Hello and welcome to our talk on leveraging social media to unite and advance team physiatry. I am Dr. Sharma, I'll be the first speaker here today. The objective that I'm going to cover is defining current social media concepts, formulating a strategy to effectively interact with our colleagues, as well as educate our patients. First of all, are you on social media? Well, I understand this is a video format and it's not as interactive, but we'll still try to keep it that way, just to keep things flowing. The chances are you probably might be. If not, most of your patients probably are, but we're going to talk about some of those statistics now. So around the world, this is data as of 2020, with a world population of almost 8 billion, about 55% of that population is on social media. And about 5 billion of them have mobile phones, which is where most of this is accessed through. And then finally, on the right side, about almost 4 billion, about 49%, are active social media users. So in the US versus the total population around the country, around the world, almost 70% of US users are active on social media. One of the most popular formats, the platforms that's used is Twitter, with over 330 million active users a month, 152 people using it daily, 500 million tweets a day. Of course, this varies depending on current events during pandemics, elections, any current event where information is shared much more rapidly as updates are coming out. About 22% of US adults are on Twitter. And some of the demographics, this is about two-thirds male to one-thirds female. 71% of people say they use Twitter to get their news compared to actual news stations and so forth. All right. Another popular platform is Instagram, with over a billion active monthly users, over 500 million daily users. The platform is a little different. Instead of a lot of text, the primary form of communication here is through pictures and videos. About 37% of US adults are on Instagram. About 37% of US adults are on Instagram. And the breakdown is a little more even here with a little extra female users of 56%. Fun fact, the most Instagram food is pizza. Number two comes in, sushi comes in number two. All right. And also Facebook. Facebook has the widest use, about 2.5 billion active monthly users. About 70% of US adults are on Facebook. About male and female, again, fairly close, 57% male. 72% of adults age 50 to 64 are on Facebook. And, again, more than 60% of adults over age 65. So this is a format that usually ends up being more widely used even by more elderly people. Fun fact, over 1 trillion presses of the like button on Facebook. All right. Now, does the influence of social media expand to include healthcare decisions? Like we said, about over 70% of people are getting their news off of Twitter. Well, what about healthcare news, healthcare decisions? About 75% said that they use social media to research their symptoms. And I'm sure you can relate. You must have had patients in your office who, before they've seen you, they may even be candid and tell you, hey, I Googled my symptoms for my shoulder pain or my knee pain, and it says I have X, Y, and Z. Or I'm worried about this, I'm worried about that. So, you know, people are definitely out there searching before they come in. About 90% of 18 to 24-year-olds actually trust the medical information they see on their social feeds. Again, this is very important to make sure that the proper information is being shared and that we have qualified professionals out there debunking some of the wrong information that's out there. About 40% indicate that a provider's social media presence impacts their decision-making or opinion of the provider. Now, if you don't have a social media presence, then that's kind of left up in the open, up in the air. So we really want – we're going to touch on how to get started and how to set up your presence online. Okay. The CDC is encouraging leaders in healthcare to use social media. It's arguably one of the most influential healthcare organizations in the world, encouraging providers to use social media, and that's very significant. The CDC itself is very active on social media through multiple apps, multiple Facebook profiles. They have a YouTube channel, a Twitter feed, and multiple blogs. And they want to work towards health equity. Health equity is achieved when every person has the opportunity to attain his or her full potential, and no one is disadvantaged from achieving this potential because of social position or other socially determined circumstances. In this case, still having access to the Internet, to access social media accounts, could pose as a barrier. But as long as they do have that access, it should be widely available. This information should be available to everyone. The World Health Organization also endorses the use of social media to spread information, and they recognize that social media is a great tool for reaching underserved populations globally. Also represents a shift in that thinking that was likely influenced by the way millennials approach health-related information, so that it is quickly accessible and easily disseminated. Okay. And then we wanted to touch a little bit on conventional and alternative metrics. This was a paper published by Dr. Milton and team. Dr. Niehaus and Dr. Gutierrez are co-authors on this with myself as well. There's a focus by a lot of the journal, academic journals for every specialty now, focusing on bibliometrics. So bibliometrics measures the impact of publication-related scholarship. In short, there are conventional and alternative metrics. Conventional metrics, these are what you may be used to hearing in the academic setting. These are the journal impact factor, the H index, the Hirsch index, and citation counts. These have some limitations. So one of the limitations for the H index are both for quantity and quality. So this may not necessarily account for an article's age. So possibly an older paper may make the researcher look more productive, even if that one paper is getting cited over and over versus a newer author with multiple strong publications in the field. So this is also kind of considered a lagging indicator that takes years to accumulate. Alternative metrics measures the impact of an individual article over multiple domains based on social media activity indices. Alternative metrics can maybe be influenced by the scientific community's or public's interest in a topic. So that's one limitation. But many medical journals, especially all of the rehab journals, are already using alternative metrics and promoting the journal articles online. As a result, understanding the ongoing implementation of bibliometrics is important for both academicians and trainees. So will Twitter increase your citations? Well, Twitter was actually found to be an important predictor of citation rates. Articles and journals with lower impact factors can still generate considerable Twitter activity and then in turn become highly cited down the line. So this is an example of conventional metrics where you see the number of citations. If you go up in Google Scholar for a researcher, you'll see the number of citations, the H index, and so on. And then for altmetrics, a lot of journals are doing this now where they'll have a link for altmetrics. You can press that button and it'll give you a score and some data on where that article is being shared, who's sharing it, and how often it's been shared. So what can Twitter do for your research? Well, visual abstracts, like a lot of the journal sites