CLIMACTERIC 2013;16:609–610


Social media and health Anna Fenton and Nick Panay

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Social networks have long been an integral part of human socialization. However, the 21st century has seen the development of new electronic forms of networking such as blogs, podcasts and wikis. Networking platforms such as Facebook, LinkedIn, Twitter, Pinterest and others are leading the way in new methods of medical communication. They provide many new opportunities and a powerful tool for information dissemination. Online communal spaces are created that allow individuals to interact even if it is with a short-term common purpose, but they also pose a number of significant challenges. Those born after 1980 are often referred to digital natives, as they have grown up fully aware of the opportunities offered by digital media. This is in contrast to older individuals or digital immigrants who have had to learn these new skills. Despite most of the audience fitting the description of digital immigrants, 90% of those attending a recent Australasian Menopause Society congress had used at least one form of social media, and recent surveys in the USA suggest that nearly all medical professionals have a social media presence1. A PubMed search for “social media and medicine” generates over 7000 hits and clearly demonstrates the impact of these networks on our practice. The literature in this area has grown by 50% in recent years, and this growth has meant that most medical regulatory bodies have had to issue guidelines for the use of social media by doctors2. These cover such diverse issues as patient confidentiality and maintaining appropriate boundaries with patients and colleagues. Social media provide a number of important benefits for patients. Clinicians and patients are able to share stories and experiences. This kind of social network has been shown not only to improve understanding of medical conditions and their management but also to lower levels of stress and depression among patients3. From a physician’s perspective, there are opportunities to enhance professional networks, collaborate on difficult cases and increase involvement in CME of doctors in remote areas. Doctors are no longer limited by geography or time zone. Medical researchers are able to identify patients willing to take part in a clinical trial. Public health agencies are also aware of the power of social media. They can track the onset of epidemics by the number

© 2013 International Menopause Society DOI: 10.3109/13697137.2013.850964

of medical queries occurring on social media sites. Emergency communication networks can be established, and understanding advanced of vital public health issues such as the role of vaccinations. We know that norms and behaviors spread along social networks. Our lifestyle choices are influenced by the behaviors of those with whom we have social ties. For example, research suggests that our rate of becoming obese increases by 0.5% for each obese social contact we have. Network therapy can alter behaviors in a positive way, such as reducing alcohol consumption4. However, the benefits of social media are balanced by some caveats. There is a risk of excessive self-disclosure by physicians. Individuals may feel disinhibited online and this can lead to negative effects on their reputation. It is easy to blur professional and personal boundaries. The impact of ‘friending’ patients on Facebook is one such example. The values of the medical profession in terms of confidentiality and one-onone contact diverge from the values of social media, which celebrate openness and informality. Doctors are generally held to higher standards of behavior than most professions, and there are already several examples of disciplinary action taken in response to inappropriate use of Twitter or Facebook. In a survey of state medical boards in the USA, 70% had taken disciplinary action for unprofessional physician behavior online5. Medical practitioners do not write the majority of medical blogs. They are frequently the opinions of patients or those with vested interests. There is a wide variation in the quality of the information and many bloggers misquote opinions of medical practitioners but, in the process of doing so, give the opinions credibility. A very real issue for public health practitioners is the tainting of public health messages by negative opinions on blog sites. It takes time to maintain an effective social media campaign for a medical practice, and a dedicated site administrator is required to moderate the content and remove spam and abuse. The issue of compensation for time spent providing information on social media is also a vexed one. As a journal editor, social media can be used to increase the visibility and longevity of a manuscript6. Publishers, to enhance the profile of manuscripts, have used blogs, Facebook and Twitter. Many of the major general medical

Editorial journals use this approach to publicize the content of their journals, but it is seen less among specialist medical journals. It provides added value to authors, the cost is low in terms of time and money, it engages an audience beyond the core group and provides content in a form that suits the preferences of the reader. The existing methods of assessing the Impact Factor of a manuscript are increasingly being influenced by the impact of Twitter and Facebook. Climacteric is always looking at new ways to engage our readers and embracing the opportunities that social

Fenton and Panay media provide is one way forward. We can connect with a younger group of readers who are now more likely to read medical literature on mobile devices. There are exciting possibilities to extend the reach of Climacteric, better fulfill our obligations to our authors and broaden knowledge of IMS activities. We must not ignore the potential of social media in our rush to minimize the pitfalls. It has the ability to transform medical education, public health and dissemination of medical literature.

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References 1. Dolan PL. Nearly all US doctors are now on social media. Retrieved online from bil20926.htm 2. American Medical Association. Professionalism in the use of social media. 2011. professionalism-social-media.shtml 3. Liu C-Y, Yu C-P. Can Facebook use induce well-being? Cyberpsychol Behav Soc Netw 2013;16:674–8


4. Coiera E. Social networks, social media and social diseases. BMJ 2013;346:f3007 doi: 10.1136/bmj.f3007 5. Greysen SR, Chretien KC, Kind T, et al. Physician violations of online professionalism and disciplinary actions: a national survey of state medical boards. JAMA 2012;307:1141–2 6. Macrae DA, Silk SA. The use of social media to enhance the traditional journal article: a single journal experience. Clin Obstet Gynecol 2013;56:477–84


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