing blockages, stopping leaks, and repairing holes!”

Dr. Austin Chiang

Gut: An Owner’s Guide

[raftaar24]

A TikTok Doctor Talks Coronavirus Vaccines

A TikTok Doctor Talks Coronavirus Vaccines

This article is part of the On Tech newsletter. You can do this Register here Getting it on weekdays. Health information needs to reach people where they are – and people are on social media. That’s the message Dr. Austin Chiang, A 35-year-old gastroenterologist and chief medical social media officer at Jefferson Health, a hospital system based in Philadelphia. On Tiktok, Dr. Makes engaging and…

[helloyojo]

Headache Stencil’s work portrays Thai democracy as a game for the ruling elite

His works began appearing overnight on the streets of Bangkok and Chiang Mai five years ago: incendiary satirical depictions of the military officials who took power in Thailand in the 2014 coup.

Although the authorities would work quickly to erase all trace of the graffiti, there was no stopping the artist, who calls himself Headache Stencil and is often referred to as the Banksy of Thailand. Pictures of his works portraying the Thai prime minister as Dr Evil from Austin Powers or the deputy prime minister on the face of a Rolex have been shared millions of times on social media.

Continue reading...#designguardian

[aliveandfullofjoy]

2016 Golden Elliott Awards

Damn, y’all. It’s taken long enough.

My apologies for taking so much longer than usual to post these (I mean, last year these were up the Monday after the Oscars, and this year...does anyone even remember who won? Other than that miraculous Best Picture fiasco?). It was my first awards season out of school, and that proved to be a new, exciting challenge. That said, 2016 was a pretty fun year for my personal awards. Not only could I barely decide on a solid ranking of all of the films throughout the year, but I also found myself with the strange issue of liking many, many films, but truly loving few. All that aside, however, I believe these awards to represent my viewing experiences of 2016 very well. 

Of course, there are always films I don’t get around to, even if this year the list stings a bit more than usual. I expect many of these to make quite a dent in my ballot once I get around to them, but I waited long enough to post this. A mostly complete list of those I didn’t get to are:

Aquarius

The Fits

I Am Not Your Negro

Lemonade

My Life as a Zucchini

Nocturnal Animals

O.J.: Made in America

The Salesman

13th

Toni Erdmann

20th Century Women

But let’s not detract too much from the 34 films from 2016 that I did see! I didn’t have the time/energy to go through and make pretty graphics for all of the categories like last year--just the top ten films. Again, my bad. 

So! Without any further procrastination!

2016 GOLDEN ELLIOTT AWARDS

TOP TEN FILMS:

01. Moonlight / dir. Barry Jenkins / USA The one film of the year that won my heart. Jenkins’ visual symphony on a young man’s life is an ingenious deconstruction of masculinity and a much overdue spotlight on a narrative that all too often falls outside of the visibility of the mainstream. With as many excellent films 2016 gave us, there was no contest for the best. 

02. The Handmaiden / dir. Park Chan-wook / South Korea Park Chan-wook’s labyrinthine Handmaiden may be the closest anyone has come to Hitchcock’s level of intrigue in decades. With sumptuous production values (seriously, there’s no more beautiful movie from this year), a tightly-wound suspenseful plot, a remarkable cast, and a genuinely moving romance, The Handmaiden is one of the most impressive cinematic achievements in years.

03. Silence / dir. Martin Scorsese / USA A longtime passion project for Scorsese, Silence is as harrowing a look at faith as possible. Wisely sidestepping anything resembling a white savior trope, the audience ventures deep into 17th century Japan and into the crumbling psyche of a man desperately clinging onto his relationship with God. It’s difficult, stunning, deeply rewarding work. 

04. Arrival / dir. Denis Villeneuve / USA That Arrival, a film about aliens and a linguistics professor, manages to feel like it reaffirms the bond that connects all of us is a testament to the vision of director Villeneuve and writer behind the source material Ted Chiang. As the film comes to a close, the mind spins, and the heart soars.

05. I, Daniel Blake / dir. Ken Loach / UK Between Brexit and the already infamous presidential election, 2016 was mired with a heavy political cloud for much of the western world. Loach’s I, Daniel Blake, which won last year’s Palme d’Or at Cannes, was the angriest cinematic voice in the rabble of 2016 politics, making an impassioned case for the downtrodden man and making an unforgiving condemnation of the government. Brutally powerful stuff. 

06. Love & Friendship / dir. Whit Stillman / Ireland/France/Netherlands Love & Friendship isn’t just the funniest Jane Austen has ever been onscreen, it is also the funniest film of 2016 by a wide margin. With a gleefully snide central performance from Kate Beckinsale and a cast of wonderful character actors, this film sets a new bar for how enjoyable a sitting room period piece can be. 

07. Julieta / dir. Pedro Almodóvar / Spain With the great director’s brand of theatricality and a staggering leading performance from Emma Suárez, Julieta is an ocean-soaked, color-bursting melodrama and is also one of the year’s more underseen gems. That’s a shame, because Julieta is primed to join the director’s greatest works in the pantheon of Spanish cinema. 

08. Manchester by the Sea / dir. Kenneth Lonergan / USA Lonergan’s latest is the slightest bit of a mixed bag. While certain parts feel overcooked and a bit false, most of the film lives in an extraordinarily painful emotional state, but one that feels devastatingly honest. The beautiful New England scenery acts as the backdrop for this painfully sad, but rewardingly affective film.

09. Hell or High Water / dir. David Mackenzie / USA About twenty minutes into Hell or High Water, the thought occurs to me that most of these characters probably voted for Trump. That’s not a slight against them, however much I may hypothetically disagree with these fictional characters--if anything, it makes the film an extraordinarily powerful portrait of Americans in the middle of the country who feel like the government has abandoned them. Now, several months in, it feels like this new administration is poised to do the same. This is a thrilling neo-western with a clear political mindset that feels like a future American classic. 

10. The Red Turtle / dir. Michaël Dudok de Wit / France/Belgium/Japan With not a single line of dialogue over its 80 minute runtime, The Red Turtle is a powerful fable of human resilience and our relationship with nature. Gorgeous animation and a powerful score, and an Adam and Eve story to match the best of them makes The Red Turtle the finest animated films in a very, very good year. 

BEST DIRECTOR

01. Barry Jenkins, Moonlight 02. Park Chan-wook, The Handmaiden  03. Martin Scorsese, Silence 04. Denis Villeneuve, Arrival  05. Ken Loach, I, Daniel Blake

BEST ACTOR 

01. Ashton Sanders, as “Teenage Chiron,” in Moonlight 02. Trevante Rhodes, as “Adult Chiron/Black,” in Moonlight 03. Casey Affleck, as “Lee Chandler,” in Manchester by the Sea 04. John Goodman, as “Howard,” in 10 Cloverfield Lane  05. Adam Driver, as “Paterson,” in Paterson 

BEST ACTRESS

01. Viola Davis, as “Rose Maxson,” in Fences 02. Isabelle Huppert, as “Michèle LeBlanc” in Elle 03. Amy Adams, as “Dr. Louise Banks,” in Arrival 04. Emma Suárez, as “Julieta Arcos,” in Julieta 05. Kate Beckinsale, as “Lady Susan Vernon,” in Love & Friendship 

BEST SUPPORTING ACTOR

01. André Holland, as “Kevin,” in Moonlight 02. Mahershala Ali, as “Juan,” in Moonlight 03. Tom Bennett, as “Sir James Martin,” in Love & Friendship 04. Lucas Hedges, as “Patrick Chandler,” in Manchester by the Sea 05. Issey Ogata, as “Inoue Masashige,” in Silence

BEST SUPPORTING ACTRESS

01. Hayley Squires, as “Katie Morgan,” in I, Daniel Blake 02. Lily Gladstone, as “The Rancher,” in Certain Women 03. Naomie Harris, as “Paula,” in Moonlight 04. Kate McKinnon, as “Jillian Holtzmann,” in Ghostbusters 05. Rachel Weisz, as “The Short-Sighted Woman,” in The Lobster

BEST ORIGINAL SCREENPLAY

01. Paul Laverty, for I, Daniel Blake 02. Kenneth Lonergan, for Manchester by the Sea 03. Taylor Sheridan, for Hell or High Water 04. Jim Jarmusch, for Paterson 05. Mia Hansen-Løve, for Things to Come

BEST ADAPTED SCREENPLAY

01. Barry Jenkins and Tarell Alvin McCraney, for Moonlight; based on the play In Moonlight Black Boys Look Blue by Tarell Alvin McCraney 02. Whit Stillman, for Love & Friendship; based on the epistolary novella Lady Susan 03. Eric Heisserer, for Arrival; based on the short story “The Story of Your Life” by Ted Chiang 04. Park Chan-wook and Chung Seo-kyung, for The Handmaiden; based on the novel Fingersmith by Sarah Waters 05. Jay Cocks and Martin Scorsese, for Silence; based on the novel Silence by Shosaku Endo

BEST ANIMATED FEATURE

01. The Red Turtle / dir. Michaël Dudok de Wit / Wild Bunch and Studio Ghibli 02. Zootopia / dir. Byron Howard and Rich Moore / Walt Disney Animation Studios 03. Kubo and the Two Strings / dir. Travis Knight / Laika Entertainment 04. Moana / dir. Ron Clements and John Musker / Walt Disney Animation Studios

BEST ANIMATED SHORT

01. The Head Vanishes / dir. Franck Dion 02. Piper / dir. Alan Barillo 03. Borrowed Time / dir. Andrew Coats and Lou Hamou-Lhadj 04. Blind Vaysha / dir. Theodore Ushev 05. Inner Workings / dir. Leo Matsuda