are now making, they increase the impressions that you have on social media sevenfold, the number of retweets more than eightfold, and the number of visits to the article where they click the link in the tweet or in the post to go to the actual journal page and view the entire article in its entirety after seeing something that drew them into it. Okay, so when we click on that alternative metrics button, this is some of the data that we get. This was an article shared by the American College of Sports Medicine on physical activity in patients with cancer. So when we first click, we can see where that article was shared. It appears to be most shared in the U.S. and then in a few places in Europe and then Canada and Australia. If we go down here, the next place that we'll see is the breakdown. So it gave it an altmetric score of 310, so it was tweeted by 381 people, blogged by someone on seven Facebook pages this was shared, and it was also picked up by news outlets as well as readers on Mendeley. And then if you click on a further breakdown of, for example, those tweets, we'll see the demographic breakdown. Now, almost about 68% was shared by members of the public. Scientists and practitioners, doctors, nurses, therapists, other health care professionals made up for about 14% of people sharing this article. So that means almost 68% were shared by members of the general public. These could be fans of just health, of wellness, of exercise, who are following these stories. But to be fair, the barrier here was if they were self-identified as a scientist or as a doctor in their profile, then they were counted in those others. Otherwise, they were just counted as members of the public. Whereas if your screen name might just be CookieMonster21, we might not know that you are a physician if you're not listing yourself as such. So you might just show up as a member of the public. We will also talk about appropriate usernames. Okay, so what happened to the dissemination of this important study when we implemented a social media strategy? This was an article put out recently. The point was that, sure, this can definitely increase the metrics for an article that comes out. But what about if it was done for an article a year or so after it had already been published? What happens then? Well, in this case, they started sharing this article about a year after the publication of the study. And at the time, it only had 45 shares, 394 downloads, and two citations. A week after putting this social media strategy into place of coming up with the visual abstract and promoting the article online, the shares went up to 310, and we had almost 3,000 downloads. And then a year after that strategy was implemented, we had almost 800 shares, almost 6,000 downloads, and six citations, starting off with two citations about a year ago. So the point was that this strategy is effective even for articles long after they've been released. Okay, okay, so maybe you're convinced, so how do we get started? Well, we're going to touch a little bit on that. First of all, on Twitter, this is kind of the Twitter hierarchy. As an observer, you may just be down at the bottom lurking and liking tweets, getting a little more involved. You might retweet and share something that you found interesting, like a journal article or a new research study, replying to topics and then discussions, and then tweeting yourself and sharing something that you might be working on or some of the latest research from your team. Okay. These are an example of your usernames. This is my Twitter profile on the left and my Instagram profile on the right. For consistency's sake, I try to keep the same username. So mine is my first name, last name, MD on both. And then you want to have a profile here, a short few lines about where you are, what you're doing, and some hashtags for some topics that you follow. So when anyone searches hashtag physiatry, that your profile shows up. Okay. And my personal recommendation is to keep these open, keep these public, because you want these to be found when someone searches. And we'll touch on why later on. Here's a profile of Dr. Silver, who is a professional at all things social media. One cool thing I wanted to show you here is, again, she uses that format for her username, some hashtags for causes that are important to her. Also has a link to her website where patients and colleagues can find more information. I just have my two social media pages linked to each other. But the cool thing here is with a lot of these users, you can click this button here and find lists. And she's actually put together some lists for different subspecialties. So she may have lists of cancer rehab experts. She may have lists of sports medicine experts and so forth. Okay. So this is your brand. You know, we really want to make sure that you're representing yourself in a way where you can control the narrative. So just do it. What does that stand for? I'm sure you may have heard of the slogan before. Nike might be what comes to mind. What about I'm loving it? Yeah, that's right. McDonald's. Can you hear me now? That was Verizon. Like a good neighbor. You got State Farm. The ultimate driving machine, BMW. But what about my good friend here, Dr. Padre Guzman? What about that? Is that a brand name? Well, sure it is. But what comes up? What's the first thing that pops up into mind? Well, as most people would do, whether they're colleagues, employers, or patients, you would Google this man. So you Google this doctor, and these are the results that come up. Okay. So you have a professional page. You click that first one. And that shows his professional profile on his hospital website. Okay. But if he had a social media page, which he does now, by the way, after some convincing, he can share a Grand Rounds talk he did or a national conference where he presented on lymphedema. And if you happen to be a patient who's going to see him for lymphedema, you know, you see this, you're thinking, wow, Dr. Padre Guzman is an expert in this, and that's what I'm seeing him for. It's a little reassuring. It also puts a personal touch on things, and it lets patients feel a little more comfortable going in before they meet you for the first time. And this is something where you can totally control the narrative. And that's why you keep all of these profiles public, so that they show up in the Google search results when people are searching for you. Okay. Another platform gaining popularity that my colleagues are going to be talking about in a little more depth is TikTok. Here is a video from a pediatrician in Ohio, Dr. Baldwin. And she shares something about vaccines in a way that's fun and catchy and makes it easy for people to follow along, as well as debunking some myths along the way. So we can play this now. ♪ Show you how it goes ♪ ♪ Now I'm walking by yourself, now I'm walking by yourself ♪ Here we go. So we usually open up the floor to questions, but since this is the one way here, we'll cover some commonly asked questions that we often get. There's so many different platforms. Which one should I use? Well, it's good to have a presence on any of these, Twitter, Instagram, TikTok to make it more interactive, LinkedIn, as well as some others that my colleagues are gonna talk about. But Twitter is the one that's tracked academically by journals and by alternative metrics. So we would recommend that you at least make a page there. Well, which one's more important? Is it alternative metrics or conventional metrics? Well, they work complimentary to each