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On this special episode, I’m on the other side of the microphone. It’s an honor to be interviewed by Cory Calendine, MD, an orthopedic surgeon with a tremendous social media presence. Visit him on Instagram and TikTok @corycalendinemd.

We have a conversation on the explosive growth of TikTok, its impact on medical misinformation, vertical short videos, how physicians can start on social media, what’s next for KevinMD, social media trends to watch for, and physician speaking.

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Transcript

Cory Calendine: Thank you all so much for joining me today. We’re here talking to Dr. Kevin Pho, who obviously needs no introduction if you’re a physician. And if you’ve ever looked into social media, you can’t help but bump into KevinMD, famous from KevinMD.com, but now expanding into podcasts and so much more. Kevin, thanks so much for spending some time.

Kevin Pho: Hey, Cory, it’s great meeting you, and I’m so happy to talk about this.

Cory Calendine: Yeah. So we connected, and we were just talking about this before, we connected through TikTok, believe it or not. And obviously you built your home, though, on KevinMD, this blog model, really before it was even popular. The same year, a guy named Mark came up with this idea called Facebook. So clearly you were ahead of your time. Walk us through that. What were you thinking at the time? And we know you’ve been successful with it.

Kevin Pho: So I always say that I would have liked to say that I had a business plan and that it went according to plan, but obviously not, right? So back then, very few physicians had blogs, right? I would say probably fewer than 50 or so, maybe 75 or so. And I think I was encouraged to write one because I had a lot to say about medicine.

I think one day back then, there was a drug recall, and I wrote something on my blog. The next day, I walked into the exam room and talked to a patient, and they said, “You know, I read your blog post this morning, and I was really comforted by what you had to say.” And that’s when I first realized that with what were the beginnings of social media, blogs, right, we can not only connect with patients one-on-one in the exam room, but of course one-to-many, not in the exam room. And that’s only been exploding in the time since then. We have so many different tools and platforms where we can connect not just with patients but with each other. That’s of course how we met, on social media, and there are so many applications.

So I think yes, there are a lot of negatives to social media, but I do think that there is a lot of power in social media in terms of how we can communicate our message, how we can advocate for our profession, how we can clear up misinformation, and how we can educate patients. And now with things like TikTok, I think that only furthers the evolution of these different types of platforms where we can connect with both doctors and patients.

Cory Calendine: Yeah, that’s a really good point. For me, you know, in orthopedics, I’m in a hurry, right? I mean, surgeons just always seem to be in a hurry for some reason. But it’s really allowed me to connect to patients, get some of that education done, and make a meaningful connection. Kevin, I love that story that I’ve heard you tell about the patient seeing your blog post. Patients now feel like they know me before they’ve met me.

Kevin Pho: And that’s good for them, right? They feel very comforted by that, and they’re educating themselves, which I think is good. If we don’t do it, somebody else is going to do it, right? So that’s kind of the key of us being involved. If we as physicians aren’t leading the way in educating, somebody else is going to give them some bad information. We certainly learned that with the pandemic. Do you have a lot of patients who find you on TikTok first, or on Instagram Reels, and then they bring it up in your first meeting in the exam room?

Cory Calendine: Yes, I do now. You know, it’s just like you started in 2004 and grew. TikTok was an accident; we can talk about that shortly. But a year ago, I accidentally posted a video to TikTok, and it kind of had some legs, and so it’s very interesting. But now I’ll bet it’s every day that I have clinic, I sit down with someone who says, “Yeah, I saw your reel on Instagram,” or, “I saw your Facebook.” You know, Facebook has really taken off with short video content.

That term social media has kind of gotten redefined. I mean, your namesake, man, I wrote it down, I think it’s so good: “Social media’s leading physician voice.” But social media from where it started, you know, blogging, right, to where it is now is very different, right?

Kevin Pho: Oh, it is a tremendous evolution, right? Social media at its core is really two-way communication, right? Because before social media, the only way that we could share messages was going on television and maybe writing an opinion piece in a newspaper, but it was really just one-way communication. It was really whoever was in a newspaper or on television talking to the audience. And then with blogs, you were able to comment; you had the genesis of that two-way communication. And that’s only been furthered with things like Facebook and Twitter and LinkedIn, where a content creator can post a video or an article, but then you would get that immediate feedback in terms of whether the article was good, or it would just open up a whole can of discussion. And sometimes the discussion would be better than the article itself.

