The risk physicians take when going on social media

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I am at a conference that is encouraging physicians to engage in social media. This is something I was always a proponent of. I felt strongly that as physicians, we help set the tone of accurate medical information. Especially now in this age of disinformation and “alternative facts,” our voices are crucial.

I used to be an active Twitter user. I had 21,000 followers and was verified — with a blue checkmark next to my handle telling the whole internet so. On January 2, 2019, I posted a link to an op-ed from the New York Times entitled “The Special Misogyny Reserved for Mothers.” I was particularly struck by the fact that many women live with dyspareunia (painful sex) after giving birth. We can do something about this, but women don’t tell us about it. As a family medicine physician, I ask my patients about their sexual functioning as I see it as a barometer of their overall health. I put up a tweet with the link to the article and said that we talk about men’s sexual dysfunction but not women’s. It seemed straightforward.

Little did I know that there is a group, comprised of mostly men, called “intactivists” who are against male infant circumcision. They are upset that they were circumcised as infants and have weaponized the internet on a worldwide scale. These “intactivists” are the ones who decided to latch onto and comment on this Twitter thread — a thread about women. I was, of course, confused. This was not about them.

“Intactivists” hold the false narrative that male circumcision is genital mutilation — trying to equate it to female genital mutilation (FGM), an argument that, medically, I will not agree with. I stopped doing obstetrics over a decade ago, but when I did infant circumcisions, we did consent them as a cosmetic procedure. Male circumcision, however, has medical benefits (lower infection risk, lower transmission of HPV and HIV). The same cannot be said of FGM.

One of the “intactivists” claimed they were “psychologically damaged” from their infant circumcision. So on Twitter, I stated: On behalf of all women I apologize for your “psychological damage” please get the help you need. This apparently inflamed the mob. Someone from a state that I do not live in took a screenshot of the tweet, sent it to my state board of medicine with a “complaint” that I was “publicly shaming victims of genital mutilation.”

The rules around social media are quite simple — no personal health information, a rule which I have never violated. Some physicians stick to strictly medical topics on social media; others will dip their toe into other arenas. Regardless, we are supposed to have First Amendment protection. I had death threats and many nasty emails. They have flooded bad reviews on Google, Healthgrades, etc. to bring ratings down. (Yet another reason the online rating systems are ridiculous anyone can state they are a patient there is no way to verify, and HIPAA prevents physicians from defending themselves).

Although this is clearly beyond the board of medicine’s jurisdiction (not a patient, not in my state, not a procedure I do) and they should have dismissed this out of hand, they sent it to me to answer. I, of course, crafted a response with an attorney, citing the First Amendment and SLAP suits. I also stated that by advancing the complaint at all and allowing this group to have ANY credence and threatening my license to practice medicine, the board is derelict in its duty to protect the public.

I had to shut down Twitter and any public Facebook presence. The anti-vaxxers followed the intactivists and deluged my page. Trying to block them is like a game of whack-a-mole. With my livelihood at stake and death threats, it is no longer worth it to have a social media presence. I was on social media as a service. I was not being paid for it; I did not receive anything for it. I was there simply to help be a voice of accurate medical information.

The state board of medicine, by pursuing this complaint, is clearly showing their animus. It is an outrageous example of constitutional violations by boards of medicine. It is not unique. I am spending outrageous amounts of money and energy in defense of this nonsense. Given this environment and the current state of medicine, the punitive stance boards of licensure, physicians today have to ask themselves if social media is worth it. We, unfortunately, are not offered constitutional protections as other citizens are. We are sub-citizens.

The author is an anonymous physician. 

Image credit: Shutterstock.com

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