other because like we said, the conventional metrics are more of a lagging indicator, alternative metrics give you more of a snapshot in time today on how your article is being shared. So we recommend using them in a fashion that's complimentary to each other to get a more complete picture. Should you make separate accounts for your personal and professional lives? What about a business? Yes, yes to all of those. It's totally fine to have a different accounts for everything. You know, you don't necessarily, you don't need to share your personal life. You can leave those accounts for your friends and family. And can we help you get started? Of course we can. You can reach out to us. Normally we would break out into workshop, but if you have any questions, please let us know. Thank you very much. And the rest of the team is up next. Hi, Dr. Monica Verdisco-Gutierrez here. And I'm also happy to be here doing Virtual Academy APR 2020. Just talking about advocacy is gonna be my main thing and how I use social media for that and help you again, delve in more about your brand and hashtags. So you kind of heard Dr. Sharma and what he was talking about before. So kind of one of my first questions is, how are you using social media? Are you using it for good? Are you promoting medicine? Are you doing TikTok dances about rehab? Then that's great. Are you using it for evil? I'm sure not really evil, but kind of just really get you to think about what you're putting out there. And because what you're putting out there is your personal brand and people are gonna know you for it. And how do you wanna be known when you're out on social media? This is one big thing that came out recently in the Twitter and the social media world was called Hashtag Med Bikini. And so there was an article that came out that talk that was in a vascular surgery journal where they went and looked at vascular surgery residents. They created fake accounts and then creeped on vascular surgery residents social media accounts and then said what was professional or not and saying that vacation pictures, drink pictures, bikini pictures were unprofessional. And then this created a whole wave of outrage about professionalism and what's professional and cat doctors have their own lives. And so I bring that up because actually that article ended up being retracted, but it was not the first article that had occurred related to this. First professionalism, it's one of our tenants, it's one of the core competencies for residents and it was part of our Hippocratic Oath. And there was a study where they looked at, before this in 2017, they looked at unprofessional content on US urology resident graduates. And it was almost same stuff that was part of this scandalous vascular surgery article, but three years ago and what they deemed to be unprofessional. And some of it was, yes, it's very unprofessional. You can't break hip on there. You shouldn't be doing something just really engaging in unlawful behavior, having drugs, doing drugs, that sort of thing. That's obviously very unprofessional, but it was the potentially objectionable content that really got some people fired up because maybe talking about politics or controversial topics, because now physicians wanna be engaged with those kinds of things. They wanna advocate for, whether it be vaccines or gun control or race relations, those things are really important, but also some people see that and may judge you inappropriately. So even though we know it's important to engage people are out there being judgy no matter what. So in this study from 2017, most of urology residents were men. 72% had publicly identifiable Facebook profiles and 40% had unprofessional or potentially objectionable content. 13%, it was explicitly unprofessional. So the stuff that I talked about, were you breaking HIPAA? Were you doing something that was unlawful? So that is very inappropriate if you are Dr. John Smith, who is a urologist, who is doing something explicitly unprofessional and saying even self-identifying as a urologist on social media. So I still say, I think it's fine to show your vacations, show your life, but please do not do these explicitly unprofessional things. So I like to give examples about what do doctors have and you kind of heard a little bit about this before. So these are just kind of some snapshots of Facebook pages. Dr. McDevitt, he is well known in the field. Yes, this is his wonderful family's picture, but some people make judgments on this too, especially if you're a woman. Dr. Nagpal, he's someone, he has a professional page, which is very nice and highlights all the excellent pain work he does. And then he has a personal one for his friends, where he talks about just some of his hobbies. And then Dr. Hammond, she's another well-respected expert in brain injury medicine. And she keeps it very plain and simple. Very little judgment can be made there. So again, you are what you're putting out there. That is your brand. I don't wanna throw stones. So I'm gonna show you, even I have social media account that I try to engage in. And just talk about things that I like. You'll see me at meetings, me running, since that's one of my big things. So I put it out there as well. So again, it's people are gonna say, you are what you eat, you are what you tweet. So what you're putting out there, people are gonna judge you for. So you have to create the right brand and advocate for what you want. So what's part of the branding game? This is from one of my friends. He's a professor at UT Austin. He used to coach in the NFL. He teaches, he leads their center for sports leadership at UT. And some of these slides are from him. So why is it important? Things that are out there can be drama. So there was a few years ago, the little league removed a soccer team because they posted a picture of them shooting the middle finger. And yeah, that's a little league drama and they're obviously gonna learn. But what happens when it affects you and it takes away your college admission, like it did at Harvard, where there was a Facebook group where everyone who was accepted went into. And some of the students who were accepted started sharing very offensive memes, including anti-Semitic and racist memes. And Harvard found out and they rescinded admission. And that can change their life forever. So you don't want to lose your job or your career for something that you put on social media. There are position papers now. Almost every society has one that talks a little about what's professionalism and what you should do in social media. There's also, they've looked at state medical societies. State medical societies, 92% have had some kind of violation of online professionalism that has caused a physician to lose their license. So it can also lead to you losing your license. So what are the key takeaways that are recommended for social media playbook? The first one's the delete, button, submit. So even though you put something out there, someone can screenshot it and it is still available for people to see. So again, just kind of think about before you post. Control your circle. So if you have a professional account or you have one related to your business or to your department, then who are the people that are controlling it and what are they putting out there? And just like there was a few years ago, again, Ted Cruz, he's very conservative senator from Texas. And in one of his tweets, they liked porn in the middle of the night. And that's something that then he said, okay, he looked into it. Because again, he