And now we talk about video shorts, right, and TikTok and YouTube Shorts and Instagram Reels. I think that’s only poured gasoline on the fire, where everyone can create these one-minute-or-less vertical videos on TikTok, and they can spread like wildfire. So I think that, again, it’s fascinating to watch this evolution of how we can communicate, and how the modality that we can communicate with on social media is really just changing almost by the month. You know, what is hip now, six to 12 months ago it could be completely different.

Cory Calendine: Yeah, that’s exactly right. And with that short video content, I told you I might bring it up. I actually recorded a video of me walking down the hallway. I have one of those surgical helmets on that has the light. Kevin, I don’t know if you’ve seen that, but it’s just this ridiculous frame that I wear that has a light off the front that I use during surgery. I’m walking down the hallway, and I say, “Hey, have you ever wondered why you have to get to surgery so early?” And I kind of list off the reasons. You know, we’ve got to check the vitals and make sure you’re educated. But the first thing I said, Kevin, was insurance. Randomly, this was not scripted. I’m walking down the hallway, and I say, “Yeah, we’ve got to verify your insurance, and then we’ve got to check your vitals.” I thought that was relevant.

But actually, it turns out that on TikTok, that video got accidentally uploaded. My video guy pulled it down from YouTube and put it up on TikTok. It had like 2 million views very quickly, but a lot of those views, Kevin, were because I said insurance first. So the discussion in the comments was so powerful. Some people from other countries were like, “Oh, my health care is free.” That’s an interesting topic, isn’t it? Is anything free? Other people were like, “Oh, this doctor’s out for money.” Obviously, that was some of the response. But there was a very robust discussion in the comments, and that’s really why 2 million people saw it: because of the discussion. Because of what you have stated, on social media the two-way conversation is so powerful.

Kevin Pho: So yeah, and specifically with TikTok, right? I think TikTok now is what Facebook was maybe five to seven years ago. You have this all-powerful algorithm, and you don’t necessarily have to have a lot of followers, because you have people who just start on TikTok for like a week or two, and one of their posts can literally go viral and get hundreds of thousands, if not millions, of views. And I think that, obviously, there’s good and bad with that. But I think right now, as we speak in late October 2022, just having that potential to have viral content and to reach millions of people without so much having that social capital, right, you don’t have to have millions of followers to do that, that is pretty intoxicating to a lot of content creators.

Cory Calendine: Yeah, I think that’s right, and there’s probably good and bad with it. But again, if we’re not the ones saying something, somebody else is going to say something. So it’s really a call. I’ve heard you talk about how social media was an opportunity, and I’ll probably butcher your words, but then it was kind of an expectation almost, you know, like patients were asking for it. But now you see it as more of a responsibility. Flesh that out.

Kevin Pho: Yeah, I do. I think that it’s what we said earlier: If physicians and other reputable clinicians aren’t online, patients aren’t going to stop going online for health care information. They’re going to continue searching Google and Facebook and TikTok for health care information. And if reputable clinicians aren’t providing or guiding patients to reputable sources of health care information, that space, that void, is going to be filled up by people who spout misinformation, and it could be filled by people who produce pseudo-information or who want to sell you something. So I do think it is a responsibility for a lot of us in health care to also go online and be reputable sources of health care information.

And we always go back to these vertical shorts and TikTok, because this is how we met. But you know, you look at some of the recent studies, and a lot of the younger demographic, right, are using TikTok as a primary source of information. For some of them, it replaces Google, right? And I’m sure they’re asking a lot of questions in the search bar, and you have these short one-minute videos come up. I do see a lot of physicians on TikTok, but you know, that’s one of the reasons why I try to get on and get some of these reputable guests on my podcast to share information on TikTok, because no longer is it a place where you just have these dance memes, right?

That’s why I was so hesitant to go on at first, because I’m a pretty serious guy. I’m definitely not a TikTok meme dancer. But then I realized that people are using it as a legitimate source of information, and for some it’s replacing something like Google. So it is important, again, as an additional platform, for clinicians to utilize it and be that source of information when patients search for it.

Cory Calendine: Well, that’s exactly right. We need to meet them where they are, and social media and this vertical video content is where they are. You know, when we talk about social media, I always kind of think about it, and I’ve got to frame it up because I’m a surgeon, so I’ve got to keep it simple. You know, you educate, right? We’ve talked a lot around that. You’ve got to encourage. I’m sure you see this in primary care, you know, weight loss and healthy practices and lifestyle changes. So you’ve got to encourage people that, hey, there’s a better way to kind of get through life and be healthy and avoid those chronic diseases. But ultimately, you have to engage, right? You have to put some time in.

