The Wild West of Medicine

Aaron Kithcart
Next Generation is a BWH Clinical & Research News (CRN) column penned by students, residents, fellows and postdocs. This month, Aaron Kithcart, MD, a cardiology fellow, shares his experiences using social media as a physician and student of medicine.
What could a clinician learn from Twitter, a platform famous for short messages in 280 characters or fewer? As I’ve realized over the last several months, quite a bit.
Until recently, I had assumed that social media was home to puppy photos and casserole recipes. I joined Facebook and Twitter years ago to stay connected with friends and family. But after attending a social media session here at Brigham and Women’s Hospital a few years back, I realized the role it could play in my professional life, too. I’ve found that social media is not only a way to network with others, but it’s a place where people can go to learn about the latest developments in medicine.
According to Statista, there are more than 300 million active users on Twitter any given month, and an increasing number of those are health care professionals. As a cardiology fellow, I first appreciated the role of Twitter during an annual meeting of the American Heart Association that I attended. Those at the meeting or tuning in from home could debate science or reflect on their personal experiences by following the hashtag for the meeting, #AHA17. In a matter of seconds, a national conference could have a truly worldwide impact.
Social media can do more than just connect clinicians across the country and around the world. Many are now advocating for the educational potential of the technology, hosting “Twitter chats” on subjects such as pulmonary embolism or health care disparities, while others hold recurring digital journal clubs. Even if you don’t have a wide following on social media channels yet, you can join the conversation by looking for hashtags including #MedEd or #FOAMed (free open-access medical education). Increasingly, journals are publishing digital abstracts and simplified graphics displaying the most pertinent results of a study that make for rapid sharing on social media platforms.
In cardiology, it’s common to find images on social media from coronary catheterizations or echocardiograms that may have an important teaching point. For instance, a colleague of mine in Pennsylvania tweeted a rare image of an anomalous right coronary artery coming off the left anterior descending artery, a truly once-in-a-career case. Other cardiology fellows, early career clinicians and professors alike marveled at something that we were not likely to see at their own institutions. Unique cases like these can be shared much more readily on social media than in traditional journals, and the debate regarding diagnosis or management is much more spirited, on Twitter, for example, than anything you can find in a textbook.
The strength of social media, however, is also its weakness. Just as any clinician from around the world can share an interesting case from their clinic that week, anyone with Internet access can post about anything. Credentials can be hard to find, and while Twitter and Facebook have verified profiles for politicians and celebrities, no one is patrolling the medical content posted on social media. In some ways, it’s the “Wild West” of medicine.
For example, I recently came across a follower who claimed that the influenza vaccine could cause harm. As an alternative, the person advocated a diet rich in apple cider vinegar. When I challenged the person on this, linking to peer-reviewed papers citing the benefit of vaccination in patients with heart disease, I was blocked from their profile. At that point, there’s not much you can do but move on, knowing that anyone can continue sharing their viewpoint as a social media “medical expert.”
The role of social media in medical education is still under debate. Like any new technology, early adopters are paving the way for mainstream adaptation, but there’s still a long way to go. While generally accepted as a means of sharing information, at least one organization famously came under fire after banning photos from its conference on Twitter, claiming copyright infringement. Social media won’t soon replace medical textbooks, or even UpToDate, an evidence-based clinical decision support resource, but it is increasingly becoming the equivalent of the modern-day clinicians’ lounge, a place where medicine can be dissected and debated.
For me, being one of the early pioneers in this new frontier of medicine has been incredibly rewarding. I was recently asked to host a social media session at a meeting of the American College of Cardiology, and my networking opportunities continue to grow with followers now, including journal editors, chiefs of cardiology and members of the press. Social media has also made me a better clinician, exposing me to cases and educators from around the country and the world. What about you? What have your experiences been in social media in your line of work? Follow me on Twitter at @APKithcartMDPhD and let’s continue the conversation.
If you are a BWH trainee – student, postdoc, resident or fellow – interested in contributing a Next Generation column, please email bwhclinicalandresearchnews@partners.org.