Healthcare professionals (HCPs) are slowly joining the social media movement as the benefits of communicating in a professional capacity online are being recognised. An example of a doctor using social media is Dr Christian Jessen (twitter.com/DoctorChristian). As well as sharing health-related news, he has the ability to reach over 330 000 people (at the time of writing), and he directly answers general health questions posed by his “followers” (people who subscribe to receive particular social media updates).
Organisations can also have a presence on social media; Diabetes UK has a Twitter and a Facebook account with an impressive following of over 111 000 and 82 000 people respectively (at the time of writing). They use these platforms to promote their publications (e.g. 15 Health Care Essentials) directly to the public, as well as surveying people on matters such as diabetes care and organising designated times for the diabetes community to communicate with each other online.
What are the benefits of social media?
A recent systematic review by Moorhead et al (2013) showed that members of the public who are seeking medical advice are using social media to access health information on a range of conditions, with diabetes being one of the most frequently reported. Patients are seeking answers to medical questions (Greene et al, 2011), whilst HCPs are using social media to collect data on patient experiences and opinions, to implement and trial health interventions, and for health promotion and health education (Hanson et al, 2011). HCPs are now also able to conduct online consultations by video-conference (Fatehi et al, 2014).
Research has shown that the use of social media for health communication can benefit the public, patients and HCPs in many ways. Social media can offer more available, shared and tailored information; increased accessibility and widened access to health information; peer, social and emotional support; public health surveillance; and the potential to influence health policy (Moorhead et al, 2013). In particular, medical blogs written by highly educated and engaged individuals are frequently picked up by mainstream media, making them a vehicle to influence medical and health policy (Kovic et al, 2008).
Social media enables users to interact with each other at a click of a button – a process so easy and quick to use that it is possible to see the potential for higher response rates to questions posed by HCPs online compared to questionnaires handed out in the clinic or sent through the post.
Sharing informative videos on social media about diabetes and featuring people with the condition also has the potential to remedy misinformation and prejudice.
Accessibility
Social media never stops, meaning that people who can not get an appointment with their HCP at a time that is convenient to them, still have an opportunity to gain an insight into the information they need: either from a HCP who is active online or from a reputable charity such as Diabetes UK. There is also a certain “anonymity” online, meaning that people seeking medical advice may ask questions that they might not be comfortable asking in a face-to-face consultation. Information provided online may not replace the need for an individual consultation; however, it will provide an insight into the answer, with the potential to convey if further information should be sought.
Community feel
Social media also has the potential to foster a strong sense of community amongst users, bringing together people with similar conditions or who are in similar positions. Diabetes.co.uk hosts easy-to-access forums for people who are both newly diagnosed with diabetes and those who simply want to “ask a question” on topics such as weight plateauing, diets to lower HbA1c and whether others have had similar experiences to them.
A hashtag is a word or phrase prefixed with the hash sign “#” (e.g. #type2diabetes). Hashtags are used as a way of adding a “topic title” to an update on social media, and are subsequently hyperlinked to other social media updates also using the same hashtagged word or phrase. Hashtags can bring together members of the public and HCPs who are talking about the same condition – even if the discussion or mention was days, weeks or months ago.
Both hashtags and online community forums have the potential to help someone newly diagnosed with type 2 diabetes to feel that they “are not alone”, which could help increase acceptance of the condition and thus adherence to any advice given. Social media provides a route for members of the public to gain support from one another, which may be at a time when the surgery is not open!
What needs to be considered when using social media?
One of the main considerations of social media raised by the systematic review by Moorland et al (2013) were the concerns over the quality of information provided. Members of the public seeking medical advice may also be unaware of the risks of disclosing personal information online and unsure how to correctly apply information found online to their personal health situation.
Based on this information, HCPs should remind patients that online information is not an alternative to a face-to-face medical consultation and advice given should not override any tailored health plan provided. People with diabesity should be encouraged to access moderated forums and reputable social media accounts such as Diabetes UK.
If we don’t talk about reputable health-related social media accounts, online health resources or apps (an application downloaded to a mobile device to fulfil a particular purpose; see Box 1) in our consultations, it is likely that patients, particularly the more technologically savvy, may go looking for these anyway. By discussing social media or at least directing individuals to further information and support, we have the ability to steer them to reputable sources they can trust.
A healthcare professional on social media
After qualifying as a dietitian in 2009, I started blogging and engaging with social media in 2012. There are over 35 000 followers of my online presence Nic’s Nutrition across various social media networks and there is a readership of over 30 000 people on my blog nicsnutrition.com each month.
I am interested in the coexistence of type 2 diabetes and obesity (diabesity) and my blog includes information on both improving diabetes control and heart health through diet and lifestyle changes. Diabetes is a very common condition, and so articles written on the subject attract interest from both those who have diabetes and those who know someone with diabetes. My personal aim is to motivate people to lead a healthy life by showing how healthy living isn’t about living on “rabbit food”. Throughout the blog, I promote the 80/20 rule – living life 80% healthy and affording to indulge “guilt-free” for the other 20%, which I have found is a realistic goal. I understand first-hand the problems people with diabesity and obesity face when they are searching online for advice from the questions I am asked: from being confused with tabloid headlines, “Good news slimmers! Eating that bar of chocolate can HELP you lose weight” (http://dailym.ai/1u5Owur), to not knowing the best type of foods for diabetes.
Health bloggers need a passion for translating and promoting nutrition-related science into easy-to-understand health messages and practical tips in a readable and accessible manner. Members of the public who seek supplementary medical advice value a credible background and informal writing style. In my opinion, social media and blogs offer the opportunity to share reliable health advice and a chance to build a support network of people who all have wanting to improve their health in common. HCPs using social media have the opportunity to communicate directly with people and to help dispel health myths and squash scaremongering statements.
Getting up to speed with social media
The 24/7 world of social media is growing and is unlikely to disappear. It offers an arena in which HCPs can be accessed and recognised as leading experts in their health field. We should embrace the opportunity to share credible information about health whilst learning to understand the needs of members of the public seeking medical advice.
We need to accept that people with diabesity are going to go online and use social media to find information about their health conditions with or without our direction; therefore, we should be willing to discuss reputable online sources. I would encourage all HCPs to look at the information available online, and even if you do not want to join one of the social media networks, try to be prepared to talk about it with technology-savvy patients in the clinic.