You’re kind of like our godfather of social media, and always will be, and so I definitely want to kiss the ring several times during our brief discussion. But if you were going to provide some advice on how to get started, because I think that’s the reality of it: We don’t know where to start. Just for the record, I’ve never danced on TikTok, ever, and I think I’m approaching like 200,000 followers on TikTok. But again, the message I thought was so good is that you don’t have to have a lot of followers to be effective on these platforms nowadays. But what would you say, with all your vast experience seeing things coming and going? If somebody was going to start, where do they start?

Kevin Pho: Yeah, so start with the goals first. Why do you want to be on social media? A physician should never go on social media just for the sake of going on social media, or because their marketing person told them to go on it. They need to come up with a reason first, right? And when it comes to reasons why physicians should be online, essentially there are three, right? Number one, you want to clear up misinformation and educate patients.

Number two, you want to proactively define your online reputation, because physicians already have online reputations. If you Google your name online and put MD behind it, if you don’t have a social media presence or if you don’t have a platform, what’s probably going to come up is a profile from a third-party physician review site. So you already have an online reputation, whether you like it or not. So going on social media is one of the ways where you can just create content about yourself online, so when people Google you, you’re more in control of what comes up.

And the third reason is really just advocacy. It could be advocacy for our profession, it could be advocacy for a political cause, it could be advocacy for an issue you feel passionate about. So those are the three main buckets I see physicians going on social media for.

So once you have a goal and have a reason why you want to be online, then you can start talking about the other platforms. And you have to know your strengths and weaknesses, right? Are you a good writer, or are you great on television, or can you make these short videos super engaging, right? So I think that there is a platform that suits your strength, right? If you’re a good writer but not necessarily great on camera, then you can start a blog. If it’s very easy for you to make conversation, then you can certainly start a podcast and just talk to other physicians. If you’re great on camera, or if you’re a great dancer, if you make great memes, that is a wonderful way to communicate medical information, especially with a particular younger demographic, then go ahead and do that. I think the beauty of social media is that once you know what your strengths and weaknesses are as a person, there is a platform that would fit you.

Cory Calendine: Yeah, that’s awesome. The possibilities are endless. For me, I started off on several platforms. I was transitioning practices and worried about losing patients, so I started off on several platforms, but obviously my success on some has been different than on others, right? There’s some asymmetry because I’m connecting in some way. I think a real key for me, anytime anybody asks me, is just to kind of start. You know, just throw it out there. And I’ve even heard you talk about this, that it’s OK to mess up, right? We’re taught in medicine that everything has to be perfect every time, and as a surgeon, I assure you that’s my entire training and mindset. But in the social media world, it’s OK to learn as you go.

Kevin Pho: Yeah, in general, it is OK to make mistakes. In fact, if your output at first is perfect, then you started too late, right? So that’s what I learned with my podcast: just starting. If I listen back to the first few episodes I did, you know, it’s probably very cringe-worthy, right? But as you do it, your goal is just to make the next one a little bit better than the one before. And if you do hundreds of them, and in my case I’m approaching 900 of those, again, going by that motto, if the next one is just a little bit better than the one before, eventually you’re going to have a pretty good podcast. So as physicians, you have to just start. And like I said, if you start and your output is perfect, then you started too late.

Cory Calendine: That’s a great way to put it: incremental gains, incremental improvement. I think that’s always a good thing, probably in all aspects of our life. Now, time is another thing, though, because social media can kind of soak up a ton of time. You’re extremely busy. I’m sure you do all your own editing of the blogs, I think, right? And then obviously you have the podcast that you mentioned, a daily podcast, which is incredible, so that takes a ton of time, and then the speaking as well. So how did you do that? Did you snowball it? Did you start just with a blog? I really don’t know that.

Kevin Pho: Yeah, so I’m an internal medicine physician. I do primary care, so I still see patients about two, two and a half days a week. And you know, we talk a lot about physician burnout, right? I’m sure this audience is very familiar with the statistics. It’s always published that 50 to 60 percent of doctors experience some sort of burnout. So the question then becomes, what do we do about it, right? And what are the reasons behind that? I think one of the reasons behind burnout is there’s a lack of empowerment, right? We’re losing control of our profession. We’re losing control of how we can see patients. There are a lot of obstacles that prevent us from seeing patients the way we want to. There are all these EMR bureaucratic obstacles.