BEST FOREIGN LANGUAGE FEATURE

01. The Handmaiden / dir. Park Chan-wook / South Korea 02. Julieta / dir. Pedro Almodóvar / Spain 03. Things to Come / dir. Mia Hansen-Løve / France 04. Elle / dir. Paul Verhoeven / France

BEST PRODUCTION DESIGN

01. The Handmaiden - Seong-hie Ryu (Production Designer) 02. La La Land - David Wasco (Production Designer); Austin Gorg (Art Director); Sandy Reynolds-Wasco (Set Decorator) 03. The Witch - Craig Lathrop (Production Designer); Andrea Kristof (Art Director); Mary Kirkland (Set Decorator) 04. Love & Friendship - Anna Rackard (Production Designer); Louise Mathews and Bryan Tormey (Art Director) 05. Silence - Dante Ferretti (Production Designer); Wen-Ying Huang, Ding-Yang Weng, Michael Tsung-Ying Yang, Wang Zhi-Cheng (Art Directors); Francesca Lo Schiavo (Set Decorator)

BEST CINEMATOGRAPHY

01. Moonlight - James Laxton 02. The Handmaiden - Chung Chung-hoon 03. La La Land - Linus Sandgren 04. Silence - Rodrigo Prieto 05. Arrival - Bradford Young

BEST COSTUME DESIGNER

01. The Handmaiden - Sang-gyeong Joo 02. Jackie - Madeline Fontaine 03. Love & Friendship - Eimer Ní Mhaoldomhnaigh 04. Sing Street - Tiziana Corvisieri 05. Florence Foster Jenkins - Consolata Boyle

BEST FILM EDITING

01. Moonlight - Nat Sanders and Joi McMillon 02. La La Land - Tom Cross 03. Arrival - Joe Walker 04. The Handmaiden - Kim Jae-bum and Kim Sang-bum 05. Silence - Thelma Schoonmaker

BEST ORIGINAL SCORE OR USE OF MUSIC

01. The Handmaiden - Cho Young-wuk 02. Moonlight - Nicholas Britell 03. The Red Turtle - Laurent Perez del Mar 04. La La Land - Justin Hurwitz, Benj Pasek, and Justin Paul 05. Swiss Army Man - Andy Hull and Robert McDowell

BEST USE OF SONG

01. “Hello Stranger,” used in Moonlight, performed by Barbara Lewis 02. “We Know the Way,” used in Moana, performed by Lin-Manuel Miranda and Opetaia Foa’i 03. “Drive It Like You Stole It,” used in Sing Street, performed by Sing Street 04. “How Far I’ll Go,” used in Moana, performed by Auli’i Cravalho 05. “Another Day of Sun,” used in La La Land, performed by the Company

BEST VISUAL EFFECTS

01. Kubo and the Two Strings 02. The Jungle Book 03. Arrival 04. 10 Cloverfield Lane 05. The Witch 

BEST ENSEMBLE

01. Moonlight (with Mahershala Ali, Patrick Decile, Naomie Harris, Alex Hibbert, Jharrel Jerome, Janelle Monáe, Jaden Piner, Trevante Rhodes, and Ashton Sanders)

02. Love & Friendship (with Kate Beckinsale, Tom Bennett, Kelly Campbell, Morfydd Clark, Justin Edwards, James Fleet, Stephen Fry, Emma Greenwell, Conor MacNeill, Jenn Murray, Lochlann O’Mearáin, Sophie Radermacher, Jemma Redgrave, Xavier Samuel, and Chloë Sevigny) 

03. Manchester by the Sea (with Casey Affleck, Anna Baryshnikov, Matthew Broderick, Heather Burns, Kyle Chandler, Tate Donovan, Kara Hayward, Lucas Hedges, Stephen Henderson, Erica McDermott, Gretchen Mol, Ben O’Brien, Oscar Wahlberg, and Michelle Williams)

04. Julieta (with Mariam Bachir, Pilar Castro, Inma Cuesta, Rossy de Palma, Priscilla Delgado, Darío Grandinetti, Daniel Grao, Michelle Jenner, Sara Jiménez, Joaquín Notario, Blanca Parés, Nathalie Poza, Susi Sánchez, Emma Suárez, and Agata Ugarte)

05. Hell or High Water (with Gil Birmingham, Margaret Bowman, Jeff Bridges, Dale Dickey, Ben Foster, Christopher W. Garcia, John Paul Howard, Marin Ireland, Katy Mixon, Melanie Papalia, Chris Pine, and Kevin Rankin)

NOMINATION AND WIN TALLY

Total nominations: 13: Moonlight 9: The Handmaiden 8: Arrival 7: Love & Friendship; Silence  5: Julieta; La La Land; Manchester by the Sea 4: I, Daniel Blake; Paterson  3: Hell or High Water; Moana; The Red Turtle 2: Elle; Kubo and the Two Strings; 10 Cloverfield Lane; Things to Come; The Witch 1: Blind Vaysha; Borrowed Time; Fences; Florence Foster Jenkins; The Head Vanishes; Inner Workings; Jackie; The Jungle Book; Piper; Sing Street; Swiss Army Man; Zootopia 

Total wins: 9: Moonlight 4: The Handmaiden 2: I, Daniel Blake 1: Fences; The Head Vanishes; The Red Turtle

--

And that more or less concludes another year of the Golden Elliott Awards! It honestly hurts my heart that I couldn’t make these more detailed, with graphics or blurbs about my choices or whatnot, but if you’ve got questions, feel free to fire away! 

[bigyack-com]

Surge of Virus Misinformation Stumps Facebook and Twitter

SAN FRANCISCO — First, there were conspiratorial whispers on social media that the coronavirus had been cooked up in a secret government lab in China. Then there were bogus medicines: gels, liquids and powders that immunized against the virus.And then there were the false claims about governments and celebrities and racial unrest. Taiwan was covering up virus deaths, and the illness was spiraling out of control. Bill Gates, the Microsoft co-founder who now runs a philanthropic organization, was behind the spread of the virus. Italians were marching in the streets, accusing Chinese people of bringing the illness to their country. None of it was true.As the coronavirus has spread across the world, so too has misinformation about it, despite an aggressive effort by social media companies to prevent its dissemination. Facebook, Google and Twitter said they were removing misinformation about the coronavirus as fast as they could find it, and were working with the World Health Organization and other government organizations to ensure that people got accurate information.But a search by The New York Times found dozens of videos, photographs and written posts on each of the social media platforms that appeared to have slipped through the cracks. The posts were not limited to English. Many were originally in languages ranging from Hindi and Urdu to Hebrew and Farsi, reflecting the trajectory of the virus as it has traveled around the world.Security researchers have even found that hackers were setting up threadbare websites that claimed to have information about the coronavirus. The sites were actually digital traps, aimed at stealing personal data or breaking into the devices of people who landed on them.The spread of false and malicious content about the coronavirus has been a stark reminder of the uphill battle fought by researchers and internet companies. Even when the companies are determined to protect the truth, they are often outgunned and outwitted by the internet’s liars and thieves.There is so much inaccurate information about the virus, the W.H.O. has said it was confronting a “infodemic.”“I see misinformation about the coronavirus everywhere. Some people are panicking, and looking to magical cures, and other people are spreading conspiracies,” said Austin Chiang, a gastroenterologist at Jefferson University Hospital in Philadelphia.In Taiwan, virus-related misinformation on social media has fed concerns that China might be using the crisis to undermine the government of the self-ruling island.In recent weeks, there have been posts on Facebook and other sites claiming that Taiwan has concealed large numbers of coronavirus infections. There have been fake but official-looking documents promising giveaways of face masks and vaccines. A screen capture from a television news broadcast was doctored to say that President Tsai Ing-wen had contracted the disease and was in quarantine.In a statement to The Times, Taiwan’s foreign minister, Joseph Wu, blamed China’s “internet armies” for the deluge of falsehoods, though his office declined to elaborate on how he came to that conclusion. China’s Taiwan Affairs Office didn’t respond to a faxed request for comment.The Communist Party claims Taiwan as part of China’s territory, and Taiwanese officials have long accused Beijing of manipulating both traditional news media and social platforms to turn Taiwanese citizens against President Tsai, who opposes closer ties with China.Summer Chen, the editor in chief of Taiwan FactCheck Center, a watchdog group that debunks online rumors and hoaxes, said her team had been busier since the outbreak began than it was ahead of Taiwan’s presidential election in January, when the island was on high alert for potential Chinese meddling.“Throughout this whole epidemic, people have really liked conspiracy theories,” Ms. Chen said. “Why is it that during epidemics people don’t choose to believe accurate scientific information?”Facebook, YouTube and Twitter all said they were making efforts to point people back to reliable sources of medical information, and had direct lines of communication to the W.H.O. and the Centers for Disease Control and Prevention.Facebook said it bans content that could cause people harm, such as claims that discourage treatment or taking appropriate precautions against the coronavirus. Posts and videos that shared conspiracy theories were clearly marked as false, once they had been reviewed by fact checkers.When Facebook users attempt to share them, a message pops up alerting the user that the post includes information that has been deemed false by fact checkers.Those measures, however, have not stopped people in private Facebook groups from linking to and sharing misinformation surrounding the virus. In private Facebook groups, including one that totals over 100,000 members, conspiracy theories spread that the coronavirus was an invention of the pharmaceutical industry, intended to sell the public on more expensive drugs and more vaccines.While many posts simply encouraged people to take vitamins and eat a balanced diet to boost their immune system, others offered promises of immunity or cures if certain combinations of powders and drinks were consumed. Some were even more dangerous. The Food and Drug Administration referred to one “miracle mineral solution” posted many times on Facebook and Twitter as “the same as drinking bleach.”Dr. Chiang, the gastroenterologist, recently helped start the Association for Healthcare Social Media, a group dedicated to encouraging more health care professionals to post on social media so that they can dispel some of the misinformation.“People are looking for good sources of information because a lot of what they see, when they log into their social media platforms, is just scaring them,” he said.While Twitter acknowledged the presence of some of this content on its network, Del Harvey, Twitter’s vice president of trust and safety, said the company has not seen “large-scale, coordinated” efforts to misinform people about the coronavirus. After The New York Times contacted Twitter with examples of tweets containing health misinformation about coronavirus, some owners of the accounts were suspended “for spam.”Facebook said that in addition to working closely with health organizations, it was offering W.H.O. free ad space to try and point people toward accurate information on the coronavirus. The company said that it was removing posts that discouraged people from seeking treatment or suggested remedies that could cause physical harm and that it was placing warning labels on posts that were rated false by their fact checkers.YouTube, which is owned by Google, also said it was working closely with W.H.O. to help combat misinformation. YouTube’s spokesman, Farshad Shadloo, said the company had policies that prohibited videos that “promoted medically unsubstantiated methods to prevent the coronavirus in place of seeking medical treatment.”Dozens of YouTube videos, however, included titles that suggested the video offered a cure for the virus. In others, the comment sections below the videos included links to pages offering a range of alternative, unsubstantiated treatments.In some cases, those links have led people to websites that lure people in with the promise of a cure, but actually steal credit card information and other personal details.The cybersecurity firm Check Point said more than 4,000 coronavirus-related websites that include words like “corona” or “covid” have been registered since the beginning of the year. Of those, 3 percent were considered malicious and another 5 percent were suspicious.Research by Sophos, a cybersecurity company, has shown an uptick in these so-called spear-phishing messages targeting people in Italy, where coronavirus infections have surged in recent weeks. Those messages included a link to a Microsoft Word document that claimed to list cures for the virus. When downloaded, it installed malicious malware on people’s computers.Last month, W.H.O. also put out a warning about fake emails from apparent W.H.O. representatives. The emails carried malicious code aimed at breaking into someone’s computing device.John Gregory, the deputy health editor for NewsGuard, a start-up that tries to stop false stories from spreading on the internet, said the medical element to coronavirus misinformation made it different from other conspiracies the public has dealt with.Because the information about the virus is “playing out in real time, it’s always going to be easier for someone to make a false claim,” Mr. Gregory said. “Then, there’s a separation of a few days before anyone with a scientific background, or journalists, are able to debunk the claim.”Sheera Frenkel reported in San Francisco and Davey Alba reported in New York. Raymond Zhong reported from Beijing. Chris Horton contributed reporting from Taipei, Taiwan. Read the full article

