Subscribe to The Podcast by KevinMD. Catch up on old episodes!

Join us on this episode, where we welcome Brian Boxer Wachler, an ophthalmologist and author of Influenced: The Impact of Social Media on Our Perception. During the COVID shutdowns, Brian had a lot of extra time on his hands, and his twin daughters urged him to join TikTok to dispel misinformation and have some fun. What started as a fun experiment turned into an addiction as Brian chased the dopamine rush of more followers, views, and likes. But as his obsession grew, he began neglecting his real-life family and eventually hit rock bottom. As a recovered “TikTokaholic,” Brian shares his cautionary tale of the dangers of being an influencer and the importance of maintaining a healthy balance between virtual and real life. Don’t miss this insightful episode on the impact of social media on our perception.

Brian Boxer Wachler is an ophthalmologist.

He shares his story and discusses his book, Influenced: The Impact of Social Media on Our Perception.

The Podcast by KevinMD is brought to you by the Nuance Dragon Ambient eXperience.

With so many demands on their time, physicians today report record levels of burnout. Burnout is caused by many factors, one of which is clinical documentation. Studies indicate physicians spend two hours documenting care for every hour spent with patients.

At Nuance, we are committed to helping physicians do what you love – care for patients – and spend less time on clinical documentation. The Nuance Dragon Ambient eXperience, or DAX for short, is an AI-powered, ambient clinical intelligence solution that automatically captures patient encounters securely and accurately at the point of care. Physicians who use DAX have reported a 50 percent decrease in documentation time and a 70 percent reduction in feelings of burnout, and 83 percent of patients say their physician is more personable and conversational.

Rediscover the joy of medicine with clinical documentation that writes itself, all within the EHR.

VISIT SPONSOR → https://nuance.com/daxinaction

SUBSCRIBE TO THE PODCAST → https://kevinmd.com/podcast

RATE AND REVIEW → https://kevinmd.com/rate

FOLLOW ON INSTAGRAM → https://www.instagram.com/kevinphomd

FOLLOW ON TIKTOK → https://www.tiktok.com/@kevinphomd

GET CME FOR THIS EPISODE → https://earnc.me/yQyeBI

Powered by CMEfy.

Transcript

Kevin Pho: Hi, and welcome to the show. Rate and review at KevinMD.com/rate. Subscribe at KevinMD.com/podcast. Today on the show, we have Brian Boxer Wachler. He’s an ophthalmologist, and he’s the author of the book Influenced: The Impact of Social Media on Our Perception. Brian, welcome to the show.

Brian Boxer Wachler: Thank you, Kevin, very much for having me. I appreciate being here.

Kevin Pho: So we’ll get into your book in a little bit, but first off, briefly share your story and journey to where you are today.

Brian Boxer Wachler: I’m an ophthalmologist, and I ended up going to medical school nearby you, up in New Hampshire. I am originally from Los Angeles, and I realized after a few winters of scraping my windshield that it was probably better that I came back. I grew up out here.

Kevin Pho: All right, so ophthalmology. Tell us, what’s a typical day like for you? What are some typical cases that you would see?

Brian Boxer Wachler: My specialty is keratoconus, where the cornea, the outer lens of the eye, bulges out like a hernia. I was trained as a cornea transplant surgeon as well as a vision correction surgeon, doing LASIK, back 25 years ago. So I pioneered these procedures that can prevent people from having cornea transplants, one of them primarily being noninvasive, or epi-on, cross-linking. This is actually the 20-year anniversary since I first developed that procedure, and it was named after Steven Holcomb, who was the bobsledder who won a gold medal at the Olympics.

So I do a lot of keratoconus treatments, including Intacs as well, which are little micro inserts that we implant in about seven minutes under the cornea, and that helps to reshape the cornea too. So typically, when I’m doing procedures, they’ll be Intacs, Holcomb C3-R cross-linking, and then CK, and also implants for correcting vision, like Visian ICL, which is a lens that we implant, as opposed to LASIK, for people who aren’t good LASIK candidates.

Kevin Pho: All right, so just give us a brief scope of the state of ophthalmology today. For those medical students looking at different career paths, what are some questions they need to ask themselves, or things to think about, if they’re going to consider ophthalmology as a possibility?

Brian Boxer Wachler: I’ll never forget one of my professors up there at Dartmouth when I was in med school. I was expressing interest in ophthalmology, and he said one thing about ophthalmology that he really appreciates is that it’s a perfect marriage between medical treatment and surgical treatment of patients, and I would agree with that. So for anyone who’s considering ophthalmology, if you like not just medical but also surgical, and you like that balance, it’s also a good field for that.