had a circle of people who are managing his account. So it wasn't him, but it's very, could very much hurt what he stands for. That one was be aware of endorsements. So just who wants to endorse you? Who wants to retweet you? And I just tell people, just be careful for what's out there. We're physicians. You don't want to have like, oh, the makers of bread like beer want to promote you. Just be careful with that kind of stuff. Follow your child. And yes, that's like me. I'm old enough to follow my children on social media, but I also consider follow my child is follow my faculty and follow my residents because I also want to make sure that they're putting the best things forward that's out there. So that's my mama chair stuff. Post the content you want to see. So kind of when you're posting, just think like, what I want to see this, like, is this dumb? Is this cool? Is this educational? It's really educational. It's research. I want to retweet this. I want to put it out there for people. So post things that you think are pertinent. And then my own edition, my own number rule for this. It's kind of ironic that's an all caps. Is that because don't use all caps and be kinder than you are in real life. So people read things the wrong way that's on social media. So you just be really, really nice and kind when you're there. We talked about social media, again, advancing your brand. If your brand is what your research is, then I want you to connect with different journals. I want you to connect with people who maybe are in different fields but are interested in that same research. Follow your societies, your foundations, advocacy groups related to that. And then start engaging with these people, retweeting them, liking them. And it will start raising your profile in that world. We talked already about Twitter and academia. I do have a, you know, about a tweet, a slide here about if you want to tweet about your research, you know, have an exciting opener, say who the sponsoring institution is, make one or two impactful statements about what came out in that research paper. And then you can tag the stakeholders involved in it. And then you want a tiny URL or a short URL URL that links to the paper. And then usually an image is good. Images go a long way. So that's my run recommendation. If you're going to tweet about an article that you wrote is to put a picture of it there and try. And when you put the picture, you can tag the authors and the journal as well. So that's how you do that. How do you join in conversations? You can follow hashtags and the hashtags, the number sign and a word or a phrase that follows that. And for this conference, it's hashtag AAPMNR2020. It's has been for years. Well, whatever the year is after AAPMNR, whenever we have this conference, and you can even on Twitter or Instagram, you can follow that hashtag and then you can see what people are tweeting about it. If you follow it. Simplr is a company that provides healthcare media analytics and so you can have hashtags for healthcare conferences or words and phrases and hashtag physiatry is another big one. That's one that we use for our field that you may find a lot in social media. So what else has social media done for me and that it can do for you? So this was one of the first things where I saw the power of social media. There's a woman's Facebook, a woman physiatry Facebook group. And it's an amazing group full of women physiatrists from training to years on out. And someone came out and asked, oh, Dr. Michelle Tunis did. And she said, why are we not in Medscape's physician compensation report? Because they don't have our specialty there so we can't get that kind of information. So we kind of made a little slide about it and then we tweeted it out asking Medscape, and we asked nicely because that's part of the role. And we asked them, why isn't PMNR in your compensation report? And they replied within 48 hours and said they would. And years now, ever since then, PMNR has been on the Medscape's physician compensation report. So a little question and made a big step. The other thing is I love using social media for outreach. A lot of groups will outreach to me just because of the presence that I have on social media and the brand. Again, I'm big on advocating for physiatry for Latinas in medicine, for women in medicine. These pictures obviously were pre pandemic, but one of them is the picture of me with AMWA group in undergrad. So AMWA is American Medical Women Association. This is me going out and reaching out and talking to them about being a woman in medicine, about PMNR, getting the message of our field out early. The other group is LMSA, which is Latin Medical Student Association. So that is a group that they have in multiple medical schools across the country. And I would go and I just talked and I tell them my story about also being a Latina in medicine and coming from very humble background and being first generation to be in medical field and my whole large family. And it's something that really resonates with them. And I get to reach out to them in their early years because they're MS1s and MS2s. And again, telling them about PMNR and about the good work that we do. I also will try to outreach anytime I'm asked by even the lay media. It's really easy now to do lay media interviews because you don't have to go in person because of COVID-19. You're able to even just do a Zoom meeting, record it and be on the news. Again, talking about COVID recovery or COVID rehab or wherever it is. I'm doing a lot of that right now. I get to outreach with students before at free clinics and some of those connections were made also via social media. That one picture there is social media, a lot of very Instagram influencers who are in PMNR and you'll hear from one of them later, Dr. David. And so we came together and we promoted our field. We all kind of did the picture thing so we could tell society and the world that PMNR was here to help with any kind of needs they had during COVID. And we were there to support them. So just again, being supportive, putting your brand out there, advocating for our field and specialty. Other things that I think social media has really brought to my life that's really important is groups. I know Facebook's like kind of old school and now everyone's doing Instagram but Facebook has a lot of groups. There's a running groups that are for physicians and we even got together pre-pandemic to run big races. There's another group of called Proud Women which promotes women in medicine that we had yearly meetings pre-pandemic to pursue issues related to gender equity. What else social media has done for me and that's even helped towards my promotions because people that I've connected with on social media have either invited me to give presentations whether in person or now virtual. And I've been in University of Chicago. I've been to South Texas. I've been to different departments across the country at this point, but also virtually where it's really easy to do that right now. I've that one picture where it says Canaer it was in Mexico and I got a message first in one of my either Twitter inbox or Instagram in box. And they said, hey, do you wanna go to Mexico, Puerto Vallarta to present? And I was like, this doesn't sound right, but it was a real thing. And yes, I got to go to Puerto Vallarta, paid trip inclusive hotel because they saw my content of also neurorehabilitation and spasticity on social media. And that I was a big proponent for that. The other one is also, I went to Peru last