[mastcomm]

Doctors on TikTok Try to Go Viral

For decades, sex education in the classroom could be pretty cringey. For some adolescents, it meant a pitch for abstinence; others watched their teachers put condoms on bananas and attempt sketches of fallopian tubes that looked more like modern art.

On TikTok, sex ed is being flipped on its head. Teenagers who load the app might find guidance set to the pulsing beat of “Sex Talk” by Megan Thee Stallion.

A doctor, sporting scrubs and grinning into her camera, instructs them on how to respond if a condom breaks during sex: The pill Plan B can be 95 percent effective, the video explains.

The video is the work of Dr. Danielle Jones, a gynecologist in College Station, Tex., and so far has racked up over 11 million views. Comments range from effusive (“this slaps”) to eye-rolling (“thanks for the advice mom” and “ma’am, I’m 14 years old”).

“My TikTok presence is like if you had a friend who just happens to be an OB/GYN,” Dr. Jones said. “It’s a good way to give information to people who need it and meet them where they are.”

Dr. Jones is one of many medical professionals working their way through the rapidly expanding territory of TikTok, the Chinese-owned short-form video app, to counter medical misinformation to a surging audience. The app has been downloaded 1.5 billion times as of November, according to SensorTower, with an audience that skews young; 40 percent of its users are ages 16 to 24.

Although medical professionals have long taken to social media to share healthy messages or promote their work, TikTok poses a new set of challenges, even for the internet adept. Popular posts on the app tend to be short, musical and humorous, complicating the task of physicians hoping to share nuanced lessons on health issues like vaping, coronavirus, nutrition and things you shouldn’t dip in soy sauce. And some physicians who are using the platform to spread credible information have found themselves the targets of harassment.

Dr. Rose Marie Leslie, a family medicine resident physician at the University of Minnesota Medical School, said TikTok provided an enormous platform for medical public service announcements.

“It has this incredible viewership potential that goes beyond just your own following,” she said.

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Dr. Leslie’s TikToks on vaping-associated lung diseases drew over 3 million views, and posts on the flu and HPV vaccines also reached broad audiences beyond her hospital.

Striking a chord on TikTok, Dr. Leslie said, means tailoring medical messaging to the app’s often goofy form. In one post, she advised viewers to burn calories by practicing a viral TikTok dance. She takes her cues from teen users, who often use the app to offer irreverent, even slapstick commentary on public health conversations. She noted one trend in which young TikTokers brainstormed creative ways to destroy your e-cigarette, like running it over with a car.

TikTok’s executives have welcomed the platform’s uses for medical professionals. “It’s been inspiring to see doctors and nurses take to TikTok in their scrubs to demystify the medical profession,” said Gregory Justice, TikTok’s head of content programming.

Dr. Jones, the gynecologist, said she was hopeful the platform could help young people develop trust in medical practitioners and view them as more accessible. “Back in the old days, there was a town doctor and everyone knew where he lived, and you traded milk and eggs for health care,” Dr. Jones said. “You had trust in your doctor because you trusted them as a person first.” TikTok, she said, can help to humanize doctors — she’s seen that some of her own patients feel more comfortable with her because they have seen her playful social media posts.

But some doctors are also encountering responses to their videos that they did not expect.

Earlier this month, Dr. Nicole Baldwin, a pediatrician in Cincinnati, posted a TikTok listing the diseases that are preventable with vaccines and countering the notion that vaccines cause autism.

Her accounts on TikTok, Twitter, Facebook and Yelp were flooded with threatening comments, including one that labeled her “Public Enemy #1” and another that read, “Dead doctors don’t lie.”

A team of volunteers that is helping Dr. Baldwin monitor her social media has banned more than 5,200 users from her Facebook in recent weeks.

Dr. Baldwin said she started out feeling enthusiastic about the opportunity TikTok provides to educate adolescents, but her experience with harassment gave her some pause.

“There’s a fine line physicians are walking between trying to get a message out that will appeal to this younger generation without being inappropriate or unprofessional,” Dr. Baldwin said. “Because of the short content and musical aspect of TikTok, what adolescents are latching onto is not the professional persona we typically put out there.”

A spate of recent TikToks have further stirred questions about the potential for the app’s abuse. One recent TikTok post featured a medical professional speculating — as she lip synced to the Rex Orange County lyric “How Could I Ignore You?” — that her patient’s chest pain could have been caused by cocaine. Another showed an emergency room doctor mocking patients who sought treatment in the E.R. rather than from a primary care physician.

Sarah Mojarad, a lecturer who teaches a course on social media for scientists at the University of Southern California, said she has seen physicians either “bashing their patients” on the app or “whitecoat marketing,” a term that refers to the use of medical prestige to market inappropriate products like unauthorized supplements.

The youth of TikTok’s audience also raises the stakes when medical professionals misuse the platform.

“With a young audience, it’s really important to make sure that the content getting out is professional and accurate,” Ms. Mojarad said. “People may think some of it is medical humor, but it impacts care.”

TikTok’s community guidelines state that the platform does not permit “misinformation that may cause harm to an individual’s health, such as misleading information about medical treatments.” The company expanded its rules of conduct earlier this month, as its user base has grown.

Some physicians worry that TikTok’s brief, playful clips can blur the line between general education and patient-specific medical advice.

Dr. Austin Chiang, a gastroenterologist and chief medical social media officer at Jefferson Health in Philadelphia, said he has been asked about specific symptoms on TikTok and has to refer users to established medical sources, or directly to their doctors.

Dr. Christian Assad, a cardiologist in McAllen, Tex., said he sometimes scripts his TikToks, given the potential for confusion when he compresses a 60-minute talk on low-carbohydrate dieting into a 60-second musical clip.

Ignoring the platform isn’t an option, especially given the prevalence of disinformation on the app, Dr. Chiang said. Two of his more popular posts have countered the use of essential oils to cure diseases and exposed the failings of the celery juice fad diet.

“If we’re not there to be a voice for evidence-based medicine, who’s going to do that for us?” Dr. Chiang said. “Anti-vaxxers are already using social media to their advantage. By putting doctors on social media, we’re able to be a source of more accurate information.”

Still, for doctors turned influencers, the TikTok learning curve can be steep. Dr. Matthew Schulman, a plastic surgeon in New York, said the slightly older users of Instagram and Snapchat have been vital to his private practice, helping to drive roughly 80 percent of consultations. He often streams live from the operating room. “Buttock augmentation is really popular on social media,” he said.

But TikTok has presented him with cause for additional concern. The virality upside is massive: A post he made earlier this month discussing celebrity clients drew over 6.8 million views. But as he has watched his 10-year-old daughter use the app, he realized that he must exercise more caution in producing content.

