The Doctor Will Tweet With You Now: Social Media for Oncologists

Deanna J. Attai, MD, FACS

What is an oncologist’s role on social media? That is the question Deanna J. Attai MD, FACS, asked herself when she set up her first Twitter and Facebook accounts back in 2010.

“There weren’t a lot of breast surgeons on social media,” said Attai, the assistant clinical professor of surgery at the David Geffen School of Medicine at UCLA and the president-elect of the American Society of Breast Surgeons. “And the ones that were there were talking amongst themselves and not necessarily engaging with patients.”

A late-night web-surfing session gave her the answers she was looking for. Browsing her newly created Twitter account, Attai stumbled across two women discussing a friend who was recently diagnosed with breast cancer and was getting conflicting information on how to proceed.

“I sat there watching them a little horrified that these women were online in the middle of the night talking instead of asking a doctor,” said Attai. “So I just kind of butted in and said ‘I am a breast surgeon—is there any guidance I can give you? It was in that moment that I thought ‘now I get it, now I see where my role is.’”

Attai, who interacts with her thousands of followers on Twitter, Facebook, YouTube, her blog, and other social media platforms, educated other physicians on what their role can be on social media at the 32 Annual Miami Breast Cancer Conference. Her talk was titled “Social Media for Oncologists.”

Obligation to Educate

With a growing number of people turning to social media for medical advice, it is more important than ever for physicians to be contributing to the conversation.

“When the patients are left to talk amongst themselves they get so much wrong information, or information that doesn’t apply to that patient,” said Attai. “One of our responsibilities as physicians is to educate.”

Patients turn to social media because they do not always get the information they need from their doctors, explained Attai. This could be due to any number of reasons, including that patients feel too intimidated, they don’t know what questions to ask, or they don’t getting enough time with their oncologists to ask them.

The plethora of information on social media about cancer in particular both hurts and helps patients dealing with the disease. While it is beneficial that a patient can inform themselves about treatment options, a lack of understanding about the treatment needs for their particular type of cancer can lead to confusion.

“I’ve had so many patients ask why wasn’t Herceptin recommended for them because they read about it online,” said Attai. “Turns out they had HER2-negetive breast cancer. For us, that is something so basic, but it is not being explained or they don’t have the mechanisms to ask those questions ... so they go online.”

Social media offers oncologists a platform to clear up some of that confusion much quicker than they could offline.

“The beauty of social media is that all it takes is one little post that gets amplified and before you know it, thousands of people have read it,” said Attai. “You could never have that sort of reach in your practice.”

Social media is also a great place for cancer patients to gather together for support. Oncologists can play an important role in that effort—offering guidance and alleviating fears.

Attai, along with two other physicians, runs a breast cancer support group every Monday night known as #BCSM (breast cancer social media) which hundreds of survivors and patients participate in. She suggested others consider similar efforts.

“There are so many patient groups online that would love an oncologist to serve as a moderator,” said Attai. “There is so much need for information.”

Keep in mind that any information shared online should be general, and not specific medical advice, said Attai. As the physician is not actually meeting with the patient or reviewing their chart, advice should focus on everyday tips, resources, and questions to ask their doctor.

“What I give as an example is if you ran into someone in your grocery store and she came up to you and said ‘my sister-in-law in some other state was just diagnosed, what does she need to be aware of and what does she need to ask her doctor,’” said Attai. “It is that conversation, it is on that level. It is general advice, general guidance, and general support. As long as you keep it in that context then you are OK.”

Improve Online Reputation

Social media participation can also benefit oncologists themselves. In today’s world, most people look up any physician or potential physician online before their visit, or after their first consultation. A lack of online presence can be damaging, said Attai.

“It looks so empty if you do a Google search of a physician and all you see is maybe reviews on Healthgrades and their location,” she said. “All it takes is one irritated patient and one negative review, even if that is your only review, and you have that one star rating showing up right at the top of Google.”

When patients see oncologists contributing intelligently on social media sites like LinkedIn, Twitter, and Facebook, it gives them more confidence in that physician’s abilities. Attai has experienced this herself.

“I’ve had patients come in for a consultation and tell me that before they came in they looked me up online and saw my videos and blog posts on social media and now I just reaffirmed everything in person and they don’t want to get a second opinion, they want to move forward immediately,” she said.

Best Practices While social media can improve an oncologist’s reputation online, the wrong kind of social media participation can also damage it.

Regardless of how tightly privacy controls are set, Facebook posts, Tweets, and other social media content will show up in a Google search. That doesn’t mean that oncologists who use social media for personal use should stop, but they need to think carefully about what they share.

“What physicians need to realize is there is no separation of professional and personal,” said Attai. “If you are online and you have identified yourself as a physician, you are held to a different standard than anyone else.”

Setting up a business Facebook account can be one way to distinguish personal social media use from professional. This page is “liked” instead of “friended,” which means oncologists don’t have to worry about the challenge of deciding whether or not to accept friend requests from patients.

“You have to keep some separation but also understand that there isn’t that much separation — so keep everything you do online appropriate,” said Attai.

That doesn’t mean oncologists should not show a little bit of their personal side online. Attai posts photos of her home garden on her professional social media accounts.

“There is nothing wrong with showing that you are human,” said Attai. “With my patients in the office, we talk about our gardens and I am the same in real life as a doctor as I am online. “

A growing number of oncologists are joining social media, but many are still hesitant, said Attai. Some don’t understand it, others think it’s not important, and others are just not aware that a patient community exists on social media. It can be overwhelming to jump into social media, but Attai says it is absolutely necessary.

“It is important for physicians to be out there and engaging with the patient population,” she said. “There are a lot of different ways you can be present on social media and you don’t have to do it all, but you should do something.”

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