From Dr. Ruth to Dr. Oz, numerous medical personalities have emerged to meet the demand for health information over the decades. Popular interest in medical topics is nothing new, but within the last five years, as platforms like TikTok have grown in popularity and as the COVID-19 pandemic increased interest in medical topics, the number of clinicians posting popular content on social media — promoting medical topics, products, and lifestyles — has grown.1 While doctor influencers and other medical professionals on social media can help educate the broad internet audience, there are also potential dangers to be careful of, not to mention the dangers associated with influencers who are not qualified to give medical advice. 

The American Medical Association’s guidelines on “Professionalism in the Use of Social Media” were last edited in 2017. They contain a brief, seven-point set of stipulations which are centered around the importance of protecting patient privacy and the patient-physician relationship. They only briefly warn of the danger of “undermin[ing] public trust in the medical profession,” an issue that gained particular prominence during the pandemic.2 

Controversy has long trailed various medical personalities: one study found that evidence supported less than half of recommendations on The Dr. Oz Show.3 In a social media era, with content generated and shared at a much larger scale, the same issues are of even greater concern when it comes to doctor influencers. With scant regulation in many social media spheres, doctors influencers can be a source of medical misinformation — or the solution to it.4 

 Medical recommendations can be highly nuanced depending on the patient. Some doctor influencers are more explicit in highlighting this fact than others. Dr. Mikhail “Mike” Varshavski, a family practice physician with a viral social media presence, named “the Sexiest Doctor Alive” in 2015, includes a notice on his YouTube page emphasizing that his content does not replace a consultation with a doctor. Indeed, many health professionals have stated they have been inspired to develop their social media presence by virtue of their recognition of the importance of encouraging patients to seek out individualized care and suppressing misinformation.1 

Social media in medicine can help create patient communities, improve patient education, remove stigma from certain health conditions, and, especially in socially vulnerable populations, improve access to health information.5 One 2021 study suggests that content about brachytherapy can provide patients with “another avenue for support and reliable source of treatment information” on radiation, which many patients are hesitant to pursue. However, the study found that physicians produced only 11% of brachytherapy-related posts on Instagram during the study period, while 79%, were from patients and other Instagram users. The study encourages increased physician social media presence to remedy this gap.6 

In some specialties, especially more technical or niche fields, there is already greater physician participation: plastic surgery influencers on Twitter7 and TikTok8 have been sources of study, and evidence shows that these influencers are predominantly — but not exclusively — board-certified surgeons. Many medical specialties with large social media followings lie adjacent to the beauty industry, both because of public appeal, and because of the associated financial incentives for influencers. In dermatology, board-certified physicians appear to comprise a small fraction (6 out of 146) of Instagram accounts with popular dermatology content, according to an article in the Journal of the American Academy of Dermatology (JAAD). Most influencers (135 of 146) directly promoted brands, products, and services, often in a self-promotional way.9 While influencers with material ties to products they are promoting are required by the Federal Trade Commission to make advertisement statuses explicit, this does not prevent viewers from seeking treatments or implementing lifestyle changes that may not be right for them. The authors of the JAAD article propose that social media “may represent an unrealized opportunity for dermatologists and dermatology organizations to share quality educational content to counter potentially biased promotional content and misinformation.”9 

Finally, it is important to acknowledge the ways in which, outside of social media, doctors can be influencers — and easily influenced. Reporting from ProPublica has shown that drug and medical device companies paid more than 2,500 physicians at least $500,000 to promote medications and technologies between 2014 and 2019, with over 700 receiving more than $1 million. The authors emphasize the importance of exercising caution surrounding use of the top-promoted drugs, which have been found to be “less likely than top selling and top prescribed drugs to be effective, safe, affordable, novel, and represent a genuine advance in treating a disease.”10 

Overall, ProPublica suggests that the relationship between clinicians and drug/medical device companies has not changed significantly over the past decade.9 While most money for drug-advertising goes to TV advertisements, with the amplification of social media and other platforms, regulatory agents and lawmakers will need to consider the multifaceted ways in which physicians may influence patient populations.11 

References 

1. Konstantinovsky M. Doctors are now becoming influencers—and lines are becoming blurred. Glamour. Published November 11, 2022. https://www.glamour.com/story/doctor-influencers 

1. Professionalism in the Use of Social Media. American Medical Association. Accessed May 27, 2023. https://policysearch.ama-assn.org/policyfinder/detail/social?uri=%2FAMADoc%2FEthics.xml-E-2.3.2.xml 

1. Korownyk C, Kolber MR, McCormack J, Lam V, Overbo K, Cotton C, Finley C, Turgeon RD, Garrison S, Lindblad AJ, Banh HL, Campbell-Scherer D, Vandermeer B, Allan GM. Televised medical talk shows–what they recommend and the evidence to support their recommendations: a prospective observational study. BMJ. 2014 Dec 17;349:g7346. doi: 10.1136/bmj.g7346. 

1. Ranpariya V, Chu B, Fathy R, Lipoff JB. Dermatology without dermatologists? Analyzing Instagram influencers with dermatology-related hashtags. J Am Acad Dermatol. 2020 Dec;83(6):1840-1842. doi: 10.1016/j.jaad.2020.05.039. Epub 2020 May 13. 

1. Otero P. Social media… should pediatricians be influencers? Arch Argent Pediatr 2022;120(3):150-151. doi: 10.5546/aap.2022.eng.150.  

1. Kesaria AZ, Bimali M, Patel M, Prabhu A, Kesaria S, Xia F. #Brachytherapy: Physicians As Influencers on Instagram. Cureus. 2022 Feb 23;14(2):e22524. doi: 10.7759/cureus.22524.  

1. Chandawarkar AA, Gould DJ, Grant Stevens W. The Top 100 Social Media Influencers in Plastic Surgery on Twitter: Who Should You Be Following? Aesthet Surg J. 2018 Jul 13;38(8):913-917. doi: 10.1093/asj/sjy024. 

1. Das RK, Drolet BC. Plastic Surgeons in TikTok: Top Influencers, Most Recent Posts, and User Engagement. Plast Reconstr Surg. 2021 Dec 1;148(6):1094e-1097e. doi: 10.1097 

1. Ranpariya V, Chu B, Fathy R, Lipoff JB. Dermatology without dermatologists? Analyzing Instagram influencers with dermatology-related hashtags. J Am Acad Dermatol. 2020 Dec;83(6):1840-1842. doi: 10.1016/j.jaad.2020.05.039. 

1. Ornstein C, Weber T, Jones RG. We found over 700 doctors who were paid more than a million dollars by drug and medical device companies. ProPublica. Published October 17, 2019. https://www.propublica.org/article/we-found-over-700-doctors-who-were-paid-more-than-a-million-dollars-by-drug-and-medical-device-companies 

1. Bulik BS. The top 10 ad spenders in Big Pharma for 2020. Fierce Pharma. Published April 19, 2021. https://www.fiercepharma.com/special-report/top-10-ad-spenders-big-pharma-for-2020