year where I got to also was invited through connections that I made through social media. So again, it's opened a lot of doors for me. And so I'm really grateful for those connections. I want, please interact with me, find me on hashtag so me means social media. I'm on Twitter, I'm on Instagram, on Twitter at MV Gutierrez MD. I recommend that you have a name that has what your title is in it. My whole full name won't fit as my app, but and then put a little bit about yourself, put a hashtag or two in there for what you, you know, I'm there for physiatry, I'm there for underrepresented Latinas in medicine and also say that it's my ideas. And I'm not, what I'm saying is not my institution and also do the same on Instagram. My Instagram is a little bit more personal, maybe a little bit more running and such a few family pictures, but still a great way to interact. The last thing I'm gonna talk about today is Doximity and Doximity is maybe something that you've heard about, but it is, yes, a privately owned company that physicians can get on and they can read articles, they can get CME. But one thing it also does is that it is where you vote the best rankings for the best hospitals and also the rankings for the best residency programs. And before the rehab hospitals were previously determined only through expert opinion. And now it's a combination of expert opinion and some other things. And I'll go into that just because it's important. There's about almost 7,000 PM&R Doximity members who are getting to make these decisions. So now expert opinions, 50% and the rest of the stuff, they're looking at your outcomes, they're looking at patient volumes, your services, your technologies, your safety is now something that's important with that. They look at very small percentage of your CARF accredited and if you have NIDILRR designation. So if your hospitals begin to that, then you have to, your hospital also starts promoting things and you have to be signed up on Doximity to be able to do it. Same thing for residency. Doximity has a residency navigator and they use objective data. Like they have real data on what percent are board certified, which percent are doing research, et cetera. And then it's also a voting where not current residents, but alumni are able to vote for the top residency program. So I'm gonna just put in a shout out to a UT Health Science Center in San Antonio who has an excellent residency program and who I also pushed the voting out to our alumni as well. One study that they looked at it and said, okay, yeah, it is partially popularity contest. And if you have a lot of alum and you get them engaged, you can do better in Doximity. So take home messages today. The world of social media is big and we wanna use it for good. And it's also small and people can take screenshots and can read things the wrong way. But I want you to build your brand, know what you stand for, support your field, use hashtag physiatry. Thanks. Hey, everybody. Thanks for having us and participating in this online setup today. I'm gonna talk to everybody about kind of the common pitfalls in social media and how to learn some best practices that have been put out there in a literature and all sorts of different other things. So follow along and please feel free to reach out with me with questions and things like that. My Twitter handle is gonna be throughout this and just like everyone else would love to interact and join in the conversation as you see fit. So in general, when we think about different types of communication, I think it'd be helpful before we jump into the different types of pitfalls to talk about how the social media forum communication style is slightly different. And to kind of highlight that, I think it's helpful to kind of see that on the top left there is kind of traditional communication. So I'm talking to one of my colleagues, one of my residents, and that is really kind of a two ways closed looped form of communication. And then if that resident then thinks that what we talked about was an interesting, wonderful topic, then they might reach out to some of their other residents and it kind of spreads by that one person or one person to a small group type setup. And that's kind of one form that we kind of, I don't know, historically have started with. As we look into more kind of digital media type setups, they also tend to follow that two way back and forth closed loop format. So if I send a text message to one of my colleagues or someone, one of my colleagues who are helping give this talk, that's kind of another form, but it's still just between the two of us ideally and can be shared and moved forward, but it's still even email. So like even the big massive email forwards are still kind of chunks of people receiving that information in kind of a closed loop format. Videos in other ways are a little bit more one way in their format. So, you know, if you were to make a movie or a content on how to learn a particular area of neuro rehabilitation or bowel programs or something like that, that kind of exists and is accessible, but it's really, I'm just talking to you, similar to this actually, and you have no way to kind of communicate how it's going or your thoughts or different feedback items on how it's going. So that kind of video is kind of a one way format back into the person who's viewing it. Social media though, is a lot different than these other types. And it really follows a more open loop style. All these other systems are relatively closed in terms of, you know, how that back and forth is going, but social media, regardless of the format, whether it's TikTok, Instagram, Facebook, Twitter, is really, I can send a message out into the Twitter sphere and everyone can see that and everyone can interact with that. And that piece of information, especially, you know, hopefully it's a good piece of information that's worthwhile to be spread, can then be shared across a large population relatively quickly. And everyone can see how that piece of information is spreading. They can see who's interacting with it, who is retweeting it, who is giving comments off of it. A idea can spread incredibly fast in that social media format. And that's mainly because it's an open loop. Everyone can see how that piece of information is spreading and moving and interacting and creating kind of its own pattern throughout that social media sphere. And can kind of help with all those other pieces of information that we've talked about of how it can really spread and grow and lead to awesome, great, wonderful things. So looking at how to do this best practice wise. So you've seen some of the different profile pictures and I'm gonna pick on myself here. But in general, you kind of want best practice to have that professional photo of you with the glasses, you know, maybe a white coat, identify yourself as a physician, your name as Dr. B. Gutierrez has kind of mentioned is kind of your full professional name that ideally is what's on your publications, your actual Twitter handle profile, as you can see mine. No one really seems to spell knee house correctly or put the I or the E in the right spot. So I just took them out and just did in house MD to kind of simplify things. You can also see on my screen, it's a little bit tinier, but behind my profile picture is the place I work, you know, working in Denver, Colorado, kind of the mountains are in the background, wonderful hospital system out here. And you can see some of those things that I'm involved with in that image as well. Hashtag physiatry