Why doctors should use their real name on Twitter

Why doctors should use their real name on Twitter

The General Medical Council (UK) published new guidelines that state, “If you identify yourself as a doctor in publicly accessible social media, you should also identify yourself by name. Any material written by authors who represent themselves as doctors is likely to be taken on trust and may reasonably be taken to represent the views of the profession more widely.”  This has undoubtedly created some discomfort among a number of doctors on Twitter. This stance is consistent with my general view on the matter.

What we say on Twitter as doctors, particularly with medically related topics, carries weight.  By saying we are doctors gives our tweets a greater level of authenticity that is not commonly afforded to other users. Not only do we hold power with knowledge, we are respected for the judicious use of our knowledge which has been painstakingly acquired over many years and enhanced by a responsibility for life long learning. It is incumbent upon us to not abuse this privilege.

In my personal experience, the vast majority of doctors who declare themselves as such, will either use their real name or have reference that allows us to easily attribute their real name to what is written on their tweets.  Personally, I make the choice to use my real name “Henry Woo” as my Twitter name and for my Twitter @username, a short form of my name @DrHWoo.  My bio indicates that I am a doctor.  My website link would give reference to my real name even if my Twitter name and Twitter @username did not have such information.  I don’t think it really matters if it is your user name or bio or link that has your real name as a doctor, as long as what you say is easily attributable to you as a real person.

There should be exceptional situations where using a pseudonym could be appropriate. These include whistleblowing, doctors working in small communities or a desire to comment on emotive topics such as abortion or religion that can in some instances put personal safety at risk  If there is a specific issue that you wish to remain anonymous for, why not create a separate identity and state that this is the case.  If you really wish to remain anonymous on Twitter, then may I suggest that you do not say that you do not mention that you are a doctor in your bio – the only reason we mention that we are a doctor in our bio because we know it adds to the authenticity and respectability to what we tweet on medical matters. Not all people who tweet on medical matters are doctors – being a doctor is not a pre-requisite.  I know of a number of doctors who tweet but do not make any mention that they are doctors – I have no concerns about this – in fact I respect these doctors for not abusing the privilege of what the title doctor means.

In a free and open society, there is should only be very exceptional circumstances in which doctors should feel the need to use a pseudonym on social media. To hide because the individual wishes to publish inappropriate or controversial medical tweets indicates a lack of courage or conviction in their thoughts to use their real name.  Professional bodies will create guidance on social media to factor in the lowest common denominator level of behavior that sadly does occur among us.

Henry Woo is associate professor of surgery, Sydney Adventist Hospital Clinical School, University of Sydney, Australia. He blogs at Surgical Opinion and can be reached on Twitter @DrHWoo.

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  • http://twitter.com/sarasteinmd Sara Stein MD

    Yes! Thank you Dr. Woo, I have had the same argument with doctors repeatedly. Say who you are, and be careful what you say. If you want to educate people, express opinion, make thoughtful comments, own them. And make sure your patient vignettes are not identifiable. Unfortunately, the doctors that argue the need for anonymity are often bitter, vitriolic and sarcastic, even to the point of making fun of people. To those doctors I say, the Internet is not your therapist nor your punching bag; consider getting one or the other. It’s the elevator in the hospital and it’s full of all kinds of people, most of whom would like some information to help themselves and their loved ones. Finally, anonymous doctor, you are kidding yourself if you think you can remain anonymous. It’s not that hard to find an identify based on your tweets and blogs. I found one with 3 clicks – only to find out he’s in my city. Hopefully I will NEVER run into him.

  • http://www.christopherbaynemd.com/ Christopher Bayne, MD

    Integrity and professionalism are paramount when your name is on the line. I know some physicians have their reasons for anonymity, but I think accountability trumps all of them.

  • azmd

    What I’m still trying to figure out is this: what information that will be medically useful to patients, or academically useful to colleagues, could possibly be communicated in 140 characters or less?

    • http://twitter.com/sarasteinmd Sara Stein MD

      Um, how about this one… #Heartattacks in women may = back, shoulder, arm & jaw pain, fatigue, sweating, short of breath, chest pressure, NOT crushing chest pain! 3 characters to go, I tweeted in your honor.

