The intersection of social media, social justice and medicine

During my (Dr. Sabry) second year of medical school, there was a lecture on professionalism and medicolegal principles. I distinctly remember the lecturer referencing social media as a very dangerous platform and the advice to my class was that physicians do not belong on social media.

There were many slides showing examples of how social media can be used against physicians, including potential HIPAA violations from sharing patients’ stories and potential professional misconduct if a physician were to post anything that can be perceived as highly political or unprofessional.

While there can be challenges with communicating on social media, it is also a powerful tool to educating the public and creating social change. Although I attended that lecture almost two decades ago, I’ve noticed that many physicians still fear social media today and limit their use of it, and by extension, their impact on their community.

Worse yet, our medical leadership locally at our institutions, as well as in some of our professional organizations, still hold some of these beliefs. Social media has become a part of our lives more and more, and for better or worse, the way many people access medical information. We have recently seen an uptick in this during the pandemic, which has left the public with an interest in medical literacy and curiosity about how the medical system works. 

In 2021 as the world continued battling the COVID-19 pandemic, there was another disease that had long been hidden from plain sight but became visible on all screens across the country. The once-taboo topic of systemic racism within and outside the health care system became the topic of mainstream conversation.

Just months after the first COVID lockdown, the tragic death of George Floyd started many conversations in the medical community, including how systemic racism exists in medicine and contributes to long-known disparities in health care in Black, Indigenous, People of Color (BIPOC) communities.

Structural racism affecting patients has been documented in many studies, and the awareness of aversive racism affecting our fellow BIPOC physicians and health care workers is becoming a more common topic of discussion. The uncomfortable truth is that physicians uphold many of the policies and treatments that have been generationally unfair to our BIPOC community, and we are now seeing the world talking about it openly on social media. 

Many physicians have chosen to use their platforms to educate the public to create the change we hope to see as this conversation continues. As we observe Black History month this February, this article is dedicated to highlighting Black physicians who are equipping the public with anti-racist medical education on the various social media platforms.

We each have a responsibility to be a part of the solution to systemic racism. It will take all of us speaking out in unison to dismantle racism in medicine and truly address disparities in health care. Please access, share and follow these medical creators’ content and seek out other accounts discussing the importance of being anti-racist in health care.

Instagram

Joel Bervell is a third-year medical student who has a robust following on Instagram. He describes himself as a “medical mythbuster,” and creates content that highlights varying examples of racial bias in medicine. For example, this video tells followers about pulse oximeters’ inability to accurately measure oxygenation on Black patients due to the absorption of light and the overestimation of oxygenation.

In a NEJM study released in December 2020, Black patients were three times more likely than white patients to have low oxygen levels misread by pulse oximeters as normal or higher than the accurate value. This contributes to worsening outcomes, especially with COVID, as many of our treatment modalities were based on documented hypoxia.

Bervell was able to concisely communicate this possible life-saving fact to other medical professionals and patients in this short, 32-second video, creating awareness of the problem. He has many other educational videos, and can be found on both Instagram and Tik Tok under his username @joebervell.

Facebook

You may have heard of Amaka Eneanya, MD, MPH, the nephrologist who spearheaded the change in how we estimate glomerular filtration rate (GFR) calculations without race being part of the equation last year. With the acknowledgement that race is a social, not biological, construct, having race-based factors in tests contributes to disparities in health care due to racism.

Dr. Eneanya and her coauthors explained that included in the GFR calculations were age, sex and race, and these overestimated the GFR in Black patients. Having accurate GFR calculations can help guide the appropriate kidney health care needed for each patient. This update plays an important role in addressing health disparities as Black Americans are already disproportionately affected with kidney failure, and systemic differences in the approach of how we calculate GFR can further exacerbate this.

To show how this can affect Black patients, Dr. Eneanya contributed to a storyline on an episode on Grey’s Anatomy, when a non-Black patient was chosen over a Black patient for a kidney transplant because their GFR was lower due to this caveat of calculating GFR with a multiplier for Black patients, based on the assumption that Blacks have higher muscle mass. This is a great way to educate the public and our medical community on how racism is embedded in our practice, and an example of how we can start to dismantle it.

Tik Tok

Darien Sutton, MD, MBA, is a board-certified emergency medicine physician who has had tremendous growth on the Tik Tok platform in the past year. He has grown to almost 1 million followers by educating the public on types of cases he sees in the emergency department, or as he terms it, “Tik Tok med school.”

While he has received thousands of comments praising his ability to teach medical topics in a thorough and interesting way, he has also been subject to racism on the app himself. In response to a comment by a user stating that Black people are not oppressed because he himself is a Black physician, he drafted a very powerful response outlining what he describes as a tool for handling traumatic racism.

In the response, Dr. Sutton states that he analyzes others’ understanding of racism and the tools they use to learn. He admits that he regularly faces racism as a Black man, and that racism and anti-racism are taught to us all. He describes four stages to this learning process, which includes unconscious incompetence, conscious incompetence, conscious competence and unconscious competence. This video highlighting the four stages is a must-see for understanding what he and others go through, even in a higher position in the medical field.

LinkedIn

Uché Blackstock, MD, is an emergency medicine physician and founder of Advancing Health Equity, a consulting company that partners with health care organizations and startups to address racial health inequities to create a larger systemic impact. Through her voice on all social media platforms, Dr. Blackstock has been featured in Forbes magazine and many other publications, including the Chicago Tribune, the Washington Post and Scientific American.

She is devoted to educating the public on health equity issues both on television and through keynote speaking. She regularly posts about her experiences and the opportunities we must engage in to support diverse workforces and prioritize racial equity.

She recently posted about her new book that will be debuting in the summer of 2023 about the experiences both she and her physician mother have faced at the hands of systemic racism. She describes her book as a “love letter to my late mother…and it’s also a call to action.” Dr. Blackstock educates the public on how they can be part of the solution and be anti-racist, while she is positively affecting millions of patients and colleagues with her work.

Doctors do belong on social media

As we continue to discuss our fear of social media and weigh the pros and cons of its effects on social impact, it is important to recognize the work of our physician colleagues across the web using their platforms to do this impactful work of educating, mobilizing and empowering all of us to work together to improve public health, especially in communities that have been negatively impacted for generations by racism.

Our role as physicians is to educate and lead the public with great health care options. The truth is that doctors do belong on social media, just like everyone else. We need to meet patients where they are, and often that is on the internet. But first, we need to educate ourselves on topics such as racism to be able to address it effectively and accurately, on and off the screen.