is on there. The CU department logo is on there. My own cheesy brain logo because I'm a neuro rehab physician is up there. And then you can see that I'm involved with kind of different quality things and he for she is listed on that. You can also see my number of tweets, the number of followers I have, how many likes I've made and different lists. And I've made a list of all the different PM&R providers I've been able to find across the country. And we're really, really close to crossing that thousand people on that list. And that includes medical students that indicate they're interested in physiatry, current residents and practicing providers. So feel free to check that out, subscribe to it and erect with it and kind of see who to follow and engage with off that list. And so this is kind of what that professional Twitter example that you can also extrapolate into Instagram and all those other formats and kind of see what's out there and what it looks like. Really encourage you to use your real name, your professional name and this as we talked about is your brand, this is you, this is professional you. This is a way to get you out there and grow you in that community. And then the other thing that's important off of here is your byline. So this is kind of where you can loop in other different areas of interest. This is how you can comment on who you are in the actual community. So you can see that I'm a assistant professor in this particular department. You can see I'm a social media editor for one of our journals. You can see the different areas of interest in kind of physiatry, neuro rehab topics, medical education and some of the different areas that I'm interested in advocating for and participating in. You can also see that I've included that these are my own views. I'm not a bot and I'm not kind of promoting things that I don't necessarily agree with. You can see that my preferred pronouns is another area of things that is helpful to put out there when people try to engage with you to make sure that you're responsible in the way you're engaging different communities. And you can also see when I joined and a link to my own CU doctor profile page for the hospital I work in. And then the other kind of best practice thing that is used across all the different social media platforms now at this point is hashtag usage. So hashtag usage, think of this as a way to kind of, some of us use different folders in our inbox or different flags in terms of when we're reading and taking notes on different topics or a way to kind of categorize things. And the way I think of it as a way to kind of drop you into the most appropriate conversation for what that post or engagement is involved with. So if you think of a bigger arching hashtag, it might be med ed in terms of medical education. It might be physiatry. It might be shoulder pain. It might be stroke. And the more specific you get with that hashtag, you suddenly find that you're talking to a smaller group of individuals and probably more likely your peers. So if you take something outside of my scope of practice, but let's say sports medicine, and you bring up a article that you put together about shoulder pain in a particular type of athlete. So if you added hashtag sports medicine, hashtag shoulder pain, hashtag baseball, you are gonna suddenly find all the other people that are engaged in that relatively more narrow group and subgroup topic. And you're suddenly going to find peers to collaborate with and see what the community at large is talking about, both in the public sphere, both in physicians, both in articles being published and medical societies involved in that particular topic area and you're suddenly gonna be able to find a way to communicate, engage and interact with that group of individuals that are focused on that particular topic of interest. It really opens up your way and a path because social media can be this huge large topic area with this large flood of information suddenly when you open up that door and hashtags can help you narrow that down and filter it down to the topics and the areas and people that you really would prefer to engage with and interact with and grow that professional relationship with. So now that we've kind of talked about kind of the best practice options, it's helpful to also talk about the different areas that we all tend to make some of those mistakes. And I've done these different icons through a group called The Noun Project. So I'm gonna kind of talk through what these different areas are. And that top left is kind of that editing icon. So depending on the particular platform you're working on, you might find that you're able to edit that post you've already sent out or you might find as in Twitter's case, you can't edit it. You can only take it down and delete that post and post a new one. So it's important to take time to make sure you proofread that post once or twice before you actually get it out there. You might wanna really think about what that post might mean to someone that is on the other side of that perspective and make sure that you're presenting it in a way that makes sense, it is understandable and kind of explains that in the best way and there's no typos or mistakes. There's still posts that go out there that I have done that I have mistyped on, misspelled and they've kind of taken on their own little path and I haven't bothered to delete that post or edit it. But probably one in every, I don't know, 50 posts or so that I do, I catch a mistype or something that has happened. Grammatics are not my strong suit and I kind of let it be and it's part of who I am, I guess, but I do try to do my best to make sure that that post, especially on Twitter, is as accurate as I can make it. And this even includes links. Make sure that link you've copied into that post is actually where you want it to go. The other thing to know and we're gonna go through an example on how this can lead to some issues is screenshots. So even if you've put that post out there and you then delete it, there is still a chance that someone, while it was still up in existence, took a screenshot of that and now can share that image that you had up at one point and continue to grow that idea or post or mistype or you can imagine different scenarios that then can lead to problems and issues and misunderstandings as things progress. So really try to take that time because if it's out there, it's essentially existed for and continue will to exist for a long time. Once it's out, it's out and people can catch it, do a screenshot and it's out there forever potentially, which is not meant to scare you away. It's more to indicate that we just need to be responsible with the information we're sharing. That middle thing is kind of a more politics and rallying behind a cause and making sure that we're being conscious with how we're doing that. So physician advocacy is something that is definitely important and lots of the people who you're hearing from today are definitely involved in particular causes. It's also important to be very mindful of how you're engaging and what you want that brand to be. So it's definitely, if it's a core matter that is important to you and you wanna get engaged and participate in that particular domain, this is not meant to discourage you from doing that. It's just meant to make sure that that is a conscious choice so you may be involved with your preferred political party. You may be involved with a particular sports team or have lots of ties to a particular region of the country and