So one of the ways that I always advise physicians is that you have to have a passion, sometimes outside of clinical medicine, to balance what we do in clinical medicine. For some, you know, it could be a side gig, it could be real estate, it could be doing what you and I do on social media. And for me in particular, it’s of course what I do on KevinMD and what I do on podcasts. I love talking to physicians across the country. And I think I mentioned it: That job for me is very easy, because very rarely can you get 15 to 20 minutes with pretty much any physician expert in the country, and you have their undivided attention, and you could ask them anything you want, right? So I think for me, I just sit back, ask questions, and I just listen to what they have to say. So it’s been a tremendous blessing just to listen. I’ve learned a tremendous amount over the last two and a half years that I’ve done this.

So yeah, in terms of time, if there’s something that you’re passionate about, I think that is a healthy balance to what I do in primary care. And don’t get me wrong, that sometimes can get very frustrating, doing internal medicine primary care, but I realize that I have the flexibility to not do that all the time and not be defined by that, right? Most importantly, you don’t want to be defined by doing something that is sometimes very difficult to do. But having that balance between that and what I do on my podcast and speaking on KevinMD, I think, ironically, has probably kept me in medicine longer than I would have otherwise, if I didn’t have what I did with KevinMD. I talk to a lot of doctors, and they do medicine five to seven days a week, they’re in a hospital all the time, and those physicians tend to burn out sooner than the doctors who work a little bit less clinically but then have something that fills their cup on the side.

Cory Calendine: Yeah, I think that’s a good point, and I think ultimately you’re a better physician when you come back, right? Because this whole mantra of, “Boy, this work is really hard. I’m unfulfilled. I’m going to double, triple down on it,” doesn’t always work, right? Sometimes you need something else to kind of support you.

Kevin Pho: Yeah, so you always want to ask yourself, at the end of your life, what do you want to be remembered for, right? Do you want to be remembered for what you did or who you are, right? Do you want to be remembered as that doctor who slaved away for 40 years in a hospital and then was let go by the hospital when they had budget cuts? Or do you want to be remembered as the person who raised good kids and who was a good family man? So what do you want to be remembered by when you die?

Cory Calendine: Yeah, I think that’s a great way to say it. And I know you’ve made really a career out of not just sharing your story and the balance that you’re talking about now, but also, well, I mean, that’s the tagline. I wrote it down, Kevin; I wouldn’t remember it otherwise: “We share the stories of the many who intersect with our health care system but are rarely heard from.” So that’s maybe even an incredible way to start your social media experience: Tell someone else’s story, which is kind of cool.

Kevin Pho: Yeah, so once you build a platform, right, I spent how many years building a platform? Almost 20 years building this platform. But I do use it to elevate other physicians and let them share their story on it, because sometimes their stories are as interesting as, if not more than, whatever I can say. So it’s my pleasure to showcase other physicians, and I’ve learned so much. It’s so gratifying hearing their stories.

Cory Calendine: Yeah, you’re a great conduit for many. Not all of us have been quoted in massive publications and interviewed on TV, but to be able to kind of borrow that presence that you bring and share the story, it’s been really great. It’s great stuff. All those listening, if you haven’t spent some time on either the podcast or his website, KevinMD.com, I think it would be of great value.

Where do you see all this going? I mean, you know, we talked about how things come and go, and now it’s vertical video content on TikTok that seems to be the latest phase. I loved what you just said about building a platform. You’re obviously leaning into your strength still, right? You spend a lot of time on the blogs. How do you divide it up? I mean, where is all this going?

Kevin Pho: Yeah, so I don’t have a master plan, right? I think that it’s hard to predict where social media is going, because as I said earlier, what is trendy now may not exist just a couple of years from now. So you just have to look at trends. Sometimes you look at trends outside of health care, because whatever is trending, health care tends to be last, right, when it comes to things that are trending. So you just look at other industries. You look at the technology industry, you look at the mainstream media industry, and see what’s trending there, and eventually it’s going to make its way to health care, so you could kind of predict what’s going to happen in health care.

So right now, like you said, we have vertical shorts. And I think the core concept, though, that has remained constant over the last 20 years is that, again, patients aren’t going to go anywhere when it comes to being online. They’re going to continue to share their stories online. They’re going to continue to look for health care information online. It’s just that the medium is going to change. But the core concept is that physicians also need to be where patients are, and if it’s on TikTok, if it’s on Instagram Reels, if it’s on YouTube or Facebook or Twitter, we have to be there as well. So the core message has remained constant over the last 20 years. It’s just the different platforms and the media that have changed and evolved over the last few years.