“The demographic of TikTok is very young, and as a plastic surgeon I don’t feel comfortable marketing my services to children,” Dr. Schulman said. Simultaneously, he knows the app is growing fast. “I don’t want to be caught playing catch-up. In two or three years the platform could change, and if I already have an established account I’m ahead of the game.”

In the meantime, he said, he relies on top-notch TikTok editors — his kids.

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TikTok is now being used to combat health misinformation and it's working!

See on Scoop.it - COMPARE RISK COMMUNICATION

Dr. Rose Marie Leslie is hoping to reach teens with a message about the dangers of e-cigarettes. So she’s started posting regularly on TikTok, the popular short video app, and has collected a large following.

  Leslie, who goes by @DrLeslie and is a family medicine doctor at the University of Minnesota Medical School, has amassed more than 300,000 followers on the platform in recent months. Most of her TikTok videos offer insights on health issues that impact teens, ranging from how to talk to doctors about birth control to why it’s a bad idea for a group of friends to share a lollipop.

  She’s best known for getting real about vaping and vaping-related illness. The issue is more urgent than ever for many parents, with surveys showing that vape use at an all-time high among teens amid an outbreak of a life-threatening vaping illness. 

  Part of the problem, according to medical experts, is the teens aren’t aware of the risks because public health organizations aren’t communicating with them on the platforms they use.

  That’s where Leslie comes in.

  Leslie doesn’t talk down to the viewer, but instead shows side-by-side images of a vaping-related lung injury and a normal lung biopsy, and discusses the root causes.

  In one video, she shows her followers what vaping lung illness really looks like under a microscope. “That is terrifying,” she says in the video.

  Leslie says she gets a lot of messages from teens who have stopped vaping because they watched one of her videos.

  “I expected it as a primary-care doctor who’s often talking to teens about the health risks associated with something like vaping that’s perceived as cool,” she said.

  Greater engagement on TikTok than other platforms

  Leslie is just one of the doctors who have recently started popping up on TikTok. Far more physicians are on Twitter and Instagram, which are more popular with older generations.

  But those who have taken the TikToK plunge say they are experiencing far greater engagement on content there than on other social media platforms.

  Jefferson Health’s Dr. Austin Chiang, one of the most active physicians on social media, recently joined TikTok after reading about how it’s taking off. 

  Chiang uses TikTok primarily as a platform to talk to other young doctors about issues that matter to them, like the cost of medical education or the sacrifice of giving up their 20s to spend nights and weekends in the hospital.

  Chiang says he already sees the most engagement on TikTok, which is used by more than 700 million people daily, according to its owner ByteDance.

  Chiang and Leslie are also using TikTok to combat health misinformation.

  “I’ve heard the criticism that doctors and other medical professionals on social media are somehow less credible, or won’t be taken as seriously by their peers,” said Sherry Pagoto, a behavioral scientist and professor at the Department of Allied Health Sciences at the University of Connecticut. “But I think that school of thought is going to be a thing of the past.”

  Pagoto notes that medical experts need to meet teens where they are, rather than sticking to the older methods of advertising on television or Facebook.

  “It would be great for public health organizations to follow the lead of these medical professionals on TikTok,” she said.

  Read More: https://www.cnbc.com/2019/11/29/doctors-use-tiktok-to-talk-to-teens-about-vaping-birth-control.html

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The role of the chief medical social media officer

The antidote to fake health news? According to Austin Chiang, the first chief medical social media officer at a top hospital, it’s to drown out untrustworthy content with tweets, pics and posts from medical experts that the average American can relate to.

Chiang is a Harvard-trained gastroenterologist with a side passion for social media. On Instagram, where he refers to himself as a “GI Doctor,” he has 20,000 followers, making him one of the most influential docs aside from TV personalities, plastic surgeons and New York’s so-called “most eligible bachelor,” Dr. Mike.

  Every few days, he’ll share a selfie or a photo of himself in scrubs along with captions about the latest research or insights from conferences he attends, or advice to patients trying to sort our real information from rumors. He’s also active on Twitter, Microsoft’s LinkedIn and Facebook (which owns Instagram).

One of Chiang’s social media campaigns

Austin Chiang

But Chiang recognizes that his following pales in comparison to accounts like “Medical Medium,” where two million people tune in to the musings of a psychic, who raves about vegetables that will cure diseases ranging from depression to diabetes. (Gwyneth Paltrow’s Goop has written about the account’s creator glowingly.) Or on Pinterest and Facebook, where anti-vaccination content has been far more prominent than legitimate public health information. Meanwhile, on e-commerce sites like Amazon and eBay, vendors have hawked unproven and dangerous health “cures, ” including an industrial-strength bleach that is billed as eliminating autism in children.

“This is the biggest crisis we have right now in health care,” said Chiang. “Everyone should be out there, but I realize I’m one of the few.”

According to Chiang, doctors have historically been reluctant to build a following on social media for a variety of reasons. They view it as a waste of time, they don’t know how, or they fear they might say the wrong thing and get in trouble with an employer. Others prefer to spend their time communicating with their peers via academic journals.

But as Chiang points out, most consumers do not pore over the latest scientific literature. So health professionals need to take the time to start connecting with them where they do spend their time — and that’s on Facebook and Instagram.

  So he’s working to recruit an army of physicians, nurses, patient advocates, and other health professionals to get online. He’s primarily starting on his home turf at Jefferson Health, and with other doctors in his specialty. He was appointed to his “new and unique role” in the summer of 2018, which he got after a series of conversations with the health system’s CEO Stephen Klasko.

Klasko is a physician and avid social media user himself, with both professional and personal accounts. He’s also a notorious straight-talker in the industry who openly discusses some of the more broken aspects of the heath-care system online and at conferences, including things like the inflated costs and the flaws of medical education.

Jefferson Health’s Steve Klasko walking through campus.

Jefferson Health

In his new role, Chiang has been thinking about guidelines for health professionals on how to use the new digital tools, including things like disclosing any conflicts of interest. He thinks that more transparency about ties to industry will help doctors garner trust with the public. To spread these ideas, he’s set up a new group for health professionals dubbed the Association for Healthcare Social Media.

He’s also attempted a few hashtag-driven public awareness campaigns, including one called #verifyhealthcare to promote these ideas about disclosures, and another called #dontgoviral to counter anti-vaxxer content.

Klasko, Chiang’s CEO, sees a direct business benefit to having Jefferson’s approximately 3,000 doctors participating on social media.

“Everyone under the age of 35 uses Facebook and Instagram as a vehicle, and I want them to see Jefferson as a partner in their health so they’ll think of us” he said.

More broadly, he shares Chiang’s concerns about the proliferation of health misinformation. Measles cases are climbing, with outbreaks across the country, which many health professionals chalk up to parents refusing to vaccinate their children. That’s one of the reasons that Klasko chooses to be so active online and with the media, so that people who want to access accurate information can find it.

“Imagine if it would be easier to access The National Enquirer than The Washington Post,” he said. “I fear that that’s what is happening in health care right now.”

[hcldr]

HCSM News

Thanks Dr. Klasko @sklasko, the most innovative healthcare CEO @TJUHospital! Website opens this Friday for membership! Clinicians NEED to be rewarded for these contributions educating the public on social media! #hcsm #ahsm #medtwitter #meded #hcldr #somedocs https://t.co/x912Thnlyf

— Austin Chiang MD MPH (@AustinChiangMD) May 1, 2019

[inspirecommunity]

#Repost @radha_inspire with @get_repost ・・・ @austinchiangmd spoke with @thecompanyinspire about his new role as the Chief Medical Social Media Officer at @jeffersonhealth and the responsibility of medical professionals to engage with people about health online. (link in bio https://www.inspire.com/m/Chronic-Inspire/journal/q-and-a-dr-austin-chiang-on-medicine-and-social-media/) (photo courtesy Dr. Chiang) #verifyhealthcare #gastroenterology #teaching #medicine #healthliteracy #scrublife #QandA #socialmedia https://www.instagram.com/p/Brp9foJlCb3/?utm_source=ig_tumblr_share&igshid=1fm5mz0b1ftwt

[mastcomm]

Doctors on TikTok Try to Go Viral

For decades, sex education in the classroom could be pretty cringey. For some adolescents, it meant a pitch for abstinence; others watched their teachers put condoms on bananas and attempt sketches of fallopian tubes that looked more like modern art.

On TikTok, sex ed is being flipped on its head. Teenagers who load the app might find guidance set to the pulsing beat of “Sex Talk” by Megan Thee Stallion.

A doctor, sporting scrubs and grinning into her camera, instructs them on how to respond if a condom breaks during sex: The pill Plan B can be 95 percent effective, the video explains.

The video is the work of Dr. Danielle Jones, a gynecologist in College Station, Tex., and so far has racked up over 11 million views. Comments range from effusive (“this slaps”) to eye-rolling (“thanks for the advice mom” and “ma’am, I’m 14 years old”).

“My TikTok presence is like if you had a friend who just happens to be an OB/GYN,” Dr. Jones said. “It’s a good way to give information to people who need it and meet them where they are.”

Dr. Jones is one of many medical professionals working their way through the rapidly expanding territory of TikTok, the Chinese-owned short-form video app, to counter medical misinformation to a surging audience. The app has been downloaded 1.5 billion times as of November, according to SensorTower, with an audience that skews young; 40 percent of its users are ages 16 to 24.