There’s also a lot of technology always evolving. For example, when we’re doing cataract surgery, we have these lenses now where we replace the cataract lens with an implant, and it’s essentially a trifocal lens that helps people restore not just their distance vision but also their computer and their reading vision too. So that’s just an example. The technology is always evolving in the field. It’s a pretty heavy technology field.

Kevin Pho: All right, so let’s talk about your book. It’s titled Influenced: The Impact of Social Media on Our Perception. So tell us the background. How did this book come together?

Brian Boxer Wachler: Well, Kevin, I wrote that book as a 911 call to action for people, because I’m a Beverly Hills keratoconus eye surgeon, I have three and a half million followers on social media, and I have a flaw: I myself easily became addicted to social media. So if this can happen to me, then it’s very likely a lot of people listening right now, or their children, can also become addicted. That’s why I took it upon myself to be transparent about my experience and do the research to show people the tips and the tricks to avoid the problems that I had, especially for parents.

I’m a parent too, of teen daughters who, ironically, got me into social media, TikTok in particular, during the pandemic. I know that parents a lot of times feel like they’ve lost their children to their phones, because these platforms are designed to be addictive.

Kevin Pho: So tell us more about your own story. You said that you were primarily on TikTok, with three and a half million followers. Tell us a little bit about that story and how you got, quote unquote, addicted to that.

Brian Boxer Wachler: It was during the pandemic, and I had a lot of unaccustomed downtime. My daughters were 14 at the time, and they said, “Dad, there are some really good doctors on TikTok, and we can get you started. We think you’d be really good.” So I was like, “OK, sure.” There were not a lot of other things to do aside from Netflix at the time.

So I started finding my niche, which was calling out viral videos with health trends that were completely bogus, not true information, and millions of people were watching these videos, relying on totally false information. So I started duetting them, as it’s called, a side-by-side video, and I used the Gen Z lingo, since at the time mostly Gen Z was on there. Now a lot of adults are on TikTok too. I would call it cap, C-A-P, which is Gen Z for not true. I eventually developed this little schtick where I had a blue hat that said cap on the front, and at the end of the video I’d either put the hat on or not put it on, so that people would watch to the very end.

It was a huge need that was being filled, because when the algorithms promote a video to be viral, it has nothing to do with being accurate or not. So it’s almost like, you know, the Wild Wild West out there in social media, and that is where I really grew my platform. But I would wake up and I’d have 20,000, 50,000 new followers in the morning, and that’s an incredible dopamine rush. That’s the same behavior that becomes addictive for other things, like gambling and sex and drugs, and that’s eventually what led me to literally become addicted to TikTok for a good six months.

Kevin Pho: So when you woke up and you got, say, 10,000, 20,000, 30,000 new followers, which is a huge amount, I can only imagine what that dopamine rush would be. So tell me, how did that affect your mindset? How did it affect your personal life, your professional life? What would you do, waking up and having that type of influence?

Brian Boxer Wachler: I mean, it was just wanting more and more, because at that stage I was putting these goals on myself: “OK, I want to hit a million followers. I want to hit 2 million followers.” So I became obsessed, and it really started to interfere with my personal life, with my family in particular, to the point that I’d come home and I’d be working on my device, checking for DMs, or responding to comments, or researching new content, or even just refreshing the screen to see how many more views I got, right? Just to aggrandize my ego.

But here are my twin daughters trying to tell me about their day, and I’ve got one ear in their conversation, and I wasn’t even really listening. And by the way, for teenagers to even want to tell their parents about their day is already a rarity, right? So I was missing out on a lot of really important family time, to the degree that even when I was taking them to a volleyball tournament, I snuck away once to do a TikTok live. I got busted, because at lunch their friends, who follow me, saw me doing a TikTok live and told my girls. Of course, they were incredibly pissed off and upset, because I snuck away to, you know, do social media again. So it really became a strain developing in my relationship with my kids.

Kevin Pho: So what happened next? How did you realize, “Hey, I need to make a change”?

Brian Boxer Wachler: In fact, I didn’t even realize it. It was my daughters and my wife having literally a TikTok sit-down intervention with me, where they explained what was happening, and at the time I was in complete denial. I felt like, “How dare you attack the success I’ve had? Are you jealous? You got me started with this.” So in fact, I doubled down, trying to show them by growing my platform even more. So it didn’t work.