Cory Calendine: Yeah, there are some overriding concepts, for sure. I’m fascinated by your speakers bureau, though, too. You know, in-person meetings still exist. I’m actually at a meeting currently, and I recently sent out a post about how there’s nothing like a face-to-face meeting. Even though we’re sharing remotely, and this is more intimate than sharing among the masses, there’s really nothing like being person to person. So I’d love to hear your philosophy on that. Is that an area that’s still growing? I guess it’s coming back post-pandemic. I have all kinds of guesses, but what are you seeing with your physician speakers network?

Kevin Pho: Yeah, so before the pandemic, I think it was really growing. I’d been speaking and telling my story for about 10 years before the pandemic, and one of the things that we noticed, and I think a lot of physicians notice, is that with the quality of physician speakers, they tend to be a little bit dull, right? You know, you look at the quality of things like TED Talks, and those speakers are super engaging. They’re able to tell stories. And I just wanted to make a blend of someone who is at that TED Talk level with being a practicing physician as well. So we have about 10 physician speakers that either I’ve coached or I’ve kind of vetted to make sure that they’re fantastic speakers, and we really want to elevate the level of physician speakers.

And I also use some of my contacts. I’ve spoken at close to 100 events, so I do have a lot of contacts in terms of physician events that I’m able to reach out to, and they know what it’s like to work with me, and they trust my judgment. In that way, using that trust to expand those opportunities to other great physician speakers is something that’s been very gratifying and very successful. But of course the pandemic hit, right? So then live events pretty much died on the spot. Like you said, it is coming back. We’re starting to get more and more live events. We’re not quite at the place where we were before the pandemic, but I think that eventually, in the next year or two, we will get there.

And this is an area that I’m certainly looking to expand, because I do think that we can elevate the quality of physician speakers. There are so many great physician speakers who are out there, but then there are a lot of physician speakers who I see at these meetings who aren’t necessarily great speakers. So I think that we can marry the two. We can marry that great physician content with someone who can deliver it with the engagement that audiences now expect and deserve.

Cory Calendine: Yeah, I think that’s great. I mean, I’ve watched a ton of TED Talks in my life, and you know, maybe we need KevinMDx or something. But I think that’s a great way to say it: How do we get the message across better? I often say a message unheard is of little value, right? Obviously, we’re always speaking to ourselves first; at least that’s a philosophy of mine. But if you want to make an impact, the message has got to be heard. And that’s really the reason why I’m on social media, in order to make an impact, right? To hopefully share what little I’ve learned, and you know, you end up learning a lot in return.

What kind of events are coming up for you, speaking-wise, Kevin, as it starts to roll back? Are you speaking around medicine topics, or are these more like social media and business strategy? What’s the emphasis? What do people really want to hear from you now?

Kevin Pho: Yeah, so it’s really my social media story. You know, when talking to you, and I’m sure your audience, we’re already preaching to the converted, right? We’re already talking to physicians who know the value of social media. But we need to realize that we’re a relative minority, right? There are a lot of physicians I talk to at these conferences that see no value in social media. They see it as a waste of time. They see it as a way of just getting in trouble, because if they post an incriminating picture on Facebook and Twitter, you just hear about physicians getting fired because of that, right? So there’s a negative connotation out there when it comes to social media.

So what I try to do is share the story, like we’re talking about right now, and really present a more positive aspect of social media, and really try to convey that responsibility that I think we all should have, and give some motivation to also go online as well. And my job when I speak isn’t necessarily to convince everybody in the room to jump on social media. But if I can just make one person think twice about it and make one person see the value of a physician being on social media, then my job is done, because I think that if we could just change minds one at a time, you know, we can move the needle that way.

Cory Calendine: Yeah, it’s a great perspective. Effectively, you’re probably not going to win everybody over. A lot of those excuses, though, about, you know, the dangers of social media, “Oh, what if I post something wrong or get fired?” Really, if you just follow the KevinMD principle, start slow, you know, start with a goal in mind, and try out some things, it’s unlikely to have catastrophic consequences, but the benefits could be massive.

Kevin Pho: I do. And one of the things that we have is like an elevator test or a billboard test: Never post anything on social media that you wouldn’t feel comfortable saying in a crowded hospital elevator or just on a billboard on a highway, right? So just follow those rules, and in general, you’ll stay out of trouble.

Cory Calendine: That’s great. That’s great. You know, I’m going to have to go back and look at all my posts and see if they pass that test. I hope they do. Kevin, I appreciate so much you spending some time with me.