Although medical professionals have long taken to social media to share healthy messages or promote their work, TikTok poses a new set of challenges, even for the internet adept. Popular posts on the app tend to be short, musical and humorous, complicating the task of physicians hoping to share nuanced lessons on health issues like vaping, coronavirus, nutrition and things you shouldn’t dip in soy sauce. And some physicians who are using the platform to spread credible information have found themselves the targets of harassment.

Dr. Rose Marie Leslie, a family medicine resident physician at the University of Minnesota Medical School, said TikTok provided an enormous platform for medical public service announcements.

“It has this incredible viewership potential that goes beyond just your own following,” she said.

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Dr. Leslie’s TikToks on vaping-associated lung diseases drew over 3 million views, and posts on the flu and HPV vaccines also reached broad audiences beyond her hospital.

Striking a chord on TikTok, Dr. Leslie said, means tailoring medical messaging to the app’s often goofy form. In one post, she advised viewers to burn calories by practicing a viral TikTok dance. She takes her cues from teen users, who often use the app to offer irreverent, even slapstick commentary on public health conversations. She noted one trend in which young TikTokers brainstormed creative ways to destroy your e-cigarette, like running it over with a car.

TikTok’s executives have welcomed the platform’s uses for medical professionals. “It’s been inspiring to see doctors and nurses take to TikTok in their scrubs to demystify the medical profession,” said Gregory Justice, TikTok’s head of content programming.

Dr. Jones, the gynecologist, said she was hopeful the platform could help young people develop trust in medical practitioners and view them as more accessible. “Back in the old days, there was a town doctor and everyone knew where he lived, and you traded milk and eggs for health care,” Dr. Jones said. “You had trust in your doctor because you trusted them as a person first.” TikTok, she said, can help to humanize doctors — she’s seen that some of her own patients feel more comfortable with her because they have seen her playful social media posts.

But some doctors are also encountering responses to their videos that they did not expect.

Earlier this month, Dr. Nicole Baldwin, a pediatrician in Cincinnati, posted a TikTok listing the diseases that are preventable with vaccines and countering the notion that vaccines cause autism.

Her accounts on TikTok, Twitter, Facebook and Yelp were flooded with threatening comments, including one that labeled her “Public Enemy #1” and another that read, “Dead doctors don’t lie.”

A team of volunteers that is helping Dr. Baldwin monitor her social media has banned more than 5,200 users from her Facebook in recent weeks.

Dr. Baldwin said she started out feeling enthusiastic about the opportunity TikTok provides to educate adolescents, but her experience with harassment gave her some pause.

“There’s a fine line physicians are walking between trying to get a message out that will appeal to this younger generation without being inappropriate or unprofessional,” Dr. Baldwin said. “Because of the short content and musical aspect of TikTok, what adolescents are latching onto is not the professional persona we typically put out there.”

A spate of recent TikToks have further stirred questions about the potential for the app’s abuse. One recent TikTok post featured a medical professional speculating — as she lip synced to the Rex Orange County lyric “How Could I Ignore You?” — that her patient’s chest pain could have been caused by cocaine. Another showed an emergency room doctor mocking patients who sought treatment in the E.R. rather than from a primary care physician.

Sarah Mojarad, a lecturer who teaches a course on social media for scientists at the University of Southern California, said she has seen physicians either “bashing their patients” on the app or “whitecoat marketing,” a term that refers to the use of medical prestige to market inappropriate products like unauthorized supplements.

The youth of TikTok’s audience also raises the stakes when medical professionals misuse the platform.

“With a young audience, it’s really important to make sure that the content getting out is professional and accurate,” Ms. Mojarad said. “People may think some of it is medical humor, but it impacts care.”

TikTok’s community guidelines state that the platform does not permit “misinformation that may cause harm to an individual’s health, such as misleading information about medical treatments.” The company expanded its rules of conduct earlier this month, as its user base has grown.

Some physicians worry that TikTok’s brief, playful clips can blur the line between general education and patient-specific medical advice.

Dr. Austin Chiang, a gastroenterologist and chief medical social media officer at Jefferson Health in Philadelphia, said he has been asked about specific symptoms on TikTok and has to refer users to established medical sources, or directly to their doctors.

Dr. Christian Assad, a cardiologist in McAllen, Tex., said he sometimes scripts his TikToks, given the potential for confusion when he compresses a 60-minute talk on low-carbohydrate dieting into a 60-second musical clip.

Ignoring the platform isn’t an option, especially given the prevalence of disinformation on the app, Dr. Chiang said. Two of his more popular posts have countered the use of essential oils to cure diseases and exposed the failings of the celery juice fad diet.

“If we’re not there to be a voice for evidence-based medicine, who’s going to do that for us?” Dr. Chiang said. “Anti-vaxxers are already using social media to their advantage. By putting doctors on social media, we’re able to be a source of more accurate information.”

Still, for doctors turned influencers, the TikTok learning curve can be steep. Dr. Matthew Schulman, a plastic surgeon in New York, said the slightly older users of Instagram and Snapchat have been vital to his private practice, helping to drive roughly 80 percent of consultations. He often streams live from the operating room. “Buttock augmentation is really popular on social media,” he said.

But TikTok has presented him with cause for additional concern. The virality upside is massive: A post he made earlier this month discussing celebrity clients drew over 6.8 million views. But as he has watched his 10-year-old daughter use the app, he realized that he must exercise more caution in producing content.

“The demographic of TikTok is very young, and as a plastic surgeon I don’t feel comfortable marketing my services to children,” Dr. Schulman said. Simultaneously, he knows the app is growing fast. “I don’t want to be caught playing catch-up. In two or three years the platform could change, and if I already have an established account I’m ahead of the game.”

In the meantime, he said, he relies on top-notch TikTok editors — his kids.

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[nrip]

Doctor recruiting doctors to fight fake health info on social media

The antidote to fake health news? According to Austin Chiang, the first chief medical social media officer at a top hospital, it’s to drown out untrustworthy content with tweets, pics and posts from medical experts that the average American can relate to.

Chiang is a Harvard-trained gastroenterologist with a side passion for social media. On Instagram, where he refers to himself as a “GI Doctor,” he has 20,000 followers, making him one of the most influential docs aside from TV personalities, plastic surgeons and New York’s so-called “most eligible bachelor,” Dr. Mike.

  Every few days, he’ll share a selfie or a photo of himself in scrubs along with captions about the latest research or insights from conferences he attends, or advice to patients trying to sort our real information from rumors. He’s also active on Twitter, Microsoft’s LinkedIn and Facebook (which owns Instagram).

One of Chiang’s social media campaigns

Austin Chiang

But Chiang recognizes that his following pales in comparison to accounts like “Medical Medium,” where two million people tune in to the musings of a psychic, who raves about vegetables that will cure diseases ranging from depression to diabetes. (Gwyneth Paltrow’s Goop has written about the account’s creator glowingly.) Or on Pinterest and Facebook, where anti-vaccination content has been far more prominent than legitimate public health information. Meanwhile, on e-commerce sites like Amazon and eBay, vendors have hawked unproven and dangerous health “cures, ” including an industrial-strength bleach that is billed as eliminating autism in children.

“This is the biggest crisis we have right now in health care,” said Chiang. “Everyone should be out there, but I realize I’m one of the few.”

According to Chiang, doctors have historically been reluctant to build a following on social media for a variety of reasons. They view it as a waste of time, they don’t know how, or they fear they might say the wrong thing and get in trouble with an employer. Others prefer to spend their time communicating with their peers via academic journals.

But as Chiang points out, most consumers do not pore over the latest scientific literature. So health professionals need to take the time to start connecting with them where they do spend their time — and that’s on Facebook and Instagram.

  So he’s working to recruit an army of physicians, nurses, patient advocates, and other health professionals to get online. He’s primarily starting on his home turf at Jefferson Health, and with other doctors in his specialty. He was appointed to his “new and unique role” in the summer of 2018, which he got after a series of conversations with the health system’s CEO Stephen Klasko.

Klasko is a physician and avid social media user himself, with both professional and personal accounts. He’s also a notorious straight-talker in the industry who openly discusses some of the more broken aspects of the heath-care system online and at conferences, including things like the inflated costs and the flaws of medical education.

Jefferson Health’s Steve Klasko walking through campus.

Jefferson Health

In his new role, Chiang has been thinking about guidelines for health professionals on how to use the new digital tools, including things like disclosing any conflicts of interest. He thinks that more transparency about ties to industry will help doctors garner trust with the public. To spread these ideas, he’s set up a new group for health professionals dubbed the Association for Healthcare Social Media.

He’s also attempted a few hashtag-driven public awareness campaigns, including one called #verifyhealthcare to promote these ideas about disclosures, and another called #dontgoviral to counter anti-vaxxer content.

Klasko, Chiang’s CEO, sees a direct business benefit to having Jefferson’s approximately 3,000 doctors participating on social media.

“Everyone under the age of 35 uses Facebook and Instagram as a vehicle, and I want them to see Jefferson as a partner in their health so they’ll think of us” he said.

More broadly, he shares Chiang’s concerns about the proliferation of health misinformation. Measles cases are climbing, with outbreaks across the country, which many health professionals chalk up to parents refusing to vaccinate their children. That’s one of the reasons that Klasko chooses to be so active online and with the media, so that people who want to access accurate information can find it.

“Imagine if it would be easier to access The National Enquirer than The Washington Post,” he said. “I fear that that’s what is happening in health care right now.”

