CASE: An acute episode of “evidence-baseless” medicine
You are discussing routine gyn care with a 20-year-old new patient. When you mention the value of being vaccinated against human papillomavirus, she says that she’s heard cervical cancer is caused by a weak immune system, not by HPV—and that she knows that a lot of girls have died from the vaccine.
You listen to her concerns and respond systematically, pointing out that the Nobel Prize in medicine in 2008 was awarded for the discovery of the link between HPV and cervical cancer and that 23 million doses of the HPV vaccine have been administered in the United States with 32 reported associated deaths—none attributable to the vaccine. You refer her to the Centers for Disease Control and Prevention Web site for more information.
You wrap up by asking her where she learned about the HPV vaccine.
Later that day, while you catch up on charting, you wonder: Exactly what is this Twitter? And why is it dispensing medical advice?
The answer to your first question, if you were not already clued in, is that Twitter is a social network that spreads information and links in messages (from individual and group subscribers) known as tweets, of 140 characters or fewer characters each. Because the number of characters is limited, tweeting is also known as microblogging.
Twitter is for what’s happening now, so it fits right into the 24/7 nature of the news and information cycle that increasingly characterizes our culture. You can tweet from your Twitter home page through a third-party application on your computer; or on the go by means of instant messaging or applications on a smart phone (iPhone, BlackBerry, Palm Treo, etc.). Subscribers who are interested sign on to follow your tweets, and you, in turn, sign on to follow the tweets of others—of your choosing and in unlimited numbers and potential variety.
The numbers are persuasive
Introduced in 2006, Twitter has evolved into a powerful social networking tool. According to information released at Chirp, the official Twitter developer conference held in San Francisco this past April, Twitter has more than 105 million registered users, more than 180 million unique visitors to the twitterverse each month, and, on average, 55 million tweets and 600 million search queries each day.
Four percent of news stories posted on Twitter are on health and medicine topics; compare this to 11% of stories in the traditional press. However, more and more, Twitter is becoming a legitimate source of medical information, as government agencies, organizations, hospitals, universities, medical societies, and journals use the service to disseminate information.1
That rising legitimacy means that you may want to consider becoming part of the twitterverse, for the good of your practice and your professional standing. Here are the basics of how to jump in, sensibly and usefully.
First, let me disclose myself: I tweet professionally as @DrJenGunter. I’ve met many fascinating people on Twitter—and only a few weirdoes, whom I’ve quickly blocked from having access to what I write (you can easily do that). I’m certainly not alone in our specialty: “We tweet, too,” describes the experiences of two ObGyns who use Twitter in their practice.
Twitter promotes the spread of good medical information when reputable voices utilize it. Sixty percent of patients look for health information on the Web; more than 50% of them believe that what they find there is essentially correct2,3—even though no entity controls accuracy or detects bias. In one study, high-school students were asked to research vaccines on the Web using the search terms “vaccine danger” and “vaccine safety”: On average, 65% of links identified on the first page of each search contained inaccurate information.4
Your presence on Twitter can be a powerful antidote to whatever misinformation is posted there. (Recall the hypothetical case at the beginning of this article?)
Twitter expands your on-line presence, at no cost. Like it or not, your patients are looking you up on-line.
Twitter connects you with other like-minded physicians—and with nurses, researchers, and health-care advocates.
Twitter attracts the interest of reporters and writers. Journalists use the service as a source of contacts.
Twitter can help you expand your practice and your “brand.”
An express tutorial
With Twitter, you find tweeps (people) who interest you; once you opt to “follow” them, their tweets appear real-time in your Twitter stream. You use the Twitter search function to peruse names, organizations, and subject matter, and to browse through lists of other people’s favorite tweeps. (One of the most comprehensive lists of tweeting physicians is twitter-doctors, maintained by “@hrana,” an internist who lists his location as 221b Baker Street.