The Break Room
Tweet Like Everyone’s Watching
Condensing information was my gateway, and
I quickly found more uses for Twitter beyond
filtering the latest and greatest from PubMed.
It became a new outlet for interacting with col-
leagues and patients, and even bringing attention
to various issues that I felt were important.
However, with that kind of visibility comes
great responsibility. Social media’s predominance
in our personal and professional lives is a double-
edged sword: Everyone can see your activity, so
you can reach a huge audience with your message
and you can pull information from large swaths
of the population. That also means that people
can see any negative interactions you’re having,
as well.
We’ve had countless examples from enter-
tainment, politics, and pop culture: Anything
you put online is there for all eternity. I’ve
certainly fallen into the trap of having unpro-
ductive discussions through Twitter. So now,
when I’m getting ready to send something out
to my followers – and, really, anyone with an
internet connection who might happen across
my profile – I listen to the voice in the back of
my head that tells me, “Patients and colleagues
may see this.”
I didn’t even realize how many of my pa-
tients were on Twitter until Elaine Schattner,
MD (@ESchattner), a health-care advocate
and former physician who has a large Twitter
presence, suggested I take a look at my follow-
ers list. I was totally shocked to see how many
non–health-care providers were on it. My audi-
ence was much different than I thought and
discovering that has made me a more effective
communicator.
My advice is to tweet like everyone’s watch-
ing. Don’t post something you’ll regret. Still, I
think we should be embracing patients on so-
cial media, rather than shying away from them.
I had the pleasure of participating in a Twitter
chat with patients through #MPNSM, where we
live-tweeted for over an hour, answered tons of
questions from participants, and had thought-
ful conversations with them – not to mention
with the hundreds more who were probably
following the conversations but not writing
in. It reminded me of the patient symposia we
hold at our institute; patients can come in and
listen to lectures from experts in the field. But,
through Twitter, we were able to do it live, or-
ganize it quickly, and deliver it to anyone who
searched the hashtag.
Patients and Privacy
There is a distinct advantage to opening lines of
communication through Twitter: When patients
enter the doctor’s office, there is an unmistakable
hierarchy; in that formal setting, patients may
feel uncomfortable asking certain questions, or
may forget to ask the questions they wanted to
ask. Interacting with patients on Twitter removes
some of that formality. People may feel more
comfortable having virtual conversations outside
of the confines of the doctor’s office or clinic.
As many advantages as it provides, there
are undeniable limitations of using Twitter as
a platform for patient interaction. I get tweets
from people identifying as MPN patients who
ask me for my thoughts about a treatment or
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ASH Clinical News
for a second opinion. Of course, I can’t perform
a full history and physical over Twitter, so it’s
impossible to make a fully informed evaluation.
However, I can provide general information and
steer them to various resources.
We also are governed by patient confidential-
ity and HIPAA laws, so the transparency and in-
formality inherent to social media is often at odds
with the patient protections built into the U.S.
health-care system.
Interacting with a Twitter avatar, rather than
an “in-real-life” patient, means I can’t perform
“the eyeball test” that clinicians rely heavily on
in day-to-day practice: When you walk into a
room and start talking to patients, subtle, non-
verbal communication cues can give you a sense
of what they do, how active they are, and how
their disease has affected their lives. These are
factors we consider in our treatment discussions;
they’re also things you can’t discern from virtual
patient interactions.
My strategy is to give patients as much infor-
mation as I can, but I can only explain so much
through 280 characters and limited background
information. If I can’t answer a question in the
context of Twitter, I’ll respond with, “That’s a
great question and an important topic. I have a
hard time answering that question, but you and
your doctor can discuss it.”
In some cases, I steer people toward one of
my colleagues in their region who can give them
more in-depth information or direct them to a
nearby clinical trial center if they have questions
about investigational treatments.
Obviously, Twitter is never going to take the
place of an actual face-to-face, physician-patient
interaction, but it certainly augments what we do.
If we keep it professional and recognize the limi-
tations of this type of interaction, it only makes
sense for hematologists to leverage this platform
to reach our intended audience. Also, many of our
patients are likely already on Twitter – shouldn’t
we join them? ●
Hematology Hashtags
Memorize this list of hematology hashtags to
get ready for #ASH18!
#ASHsm #MPNsm #VTE
#ASHaiku #pallonc #hemophilia
#BMTsm #immunoonc #TcellRx
#MMsm #sicklecell #leusm #transfusion #lymsm #hpm
Nervous about signing up for a
Twitter account? Dr. Gerds offers
some advice for overcoming
your fears.
Log on and
show up. “As the
saying goes, ‘Ninety
percent of success is
showing up.’ Social
media platforms
are incredibly
intuitive, so just by
being there, you
can pick up a lot of
information about
how to use it to
your advantage.”
Take inspiration
from those you
follow. “You don’t
have to tweet a lot
at the beginning,
but start following
people and look at
the conversations
they’re having.
Notice what sticks
out to you when you’re scrolling through the feed,
or what type of content started a co