The only thing that happened that really was key is that one of my videos got taken down by TikTok. It was deemed to have violated one of their community guidelines, and so my whole platform was suppressed. It wasn’t removed, but it was suppressed for about two weeks, so I couldn’t get any of my videos to go viral, as hard as I tried. It’s what in psychology is called learned helplessness, and you just finally give up. For those two weeks, I had that aha moment of realizing, when I was kind of going through withdrawal, what I’d been doing and the strain it put on my kids and our relationship. I felt awful. I remember going to the bedroom and just tearing up, because I was feeling guilty about what I’d done and how much I’d missed too, right? I mean, there were so many family experiences I was zoned out on because I was so focused on and obsessed with my device and social media, and TikTok in particular.

Since then, it’s been a really good, healthy balance. I’ve taken the pressure off myself to grow my platform, so, you know, I’m good with how many followers I have. I don’t have to keep growing. I still do TikTok a couple times a week, but not like before.

Kevin Pho: So you told your story, of course, in your book. So tell us some of the main messages that you want readers to come away with.

Brian Boxer Wachler: Well, first of all, understand that the apps, the platforms, are designed to get as much of our time as possible and to be as addictive as possible. It’s like gambling. Every time you push the button and hit the slot machine, you know it’s a random outcome whether you’re going to win or not, and that’s the same mechanism when you’re scrolling up on those videos. You just don’t know what’s going to happen next, and that’s designed to be like that on purpose. So recognize that.

Then also set limits on your social media, because a lot of times people are scrolling and they don’t have any idea they’ve spent an hour or two. It’s just flown by, and that can also be a factor. So you can set limits on the phone for the apps. And, you know, if you are getting a little bit out of control with it, ask other people for their feedback too.

In fact, in the book, there’s a whole chapter called “Living with Social Media,” where I go into a lot of these tips and tricks to show people how to manage it for themselves, but also for parents, for their kids, because kids are really challenged. Imagine: If adults are challenged, right, and myself as an example, kids, whose brains, whose frontal cortex, haven’t fully developed yet, don’t have those self-regulation skills that adults have. So they’re much more susceptible and have a much harder time regulating.

Kevin Pho: So one of the things that you mentioned earlier was that there’s a lot of misinformation on social media, especially on platforms like TikTok, and I think that your initial goal absolutely was noble. I do think that we have to have more physicians go online and do that and really call out misinformation that’s online, because if we don’t do it, that misinformation is just going to go unchallenged and influence so many others. Now, how do physicians strike a balance between doing that versus going too far and letting it consume them?

Brian Boxer Wachler: I think if you’re going to do it, and I think that’s a great call to action that you have, for physicians to go on the platforms, TikTok in particular, which is where there’s a lot of that going on, just try it. Kick around, you know, and see how it works for duetting, or another popular mechanism, which is where you do a little clip after somebody’s played a video. And you just don’t want it to start interfering and becoming obsessive.

So if you find yourself, right when you wake up in the morning, checking your phone, or right before you go to bed checking your phone for social media and the activity and what you’re missing out on, FOMO, right, fear of missing out, that’s a red flag that can help you understand that maybe you have to back off a little bit and set some boundaries for yourself. Those are some of the things we talk about in the book, Influenced, as well.

Kevin Pho: Now, if you were to start this social media journey all over again, and needless to say, you know, I think there was some good in calling all that out, but obviously there were some negatives as well, what would you have done differently?

Brian Boxer Wachler: Oh, that’s a great question. I think asking for feedback early on from my family, if they saw behavior that was concerning and I was starting to be neglectful as a parent, would have been helpful. They very well may have; I just may not have listened. Again, when you have somebody who’s addicted to anything, a lot of times being rational with them is a challenge, right? Imagine somebody who’s addicted to drugs or addicted to sex or gambling. It usually takes a multimodal approach to get them through it, and sometimes just a conversation isn’t enough.

Kevin Pho: Now, was it just TikTok for you? What about other social media platforms, like YouTube, Facebook, Twitter, things like that?

Brian Boxer Wachler: Yeah, at the time I really wasn’t focused on the others. I was posting a little bit, but I saw the most rapid growth on TikTok. So it’s like being at that one slot machine in the casino, out of all the slots, that’s paying off the big jackpots. That was TikTok.

Kevin Pho: Now, what is it about TikTok specifically that makes it so addictive? Because yes, other social media platforms can be addictive, but not to the extent of TikTok. TikTok is almost like crack, right? So, having lived through that, what specifically about TikTok makes it so addictive when compared to other social media platforms?

Brian Boxer Wachler: They really pioneered the short-form video content format. YouTube was always typically long form, meaning the videos are longer, you know, 10 minutes or 20 minutes. TikTok really pioneered the short clips, less than a minute long, and the vertical scroll, and that’s why you’ve now seen Instagram copy it with Reels and you’ve seen YouTube copy it with Shorts. So it’s that vertical scroll of short-form content, and that’s what’s mimicking the slot machine effect, particularly the unpredictability of the videos. Some people get duds and some people get really good ones, and it’s that unpredictable nature which forces people to keep going.