[nrip]

Doctors and nurses on Instagram: influencers like Doctor Mike are everywhere 

Sarah’s Instagram feed is pretty typical for a 21-year-old model-slash-influencer living in Florida. Here she is standing dreamily in front of some ferns. Over here she’s clutching Starbucks’s new Cloud Macchiato. She poses on porches, by murals, in bathrooms, often with lengthy captions that reveal what she’s up to this weekend (wedding planning, working), words of inspiration, and her very relatable love of donuts.

There’s one important difference: In all of them, she’s wearing scrubs.

Which is appropriate, considering “shesinscrubs” is her username. Along with modeling, Sarah, who asked not to reveal her last name, is a registered nurse. Over the course of just four months she has amassed an Instagram following of more than 11,000 people.

Being a nursefluencer, a term that I have admittedly made up but that describes a growing population, is similar to being a regular influencer: You get someone to take pictures (for Sarah, it’s her little brother), you post often (once a day or else the algorithm will bury you, Sarah tells me), and promote products (like almost everyone I spoke to for this piece, Sarah receives free scrubs from the brand Figs).

On the other hand, regular influencers don’t usually have to worry about whether promoting, say, CBD oil violates medical ethics. HIPAA, the law that protects patient privacy and medical records, is also presumably not a high-priority consideration.

But for Sarah, and many young health care professionals like her, a sizeable Instagram following is a salve for a litany of problems experienced by those in the field: burnout, odd hours, and a lack of a creative outlet, to start. So it’s not surprising that within the past few months, tons of accounts like hers have popped up, gaining huge followings — largely made up of fellow medical professionals — by posting an insider’s view of the industry.

It’s also raised questions about the ethics of being a health care influencer. After all, isn’t the only person who should be influencing anyone’s health their own doctor?

Where did medical influencers come from?

Instagram is a place where you are supposed to show off how “well” you’re doing, even if you’re not doing very well at all. Scroll through the feed and you’re likely to see signifiers of social wellness (friends), mental wellness (books and bathtubs), and physical wellness (yoga and photogenic health foods) that might bear negligible resemblance to one’s actual life.

Those who have succeeded at performing that wellness the most palatably for the platform have been rewarded with millions of followers, which in turn can bring brand deals and, with that, money. It’s created a new class of microcelebrities who, intentionally or not, wield enormous influence over how others live their lives, or at least how they present their lives on social media.

“I SEE PEOPLE ALL THE TIME ADVERTISE THINGS LIKE, ‘MY SPECIALTY IS COSMETIC DENTISTRY. THERE IS NO SPECIALTY OF COSMETIC DENTISTRY. IT’S NOT A RECOGNIZED DENTAL SUBSPECIALTY.”

While most of the time when we think of wellness influencers, we might think of acro-yoga couples or, on the extreme end, people like Freelee the Banana Girl, the nude vegan vlogger who lives in a South American jungle and eats exclusively fruit, there are some accounts that are actively harmful: Instagram has contended with a serious anti-vaccine conspiracy theory problem, for instance. Its algorithmic recommendation engine can also conflate many types of “health” content, so that following one anti-vaccination account might push you to follow dozens of others, but could also group them alongside accounts promoting innocuous things like plant-based diets.

Health care influencers who have flooded the site within the past few years say they’re fighting back against that kind of social media misinformation. Many nurses and doctors on Instagram combine the cute, aspirational lifestyle aesthetic of regular fashion and beauty influencers with actual medical tips from a vetted professional.

There are now so many medical professionals on Instagram that at least one hospital has created an entire position to govern it. Austin Chiang, MD, a gastroenterologist and assistant professor of medicine at Jefferson Health in Philadelphia, also holds the position of chief medical social media officer, which he guesses might be the first of its kind in the country. “I always felt strongly that we need a stronger clinician presence on social media in order to really battle misinformation out there,” he says.

It’s why last fall, he and a few peers launched the hashtag campaign #VerifyHealthcare, which encouraged health care professionals on social media to list their qualifications, such as their education, specializations, and board certifications. “A lot of us had started noticing health professionals who were saying that they were some sort of practitioner when they actually were not,” he says. “If they’re talking about health and marketing themselves as doctors, then the public could be misled.”

Many of the top Instagram posts related to plastic surgery, for instance, are from doctors not specially trained in plastic surgery despite the fact that they’ve marketed themselves as “cosmetic surgeons.” Naturopaths, chiropractors, and aestheticians are also typically not medical doctors, but some may present themselves on social media as such.

Concerns like these have been top of mind for people like Arthur L. Caplan, the founding director of NYU’s Division of Medical Ethics. “I see people all the time advertise things like, ‘My specialty is cosmetic dentistry.’” he says. “There is no specialty of cosmetic dentistry. It’s not a recognized dental subspecialty.”

On Instagram, health care isn’t just a day job anymore, it’s a personal brand, and an increasingly lucrative one at that: All the health care influencers I spoke to had seen their followings skyrocket in the past year, which some hope will lead to bigger brand deals.

But wait, why do doctors need side hustles?

Dentist Joyce Kahng has more than 13,000 followers on the account she launched just a year ago, @joycethedentist. When she first started, she posted up-close images of teeth (she used her family members’ due to HIPAA concerns) because that’s what she saw other dentists doing. But, she said, laughing, “those weren’t being received well by normal people.”

Instead, the content that performs best on the page now is about her life as a dentist in addition to owning her own practice and being a professor at USC. Being likable and accessible, she says, has also translated into business: Around three-quarters of her new patients have found her via Instagram. “It gives you a competitive edge against the already saturated dental market,” she explains.

Despite health care being a relatively stable and high-paying industry, Kahng sees her growing Instagram following as an investment. “In some future, I do want to start to monetize it because at some point I need to have kids,” she says. “I just haven’t figured out the way in which to do it that doesn’t make me feel like a sellout.”

This is when I ask her the very obvious question: If an extremely successful dentist, business owner, and professor is worried about not being able to afford children, what hope do the rest of us have?

“Dentistry does pay well,” she explains. “The thing is, you have to work in order to be paid. It’s not like a corporate job where you can call in sick. If I don’t come in, every single person that I employ cannot work that day. I just imagine being pregnant and having to miss work for a month, [and] the office cannot run. That concerns me.”

It’s not as if health care professionals haven’t always had side hustles. The internet is filled with tips on how to make extra money as a nurse — RNs can make, on average, from $50,000 to nearly $100,000 depending on the state where they live, but when adjusted for cost of living, that number can be lower. It’s also a job that has a high rate of burnout due to the stressful work environment and difficult working conditions, which means that not everyone can or wants to make it a lifelong career.

Many nurses have recently turned to multilevel marketing as a way to supplement their incomes or as a path out of the field. And though none of the influencers I spoke to were making serious (if any) money on Instagram, most acknowledged the possibility of doing so in the future.

“I don’t think it’s fair to be like, ‘You’re a nurse, you care for other people, therefore you’re not allowed to benefit yourself financially,’” says Katy B (who also asked to keep her last name private), a registered nurse in San Francisco with more than 25,000 followers. “Most of us have a lot of student debt and trying to stay afloat. I don’t think there’s anything wrong with it as long as you’re being transparent about what you’re doing.”

Spon con, HIPAA, and medical advice: the ethics of being an Instagram doctor

That transparency, of course, comes hand in hand with the question of sponcon, or sponsored content. For the average influencer, it’s pretty simple: A brand pays them a sum of money to endorse a product, like laxative teas or viral YouTube toys, in a way that leverages their large following.

It’s different, though, when you’re also leveraging your expertise and reputation as a doctor, dentist, or nurse. Scroll through most health care influencers’ Instagram feeds and you’re likely to see at least a few #ads. Some are innocuous: Many influencers have deals with the aforementioned scrubs brand Figs, while others promote products like stethoscope charms shaped like Disney characters that can help keep nervous kids calm during checkups.

Though few peddle the kind of questionable medical treatments shilled by celebrities like Dr. Oz (rapid weight-loss pills with harmful side effects, for instance) some toe the very blurry line about what’s appropriate for a health care professional to post. Mike Varshavski, a cartoonishly handsome New York City physician who goes by the name Doctor Mike on Instagram and has more than 3 million followers, regularly posts sponsored content for everything from Clorox bleach to Quaker Oats and American Express, which could create the perception that these corporations are somehow medically approved by this doctor. (Disclosure: Doctor Mike has participated in a Vox Media panel event.)

Even average Instagram influencers now shill drugs and medical devices paid for by Big Pharma, without necessarily any real knowledge of how they work. When products fall under the health umbrella, the ethical questions are even more complicated. The Federal Trade Commission does have specific guidelines for doctor endorsements. For example, doctors should not misrepresent their specific areas of expertise. But it still raises the question: Should a doctor be paid to promote essential oils? What about NyQuil?

“I’m not sure [doctors] have any place [promoting over-the-counter products] other than to say, ‘I’m a regular user.’ I think it still undermines their professional credibility,” Caplan says. “When you start endorsing, say, aromatherapy, you’re saying you had a great time at a spa and you felt it really helped your anxiety or something. You’re getting into pseudo-medicine stuff. Some of those things can make you feel better, but you don’t want to give them scientific endorsement.”

It’s a debate that’s somewhat reminiscent of decades-long concerns about pharmaceutical companies paying or wooing doctors to prescribe their products. But this, Caplan explains, isn’t the way it works anymore. “You don’t have the old, ‘We’re gonna bring you donuts every week and you keep writing prescriptions for our drug.’”

THERE’S NOTHING IN THE HIPPOCRATIC OATH THAT CLAIMS THOU SHALT NOT HASHTAG #AD

“It’s not that everybody suddenly became ethical,” he said, laughing. Rather, now pharmaceutical companies can market directly to the patient. “There’s the ads that are like, ‘Ask your doctor about this cancer medication.’ If you have to ask your doctor about a cancer medication, you need a new cancer doctor.”