all of those things and all of those pieces of you that you introduced to that social media platform might be perceived different ways for people that don't share that particular perspective and patients that may interact with you might find it more difficult to engage with you and establish that therapeutic relationship that you might not want to put as a piece of barrier between you and them. So just be conscious with it. Lots of the people here that you're hearing from are definitely involved in causes and participate in those areas. So feel free to use our different platforms and our different brands as an example as to how we kind of walk that tightrope line of making sure we're engaged and involved while at the same time not putting a potential barrier or wedge between us and other individuals and other groups that we also interact with on a daily basis. The other thing that we've kind of touched on in different ways is try your best to be nice and not be mean. So you have to be extra nice in that social media platform, especially when you're dealing with a text-based media. It can be misread, misunderstood, interpreted in different ways, depending on where you put that comma and whether the words are capitalized or how you ended that sentence. There's even some interesting pieces of social etiquette in terms of even texting. Some people find that after a text message, if you put period after every single message that you sent, that that is an emphatic point. So who wants to go to dinner? Question mark. I think we should go to Olive Garden, period. That period might get misread depending on which generation you're from and how you use text messaging and that might come across as a more emphatic point than you might be intending it to come across as. So just be nice. And we're gonna talk about a particular scenario that unfolded and how I really feel like a good example of engaging with that conversation in a very proactive way can be kind of used. The other thing to think about, and the megaphone is there, to kind of think about when you're on this platform and you're engaging with the community, are you just promoting your own thing and that's all you're really doing? Are you posting your perspective, not really engaging with anyone else's perspective? Are you being a good citizen with that group? Are you sharing more than you're posting and in general, it's helpful to think of 80% retweet and share and like ratio to 20% you're actually putting out there. If you're engaging with other people and promoting their ideas and even engaging in those areas that you feel less comfortable with or really are kind of engaging more and more, they're more likely to engage and interact and promote the areas of interest that you're putting out into that area, just like in your department, just like any other group or community you're in, the more you interact with each other, the stronger that bond gets and the more your information can spread and engage and reach out to those areas of people that you wanna do. So having gone through those pitfalls, I'm going to go through an example that highlights one of those areas of causes that I'm involved with and some of the other people on this presentation are involved with and how it kind of played out. So, oh well that is really tiny, but essentially this was a post put out by Esther Cho, who is one of the big physician people out in the Twitter universe, and it was a snapshot of a publication by the Dallas Medical Journal and it essentially talks about why this particular provider's perspective on why there is a pay gap between male and female physicians and it kind of hints at if they worked a little bit harder or kind of you can kind of read the post on that perspective and that led to a significant response and off of that. And here is kind of, I did not intend this to be this small, but this is what Dr. Monica V Gutierrez's response and how it kind of highlights and I'll read it to you. She basically said I'm so upset that this was even published and she included some emoticons on the feelings that she was experiencing and like this is a good way to approach this. This is, I am really hurt. I really felt bad. I saw this. This impacted me this way. And then the second part of her post is really saying I want to help. I am happy to interact with this. I want to help change this topic and move it forward and publish kind of a bigger article in response to this perspective and how it's just not exactly a idea that we should really kind of be talking about and we can change this conversation. And another provider went back into this particular person's social media profile and saw this post from them and this kind of further changed that conversation and colored it a different way. And ultimately it, this particular physician was ultimately resigned from all of their leadership roles in response to this comment and it really led to change, but it's also important to kind of see how this can, these types of things can lead to positive changes even though they can be tense topics to share and engage with and how to approach them in a positive and respectful way to lead to good outcomes. And again this is all about creating that community and culture around physicians, medical societies, and their journals and how to promote ideas and make changes. Okay references and on to the next topic. Hello I'm Sharon David. I'm very grateful to be here and just share with you a little bit of some information about how we can use social media and medicine. So so these are our agendas for today. We're just gonna go over some common terms in regards to social media, talk about the different institutional goals for using social media, other institutional or personal goals, and then what your different options are and how to grow your presence. So the first term I want to just really identify is social media. What exactly is social media? It's an interactive computer mediated technology. So that's how platforms like Instagram and Facebook and Twitter, the social media platforms stand out from other web-based services because they're interactive. It's a two-way street. People can communicate with each other versus things like Amazon Prime or you know streaming on Netflix. Those are also web-based services but they're not interactive. The other topic I wanted to just briefly touch on is something called micro learning, which I will get into a little bit later. But micro learning is just online education provided in these small little learning units. It's typically focused on skills-based information but it doesn't have to be. And research suggests that micro learning is found to improve knowledge, confidence, and engagement. So I want to continue talking about just goals, institutional or personal goals for using social media. So is it to educate? Are you trying to educate the general public? Are you trying to educate your residents? Are you going to focus it more on the GME group? You can also use social media for recruitment. You can use it to attract people to your organization. People are using mailings and looking at back of the journals less and less now to find jobs. They're looking more at LinkedIn to really look for jobs, things like that. The other thing in addition to attracting people to you, you can use social media to maybe weed out some not so ideal candidates for your program. There was a recent study done in the Journal of Surgical Education. They interviewed 250 program directors in general surgery and surgical subspecialties. And they asked