Input requested: How should doctors Tweet? One doc, two feeds.

The same discussion where I met Regina Holiday and learned about 73 cents was also one where I received advice about how doctors should engage in social media.

I specifically remember what Regina and the group said (in paraphrase) – “Show me the DNA of a high quality doctor.” and “Demonstrate that this/you are a doctor that I’m going to love.”

This is a very different need than “Tell me what I need to know about when to get a flu shot.” Not that patients don’t want this information also, of course.

In doing some more reading and experiencing, I thought about the outcome of social media in health care in creating engagement with the profession and health system compared to the outcome of providing information. Beth’s blog has a nice discussion about this (Engage, then Educate) in regard to the San Francisco Symphony. My hypothesis is that the principles are the same.

With that in mind, my colleague Rahul Parikh, MD, a practicing pediatrician and accomplished writer across many venues, worked on an experiment together and we’d like your feedback.

Click on any image to make it larger

This is his physician twitterfeed for patients:

This is him tweeting one way, let’s call it “standard” (more “education”):

This is him tweeting a different way, let’s call it “DNA – Enhanced” (more “engagement”):

Here’s the input we would like:

  1. Do you notice the difference in the content/approach?
  2. Which way would you want your own doctor. to tweet? (or a different way not shown here)
  3. If you were looking to choose a doctor, does either approach draw you more to a potential physician?

Thanks for your comments in the comments, and thanks again to the patients, who continue to demonstrate that they are more than willing to help us perform well for them – all we have to do is ask.

You can also follow and tweet either Rahul (on his professional feed, different than the one above) or myself. Don’t worry, we’ll compare notes.


This is a really interesting experiment. I don't know how others will feel, but for me… Going in I was sure I'd prefer the "DNA Enhanced" feed… but after reading them both, I actually preferred the professional version… Because it was focused on giving me information I could use. The second feed felt a bit like TMI (moment to moment info about specific cases of rash or things that Rahul was doing IRT). I might want that kind of info from a best friend or family member… but from a peer, not so much.

I think the best type of feed might be a hybrid – 90% professional, but punctuated with personal/real-time commentary WHEN the person wanted specific feedback from me (the audience). We need to keep the signal:noise ration tight… and random observations can feel like noise if they have no application or call to action.

My 0.02 from the epicenter of healthcare, Washington, DC. 🙂

Thanks for taking a look from the (your :)) busy epicenter, Val!

I noticed you said, "from a peer" – if this was a twitter feed intended for patients rather than other doctors, would that impact your assessment?

Hi Ted,

You pose an interesting question.

As a patient, I'm pretty sure I wouldn't want my physicians tweeting anything that has to do with my case. On the other hand, news on research findings, FDA approval of a drug that's relevant to my care, or a new clinical trial for which I'm eligible – that might be worthwhile.

But even for generalized information, I'm not sure the risks associated with being on a "disease" or particular doctor's recipient list outweigh the benefits. Say someone has ulcerative colitis – would she want to be on her gastroenterologist's Twitter list for that?

I doubt it, at least as things stand. Twitter errors are too easy.

Very interesting experiment Ted. Was curious on your post because I just finished up an article for the AHLA on social media, including some discussion on tweeting patients and physicians.

Like Dr. Val I thought I would find myself liking the DNA enhanced version better than the more sterile version. However, I may be leaning toward liking the educational stream better. I sat and thought for a minute on why and one of the reasons I came up with may have to do with conditioning. I still think of physicians as experts, advisors – especially those who I don't have a personal relationship with. The educational stream is much more in line with that approach. Like Dr. Val I feel sort of like a voyeur on the enhanced stream – seeking a little too much personal information. However, it does give you a little better look at the "under the hood" life of what a physician does on a daily basis.

The lawyer in me also looked at the second stream as one which included tweets that could come back to bite or be helpful in litigation. For example – lets say the dermatologist misdiagnosed the rash and there is now litigation where both the dermo and Dr. Parikh have been sued. Another example, the tweet involving "goal of KP docs is to respond to email within 48 hours". I would love to have that on cross examination of Dr. Parikh in a case where he failed to respond to a patient within 48 hours.

Look forward to others comments and thoughts.

VERY interesting experiment! Different feeds for different needs.

You're probably not surprised that I prefer the more engaged one, for general conversation – "Hey, look at this." The other ("professional") one is more like a news feed, and would be good for keeping tabs on news.

Facts vs reflections?

Hi Dave/all,

interesting to me that the patient (one so far) appreciates a different approach then the professionals do.

Other comments are well taken.

Our goal is to think about what it is the patients want (this is for patients, not peer-to-peer tweeting) and then manage within the guardrails, as Bob points out, but not the other way around (what if all of health care were designed that way…),

Looking forward to more reactions and commentary – we are without precedent here….


Tricky space but I am thinking "De gustibus non est disputandum." (In taste there is no dispute.) I generally prefer the 2nd (engaged and connected) style for the following reasons:

– A personal tweet style allows a follower to "try on" (risk free) a caregiver's judgment. When the style feels like too much, or the doctor lands in the TMI Zone, then patients may unfollow with no negative consequences from the "authority." Flip side, if he or she is balanced and demonstrates an active curiosity within his/her field of influence and network, a patient may be very interested will listen carefully to learn as much as possible. This is the sweet spot, a powerful bond of affiliation.

– As a patient, I don't make the leap that being an engaged Tweeter automatically correlates with being a good doctor or a good nurse. The value prop for me following an engaged Doc in any realm is that I receive real, authentic and transparent access to the closed world of medicine … sort of.

Real, authentic, transparent access to the world of medicine – even if fleeting – can be highly desirable to a patient. It can serve a provider as well by giving a safe platform to articulate some of the challenges, opportunities, frustrations, and doubts that are universal when caring for patients. This seems a fair trade in a social context.

As ePatientDave says, perhaps this is "facts vs. reflections" … a tricky space in any relationship.

A really interesting experiment!

I thought I'd like the DNA version more but for me a lot of it was too much information that really wasn't relevant for me. As a patient I want information I can use, news, education and reflections about medicine. Some of the DNA tweets could be turned into something I can use (like "Technology can be great, was just able to diagnose & treat rash via digital photo & e-mail!") but as presented, they didn't really spark that connection with me until I stopped to write this response. Embarrassing as it is to admit, if I were subscribed to my doctor, I would want it to be about me (because the world should be centered on me!) and not too much about the doctor except as the tweets might inspire me. Occasional reflections on the practice of medicine and/or personal comments (my current earworm, etc) would be fine with me, just not too much.

Having said all that, I'd love it if the first version provided a little more insight into why Dr. Parikh thought the links were important to his patients/followers. So as someone earlier said, a blend of the two would probably be the most appealing to me.

And despite what one of the physician's said earlier, I follow several pediatricians (not mine because she doesn't tweet) simply because I like to get their take on health news for kids. And I've gotten some great tips. especially on safety from them, so I do find it valuable.

Dear Ted,

As always, you have written another great post. I pondered this one for a bit, and discovered I preferred a mix of the two formats. I loved the personhood that can be displayed in a "DNA" enhanced format, but as an epatient I want information. I want my doctor to help act as one of my information filters. I guess I want it all.


Ted Eytan, MD