Sponcon, however, is not the main ethical concern for most health care influencers — after all, doctors and nurses endorse products all the time; as long as they comply with FTC advertising disclosure guidelines, there’s nothing in the Hippocratic oath that claims thou shalt not hashtag #ad.

Instead, that concern is HIPAA, or the Health Insurance Portability and Accountability Act of 1996, a federal law that provides privacy and security protections for patients’ medical information. Under HIPAA, all patients have the ability to see how and where their medical records are being used and prevent them from being seen by their employer or insurance company. And unlike shilling over-the-counter drugs, violating HIPAA is a fireable offense. The problem, though, is that HIPAA existed a decade and a half before Instagram did.

“It’s not as simple as not mentioning someone’s name,” Chiang explains. “Instagram is visual, so you see a lot of procedural photos. There are certainly risks in that. There’s even risks in geo-tagging or talking about a case that you’re doing.”

Some doctors and surgeons have achieved enormous followings on social media by posting procedural videos from the gross (Sandra Lee, who goes by the nickname “Dr. Pimple Popper”) to the straight-up gory. In 2015, Dr. Michael Salzhauer, or “Dr. Miami” began posting graphic videos of himself performing butt lifts, breast surgery, and liposuction on Snapchat, which regularly garnered more than a million views.

Dr. Miami reportedly secured permission from his patients to do so. Every influencer I spoke to listed HIPAA as one of their top concerns and said they were diligent about not posting anything that might cross a line.

“You can change the date, gender, or demographic, but someone from [their] work or family could recognize the case no matter how much you change about it,” Sarah says. “I would be scared to even think about posting about any of my patients. Maybe one of them saying, ‘You were a nice nurse.’”

Instagram is offering prospective doctors and nurses a look inside their world, and a way to deal with the stress

Though weighing the ethical questions like HIPAA and sponcon can be thorny, health care influencers also provide a genuine service for those interested in joining the field.

Like Kahng, Katy started her Instagram page after seeing similar accounts, and today, the majority of her followers are fellow health care professionals or aspiring ones. Though she originally went to college with the goal of being a physician, she realized it wasn’t for her. Now she’s on track to receive her master’s in June, when she will become a pediatric primary care nurse practitioner.

“I DON’T THINK IT’S FAIR TO BE LIKE, ‘YOU’RE A NURSE, YOU CARE FOR OTHER PEOPLE, THEREFORE YOU’RE NOT ALLOWED TO BENEFIT YOURSELF FINANCIALLY.’”

“My main goal is to share what my journey looks like, because in health care, especially for folks that aren’t familiar with the professional fields, there’s so many different things that you can do,” she says. “It’s cool when we all share our unique perspective of what it actually looks like on the human side.”

This explains why accounts like hers have been able to grow so quickly in such short amounts of time: There’s a real hunger among prospective medical professionals to get a sense of what the job and the lifestyle really look like.

“We’re so at risk for burnout, because we spend a lot of time taking care of other people, and I think sometimes we forget how to take care of ourselves,” she adds. “We have to brag about the cool things that we do!”

What you don’t see on Katy’s Instagram page — for reasons that are very obvious and very necessary — is her actual job. She’s currently in an emergency pediatric psychiatric care unit, where she works with children up to age 17 who are experiencing immediate psychiatric crises.

It’s difficult to imagine how the stress of such an environment can affect a person, but it does help explain why so many Instagram nurses and doctors fill their feeds with a heavily curated stream of bright and shiny images. For those who work in emergency rooms, it’s impossible to predict what the day will bring. But on Instagram, everything’s perfectly controlled.

Dustin Harris, a resident emergency room physician in Chicago, deals with the stress using humor. He’d done some standup, and started posting the funny things patients would say to Facebook. On his Instagram page, where he has nearly 18,000 followers, he posts jokes, memes, and sometimes even haikus relating to the job.

“My favorite part about it is making people laugh. It keeps me balanced. I’ll be working and I’ll see some disease, and be like, ‘Oh man, I could write a funny rap about this.’ The human body is a funny thing sometimes.”

“TV has portrayed medicine as being very dramatic or sexy,” he adds. “I felt that I could show the more real version of it. Not that those things that happen don’t ever happen, like awesome procedures or people coming back to life, but that’s not every day.”

Making light of the often dark professional realities of health care is how Sarah, the nurse in Florida, built her following in the first place. She’d started the meme account @scrublifenurses last June, which then gave her the skills and platform to launch her own personal page. Memes there range from the silly (a video of a possum carrying her babies captioned with “When you’re the only seasoned nurse on the floor with a bunch of new grads”) to the serious (the phrase “A national effort for safe staffing ratios for nurses” combined with the viral clip of Mo’nique saying “I would like to see it.”).

“A lot of our job is dealing with human emotion, and you can bring that home pretty easily,” Sarah says. “If you just bottle it all up and you already have issues with your own mental health, it can be extremely detrimental and then you lose your love for your passion.”

On both her meme account and her personal page, Sarah often posts about topics like mental health, the importance of nurses’ unions, and other national health care issues. That, of course, in addition to the stylized photos typical of influencers. “I like to post [photos that show] this isn’t what it really is, but at the same time have an aesthetically pleasing feed. It’s kind of like you have control over something, but when you’re at work it’s chaos.”

Nursefluencers aren’t going anywhere anytime soon

The benefits of being a health care professional with a big Instagram following — having a creative outlet, the ability to market oneself, and the sense that you’re combating misinformation on the internet, for instance — mean that the phenomenon isn’t likely going to slow down.

One problem, though, is that medical students aren’t exactly taught how to use Instagram responsibly. Caplan, the medical ethicist, says that at most they’ll get a single lecture on social media, which he attributes to the generation gap. While most current medical students have grown up using social media, their professors didn’t, and may not be prepared to advise them on the peculiarities of the health care internet.

In a piece for Slate in November 2018, medical student Vishal Khetpal wrote about how organizations and companies would approach him and his classmates to appear in white coats while endorsing products or attending events despite the fact that they weren’t actually doctors yet.

“The uncharted ethics of social media are already confusing,” he writes, “and that’s before you add in the influence of outside interests, many of which are ready to take advantage of students’ ability to offer some stamp of medical authority to the general public about a product or idea without asking too many questions.”

“ANYONE WHO THINKS THEY’RE GOING TO STOP THE USE OF SOCIAL MEDIA BY PHYSICIANS OR NURSES IS OVER 40.

Confusion over what’s okay to post is a constant struggle. It’s why Chiang has launched the Association for Healthcare Social Media, which is currently in the process of obtaining a 501c3 designation before opening itself up to members.

“I think a lot of physicians are almost scared to get on social media because of the restrictive nature of how things were worded in the past,” he says. “We want people to share their experiences and share their expertise.”

Traditionally, health care professionals were discouraged from revealing anything about their personal lives in the public. But, thanks in part to Instagram, that’s changing.

“[There are] some old fogies who think, ‘Well, doctors shouldn’t be sharing personal information or talking about their lives in places the patients could find it, blah, blah,’” Caplan says. “Anyone who thinks they’re going to stop the use of social media by physicians or nurses is over 40. It’s just not going to stop. We have to adjust.”

Kahng, for her part, says that now, she makes sure to teach her USC students to build up their social media presence. “They invest so much money into their education and at the end of it, who knows?” she says. “They may not like dentistry, and I want them to have a following so that they don’t feel quite as trapped. They have something to lean on.”

[hcldr]

HCSM News

Thanks Dr. Klasko @sklasko, the most innovative healthcare CEO @TJUHospital! Website opens this Friday for membership! Clinicians NEED to be rewarded for these contributions educating the public on social media! #hcsm #ahsm #medtwitter #meded #hcldr #somedocs https://t.co/x912Thnlyf

— Austin Chiang MD MPH (@AustinChiangMD) May 1, 2019

[nrip]

Social Media Is Not Bad For Health Care

In any given moment we have two options: to step forward into growth or step back into safety.”

— Abraham Maslow

The New York Times recently published the Op-Ed “Dr Google is a Liar,”written by cardiologist Haider Warraich, MD. Dr. Warriach describes the rise of fake medical news, and the adverse consequences of a population who gets their medical information from social media. He shares that when countering these cultural memes of medical misinformation, which stir up strong emotions in our patients, stating dry medical jargon is not effective. He found that his patient was more open to his advice when he also shared about his own father’s heart attack. Dr. Warraich wisely argues for physicians to take back control of medical news by harnessing the power of humanism and narrative medicine to become effective story-tellers.

I whole-heartedly agree with him. Let’s stop burying our heads in the sand and pretending we can convince our patients to resist Dr. Google. Let’s put ourselves back in the driver’s seat. I believe that the next generation of great doctors will be those who communicate on the Internet effectively and in a compelling enough way to sustain an audience and engender trust. In a time when trust in doctors is eroding, our patients want to see that we are human too, and to do that we need to overcome our fears of showing our humanity. We know that when doctors and nurses are burnt out, patient outcomes decline. Literature also supports that when doctors display more empathy for their patients, outcomes improve. Humanism in medicine works best when it is a two-way street, wherein our health care system treats both patients and health care workers as human beings.