Kevin Pho: We’re talking to Brian Boxer Wachler. He’s an ophthalmologist, and his book is titled Influenced: The Impact of Social Media on Our Perception. So, Brian, when you talk to other physicians, other clinicians, about whether they should go on social media, or if they ask you, “Hey, Brian, should I go on social media or not?” what do you tell them now?

Brian Boxer Wachler: I think it’s a good idea, especially for parents, because one thing that studies have shown is that parents who want to try to regulate and have an impact on their children’s behavior on the platforms, if they are on the platforms. Sometimes the thought of a parent joining TikTok gets their blood pressure going and beads of sweat on their forehead, but the reality is, if you go and just kick the tires and see what it’s about, not create content but just understand it, then you can sit down with your child and say, “Let’s look at your app. Let’s look at your account. Let’s see who you’re following,” because not all influencers are dispensing good influence. When the child knows a parent understands TikTok because they have an account, that gives them credibility, and that has therefore been shown through studies to help modulate their activity, versus parents who’ve never been on it and just say, “You’ve got to do this, or do this, with your social media.” It’s hard for kids to really take that seriously.

But for doctors, physicians, health care providers who want to be a part of social media and help sort of participate in the Wild Wild West aspect of the videos, calling out videos that are not true or, on the flip side, endorsing and approving the ones that are true, definitely take a look at it. I would encourage you to do that, because you’re going to be providing a community service for the public in that respect, and you may even really enjoy it.

In my book, Influenced, there’s a whole chapter at the very end to help people responsibly grow their platform, even if they want to be influencers. The chapter is called “So You Want to Be an Influencer,” and it’s not just my insights and pearls. I interviewed 15 other highly respected, successful influencers, many of them also doctors, about their insights too, the good and the bad, and how to grow their platform, and some of those tricks too. They were very open about their experience, in a completely transparent way, which was really appreciated and rare, and that makes it a great chapter for that purpose too.

Kevin Pho: Now, when you called out misinformation or inaccurate medical information on TikTok in general, did you feel like you made a difference? Did you feel like you moved the needle when you did that?

Brian Boxer Wachler: I really did. I really felt like I was having an impact, because I would see comments from people saying, you know, “Thank you so much,” or “I was going to buy this,” or “I was going to try this.” I really felt like I was having a much broader reach. I mean, I love practicing ophthalmology. I love treating keratoconus and helping people with the other conditions that we talked about. But this was allowing me to reach even more people, you know, hundreds of thousands or millions of people regularly, to help save them, at the very least, from doing something that was going to waste their time and have no effect, or at the most, prevent them from hurting or harming themselves in a way that even could be fatal. Because there have definitely been viral trends that have led to people dying from trying things that they really shouldn’t have, because a lot of times critical thinking is checked out now with people, and that’s why these videos often have such an effect on the viewers. But also, doctors and health care providers can endorse, you know, good content that’s accurate too, and that can also help people in that respect.

Kevin Pho: And my final question: What are some of your take-home messages that you want to leave with the KevinMD audience?

Brian Boxer Wachler: So these are some of the tips that I talk about in the book, Influenced. Number one, when you’re at the dinner table or you’re out for dinner, don’t have your phone with you, or keep it away. Personally, when I go to dinner, I don’t even bring my phone with me, because you want to focus on having real conversations like you used to have before we had social media. As human beings, that’s what we need. We need those real social interactions with people. Even if it’s over Zoom, it’s still a real interaction, versus just, you know, messages going back and forth.

Number two is don’t check your phone right before you go to bed, and don’t check it right when you wake up in the morning. And number three, set time limits if you feel you need to. The apps do allow you to have them shut down after, let’s say, 20 or 30 minutes, whatever you want to set on them. There are many other tips in that chapter, “Living with Social Media,” but those are some key ones.

Kevin Pho: And how can people reach you or find your book?

Brian Boxer Wachler: People can get the book on Amazon or Barnes and Noble. It’s in all the bookstores. I was really honored that it was recently featured in the Harvard Business Review, so that really gave a boost to it being available everywhere. It’s also on Audible, so for people who like to listen to books, I actually read it in the studio. As the author reading the book, I felt like it was an extra special experience for people who like to listen to books on Audible.

Kevin Pho: Once again, the book is Influenced: The Impact of Social Media on Our Perception. Brian, thank you so much for sharing your story, time, and insight. Thanks again for being on the show.

Brian Boxer Wachler: It’s a pleasure. Thanks for having me, Kevin.