      • azmd

        Ha! OK, point made, that’s clearly one that at least is possibly useful to those patients who didn’t already know it, but how many more of those do you think you could come up with? You need to be tweeting every day or so…

        • http://twitter.com/sarasteinmd Sara Stein MD

          I do! There’s always one general education point everyday that deserves to be shared. It’s really fun – cmon in!

  • http://violentnecessity.net Michael

    “the only reason we mention that we are a doctor in our bio because we know it adds to the authenticity and respectability to what we tweet on medical matters”

    That may be the only reason _you_ can think of, but that doesn’t mean it is the only reason. I put my specialty in my bio so that others of my (relatively rare) speciality could find me and form a community of diverse physicians from across the world. It’s been very rewarding socially and educationally.

    However, I didn’t post on “medical matters” on Twitter. I didn’t answer medical questions or discuss issues with patients. I didn’t want to engage with the public or patients about medical matters. I didn’t have a motive of pontificating behind my degree that you seem to think many do. I wanted my Twitter account and other social media to be private, but public. Frankly, I find medicine in SM to be pretty boring and my tweets have to do with my other interests, but putting my specialty in the bio led to me connecting to many others like me. The “social” part of social media. And this has led to social and educational opportunities outside of Twitter in a more private venue such as email, texts, and private Google + groups.

    This would have not been possible without putting my speciality (and thus the fact that I’m a physician) in my bio but I also didn’t want patients searching for me and finding my tweets about celebrating my son’s birthday or working in the garden.

    Please don’t think your own view of a situation is complete and sufficient for everyone else.

    • http://twitter.com/DrHWoo Henry Woo

      Thanks for your comments Michael. In medicine, we all know that there are always exceptions and perhaps you are one (not that there is anything wrong with that). If you have a ‘relatively rare’ specialty, I am sure that you would know others globally in the field and there are certainly better ways than twitter to connect with them professionally. Once you start putting personal things into your tweets, you would have to be naive to think that your identity would not easily be determined if somebody were to go to the trouble of looking – if hiding from your patients and you do not want to tweet about medicine, it would seem a much better idea to use a pseudonym without mention that you are a doctor. If you really wanted to use twitter to connect with doctors in your real specialty, you could use a separate account for that purpose – these days we run separate email accounts for personal and work purposes as well as work and personal phone numbers – this is nothing new and if it comes to managing two twitter accounts, it is a way to provide some separation between work and personal. I have found that using my real name and having what I do in my bio to be great for connecting with my profession, especially with journal clubs and conference tweeting. I am sorry that you have found medicine in SM to be boring since this is not the experience of most doctors on twitter – however, if you were to use your real name, you might find a different experience and as many who have ‘come out’ have stated, you might find it liberating.

      • Michael

        You completely missed the point.

        Your original argument was that since doctors attach their professional identity to their online bios in order to increase their legitimacy by an _appeal to authority_ argument, they should also have a little “skin in the game” by also clearly attaching their true identity.

        My argument was that if there is a reason other than increasing their legitimacy and if they are also not posting on anything related to their profession, then that is no moral imperative to attach such identifying information. i.e. if someone whose Twitter account bio says “plastic surgeon” only tweets pictures of their cat and what they had for breakfast then there is no reason to have a true identify attached. I tried to give you a real life example of such a case with myself.

        Arguing that there are better ways to meet others in the profession, that “most doctors” don’t find Twitter boring (most aren’t on Twitter), that it’s easy to maintain two accounts, or that I might find using my real name on Twitter liberating, are completely off the point. They are arguments as to why one might want or could easily do what you suggest. They are not arguments against my counter argument as to the moral imperative of identifying oneself.

        If you still think that there is a moral argument that anyone attaching their profession to their bios needs to identify themselves and have a counter argument to mine, I’d be interested in hearing it.

  • http://twitter.com/bnwomeh Ben Nwomeh MD

    Hiding behind a false identity is pointless, but also if a doctor isn’t using social media to offer medical advice or engage with their patients is there any purpose for separate private and professional identities?. Would egregious commentary be tolerated by an employer because they were made using a “private” account? Also I feel patients are smart enough to understand that even doctors have interests outside their specialty and may have opinions about them. Should self-identifying doctors forgo their freedom of speech on non-health related matters, to avoid “damaging” their professional reputation?