I believe there’s a natural link between humanism in medicine and social media. While there has been a core group of physicians on social media for the past decade, we are now seeing it become mainstream. Through this increased visibility, physicians are using social media mobilization to organize and to advocate for better patient care and better work conditions. Last November, as a criticism to the American College of Physician’s position paper describing a public health approach to tackling gun-related deaths, the National Rifle Association tweeted that “self-important anti-gun doctors” should stay in their lane. The medical community swiftly responded with the #ThisIsMyLane campaign, rallying around their first-person, often harrowing accounts, of caring for the gunshot victims in ERs and operating rooms. Dr. Dave Morris, MD, a trauma surgeon in Utah posted a photo of his blood-soaked scrubs and said “Can’t post a patient photo, so this is a selfie. This is what it looks like to #stayinmylane”. The tweets and hashtags went viral, garnering national media attention, and physicians effectively steered the conversation.

Leo Eisenstein, a Harvard Medical Student, wrote about this in a New England Journal of Medicine Catalyst piece. He reminds us that the term “burnout” was coined by a psychologist who was caring for marginalized patients. In today’s broken health care system, clinicians are burdened by the reality that their patients are fighting socioeconomic and structural barriers that “no medicines can touch.” If both physicians and patients feel powerless against these forces, it’s not a big leap to envision physician advocacy as part of the antidote.

Part of makes what makes social media appealing is that it allows unheard voices to become public. This is crucial, particularly for physicians, with many of us working long hours providing direct face-to-face patient care, and thus not having the time for community engagement. Social media platforms have become a watering hole of sorts, where it’s okay to share your perspective as a physician. Every Sunday night, @womeninmedchat(run by Dr. Petra Dolman, MD) hosts an hour-long Twitter chat, with guest moderators facilitating conversations ranging from how to negotiate pay, navigating residency interviews, and countering burn out, all searchable under the hashtag #womeninmedicine. The Facebook group SoMeDocs (ie. Social Media Docs), founded by Dr. Dana Corriel, MD, has provided an engaging forum for physicians to discuss a variety of issues related to social media. #SoMeDocs is branching out to in-person live meet-ups aimed at building community, and advancing shared goals. For example, when Dr. Monique Tello, MD, MPH spoke out in support of vaccinations, she was targeted by anti-vaxxers online. Through the support of #SoMeDocs, Dr. Tello wrote a widely circulated blog post about online harassment and intimidation against doctors, and successfully had the fake one-star online reviews removed.

With all of this momentum, it is important to remember that social media is a public space, and it should not be used to share protected health information, or sensitive personal material. Some physicians argue that these risks mean we physicians should stay away from social media. However, with the next generation of doctors spending at least a decade of their life on Instagram and Snapchat prior to medical school, we simply cannot ignore the fact the social media has its own place in health care. Universities have been taking notice, and creating positions to legitimize social media. My own alma mater, Sidney Kimmel Medical College of Thomas Jefferson University in Philadelphia has named Dr. Austin Chiang MD, MPH as their Chief Social Media Officer. Likewise, the newly established Association for Healthcare Social Media aims to create best practices by which all health care professionals can be guided and protected in this emerging field.

I’ve met quite a few physicians who are even just one generation older than I am that are suspicious of social media. To them, it’s extra and it’s dangerous. I can’t help but wonder if there is an underlying fear that the next generation is going about things in a different way? It seems there is denial and wishful thinking; as if we can turn back the clock in time and go back to the good old days when physicians could practice medicine without the burdens of out of control billing and EMR demands. My generation has inherited the reins, and in my opinion, we got into this mess by physicians keeping themselves separate from other industries. Insurance companies took over medicine, and meanwhile, physicians were seeing patients, writing notes, and faxing orders. We assumed that if we were providing excellent patient care, the rest would fall in line, and the work would speak for itself. Fast forward, and here we are.

Part of what’s gotten us off track in medicine is the dehumanization of patients and doctors. By sharing our stories, we remind the public that we are human, too. We have successes and failures, tragedies and triumphs. We are human. I believe that doctors can serve patients, be professional, and make our opinions known. In fact, it’s our duty, and our profession depends on it.

Pooja Lakshmin, MD is a board-certified psychiatrist and Assistant Professor of Psychiatry & Behavioral Sciences at the George Washington University School of Medicine. She is passionate about women’s mental health. You can find her on twitter @PoojaLakshmin. She is a 2018–2019 Doximity Author.

Previously published on KevinMD.

[nrip]

How social media can advance humanism in medicine

“In any given moment we have two options: to step forward into growth or step back into safety.” – Abraham Maslow.

The New York Times recently published the op-ed “Dr. Google is a Liar,” written by cardiologist Haider Warraich, MD. Dr. Warraich describes the rise of fake medical news and the adverse consequences of a population who gets their medical information from social media. He shares that when countering these cultural memes of medical misinformation, which stir up strong emotions in our patients, stating dry medical jargon is not effective. He found that his patient was more open to his advice when he also shared about his own father’s heart attack. Dr. Warraich wisely argues for physicians to take back control of medical news by harnessing the power of humanism and narrative medicine to become effective storytellers.

  I wholeheartedly agree with him. Let’s stop burying our heads in the sand and pretending we can convince our patients to resist Dr. Google. Let’s put ourselves back in the driver’s seat. I believe that the next generation of great doctors will be those who communicate on the Internet effectively and in a compelling enough way to sustain an audience and engender trust. In a time when trust in doctors is eroding, our patients want to see that we are human too and to do that we need to overcome our fears of showing our humanity. We know that when doctors and nurses are burnt out, patient outcomes decline. Literature also supports that when doctors display more empathy for their patients, outcomes improve. Humanism in medicine works best when it is a two-way street, wherein our health care system treats both patients and health care workers as human beings.

I believe there’s a natural link between humanism in medicine and social media. While there has been a core group of physicians on social media for the past decade, we are now seeing it become mainstream. Through this increased visibility, physicians are using social media mobilization to organize and to advocate for better patient care and better work conditions. Last November, as a criticism to the American College of Physicians’ position paper describing a public health approach to tackling gun-related deaths, the National Rifle Association tweeted that “self-important anti-gun doctors” should stay in their lane. The medical community swiftly responded with the #ThisIsMyLane campaign, rallying around their first-person, often harrowing accounts, of caring for the gunshot victims in ERs and operating rooms. Dr. Dave Morris, MD, a trauma surgeon in Utah posted a photo of his blood-soaked scrubs and said “Can’t post a patient photo, so this is a selfie. This is what it looks like to #stayinmylane.” The tweets and hashtags went viral, garnering national media attention, and physicians effectively steered the conversation.

  Leo Eisenstein, a Harvard Medical Student, wrote about this in a New England Journal of Medicine Catalyst piece. He reminds us that the term burnout was coined by a psychologist who was caring for marginalized patients. In today’s broken health care system, clinicians are burdened by the reality that their patients are fighting socioeconomic and structural barriers that “no medicines can touch.” If both physicians and patients feel powerless against these forces, it’s not a big leap to envision physician advocacy as part of the antidote.

  Part of makes what makes social media appealing is that it allows unheard voices to become public. This is crucial particularly for physicians, with many of us working long hours providing direct face to face patient care, and thus not having the time for community engagement. Social media platforms have become a watering hole of sorts, where it’s okay to share your perspective as a physician. Every Sunday night, @womeninmedchat (run by Dr. Petra Dolman, MD) hosts an hour-long Twitter chat, with guest moderators facilitating conversations ranging from how to negotiate pay, navigating residency interviews, and countering burn out, all searchable under the hashtag #womeninmedicine. The Facebook group SoMeDocs (Social Media Docs), founded by Dr. Dana Corriel, MD, has provided an engaging forum for physicians to discuss a variety of issues related to social media. #SoMeDocs is branching out to in-person live meetups aimed at building community, and advancing shared goals. For example, when Dr. Monique Tello, MD, MPH spoke out in support of vaccinations, she was targeted by anti-vaxxers online. Through the support of #SoMeDocs, Dr. Tello wrote a widely circulated blog post about online harassment and intimidation against doctors and successfully had the fake one-star online reviews removed.

With all of this momentum, it is important to remember that social media is a public space, and it should not be used to share protected health information or sensitive personal material. Some physicians argue that these risks mean we physicians should stay away from social media. However, with the next generation of doctors spending at least a decade of their life on Instagram and Snapchat before medical school, we cannot simply ignore the fact the social media has its own place in health care. Universities have been taking notice and creating positions to legitimize social media. My alma mater, Sidney Kimmel Medical College of Thomas Jefferson University in Philadelphia has named Dr. Austin Chiang MD, MPH as their Chief Social Media Officer. Likewise, the newly established Association for Healthcare Social Media aims to create best practices by which all health care professionals can be guided and protected in this emerging field.

I’ve met quite a few physicians who are even just one generation older than I am that are suspicious of social media. To them, it’s extra, and it’s dangerous. I can’t help but wonder if there is an underlying fear that the next generation is going about things differently? It seems there is denial and wishful thinking; as if we can turn back the clock in time and go back to the good old days when physicians could practice medicine without the burdens of out of control billing and EMR demands. My generation has inherited the reigns, and in my opinion, we got into this mess by physicians keeping themselves separate from other industries. Insurance companies took over medicine, and meanwhile, physicians were seeing patients, writing notes and faxing orders. We assumed that if we were providing excellent patient care, the rest would fall in line, and the work would speak for itself. Fast forward, and here we are. Part of what’s gotten us off track in medicine is the dehumanization of patients and doctors. By sharing our stories, we remind the public that we are human too. We have successes and failures, tragedies and triumphs. We are human. I believe that doctors can serve patients, be professional, and make our opinions known. In fact, it’s our duty, and our profession depends on it.