them how many times have you used social media and how many times did that affect your ranking of the different residents? So the study found that 33% of program directors actually ranked applicants lower after looking at their social media profile. So that's something that you can use social media for too. Reimbursement. I'll talk to you a little bit more about that later on the presentation. But you can use social media for reimbursement purposes as well. And then last but not least, networking. We are a very social group. We have physicians. Friendly group, I would say. And so we can use social media to network. So let's talk a little bit more in detail about education. We can use it to educate general public. We can use it to educate residents. But before even going into social media, you want to really see is social media appropriate for your targeted demographic? Is this something you even want to explore? Do I want to put the time and effort into social media if my prime goal is to educate? So let's look at your targeted demographics. So this is a slide. It's from the Pew Research Center. They just looked at the different age groups and how the trends of social media use was in each of the age groups. You can see in starting in 2006, years ago, no one was really using social media that much. But over time, and this graph goes into 2018, you can see that the use of social media has drastically increased, where people 18 to 29, close to 100% are on social media. Even 65 years and older are using social media. A recent study said that 72% of the general public uses social media. So it's a really good tool to consider. So okay, so you've decided I want to use social media to educate my people. What do I use? Do I use Facebook? Do I use TikTok? Do I use Twitter? YouTube? There's so many options. I don't even know where to start. So let's look. Let's see. Let's see what the research shows. So one of the first things that I found really interesting, this graph, also done by the Pew Research Center, it just showed the utilization of different social media platforms. You can see Facebook and YouTube are the two highest. The blue, dark blue line is Facebook, and the, I guess, olive green line is YouTube. So you can see that FaceTube and YouTube were the two most used platforms up until 2019, which is how long this graph goes. So just by sheer numbers, that could be something that you may want to invest in if you're gonna, if your goal is to educate possibly one of these platforms. Another benefit of Facebook is Facebook has these collaborative online communities. We heard a little bit earlier about the Women's Physiatry Group on Facebook. I'm a member of that. It's a really great way to connect with other people, other women in physiatry. We post different things about, you know, questions on current recommendations or dosage recommendations, resources in different communities. Being from a smaller town, you know, I can say, hey, does anyone know what the resources are for, you know, EMG options? Who does EMG in Fort Wayne, Indiana? So it's something that I can just kind of throw out there, and maybe someone else is in Fort Wayne, Indiana on this group, and they can respond. So these groups can be really tailored to the specific group, as specific as you want, but they can be on the broader side, too. Twitter. Twitter is up there, too. So Twitter is great because it gives you this live update. So they're really good for conferences, for example. You can put in, you can sit in a lecture and say, oh, my God, this is great. I'm loving this, and tweet that out, and attract other people to come to the lecture. So it's, they're really good for conferences. It's great for better potential engagement. The interesting thing in this slide is it does not include TikTok. So TikTok was created in 2016 in China. It wasn't available outside of China until 2017. So it took a little time to kind of gain traction, but it's not on this graph here, but keep in mind that there are 800 million users of TikTok now, so it's grown substantially. So there are a couple studies looking at TikTok, recent studies done this year, and what they found was 70% of people aged 13 to 24 are on TikTok. So if your goal is to educate the younger population, maybe you're a pediatric rehab physiatrist, maybe TikTok's the way to go if you want to target that younger group. You know, TikTok's been so popular that the World Health Organization kind of got in on this trend, too, especially when COVID hit. So there was another study done in April of 2020 of this year looking at TikTok videos. They searched hashtag coronavirus. They then looked at the top hundred videos that came up, and of the top hundred, 14% of those videos were from the World Health Organization. So if you choose TikTok as your platform, you would not be in bad company. Another interesting point with TikTok is microlearning. I briefly mentioned microlearning, how it's those short, small, little units of educational pieces. TikTok videos are 60 seconds long on average, so you know, you can certainly use TikTok for that microlearning purposes. So we also can use social media for recruitment. So you can use it to attract others to you. So LinkedIn is one of the most commonly used social media platforms to do this. Yeah, sure, there's Indeed, there's Glassdoor, there are all these other options online that you can use to gain information of potential job opportunities, but they wouldn't be considered social media platforms because they're not interactive. LinkedIn is interactive. You can respond to people's articles that they've posted, you can congratulate them on a new degree that they achieved, or a promotion. So it's true, LinkedIn is truly interactive. And the other thing I, you know, talked about using social media as a way to kind of weed out some candidates, just the same way those surgery program directors did. So you can use it to weed out, but remember, employers may be using your social media platforms to weed you out, too. So that's something to just kind of keep in the back of your mind when you're posting things. And then the last thing is using social media platforms in more novel ways. So recruitment for clinical trials. So there was a study that done to show can we use social media to recruit patients not only for therapeutic trials, but maybe just even patient registries. They really wanted to look at how physicians felt about that, how we feel about using social media in these avenues. Well, the study showed was that physicians were excited about it. We thought that, hey, this could increase visibility, awareness, improve communication, and patient engagement. This is potentially a great idea, but they didn't know how to get through it, how to actually set up that social media. They didn't know if they had that personnel support, the administrative burden. Those are things that they were really nervous about. So one of the things that the study found was if physicians felt they had the institutional support and the personnel support, and also some evidence-based training on how to use social media, they would be more willing to engage social media platforms to help recruit patients into their trials or into patient registries. So obviously that's why we're here. We are trying to provide you guys that kind of that resource to help start the conversation of using social media more and more in your practice. Reimbursement. So this is really interesting. I thought this was one of the more interesting ways to use social media. So this infographic, as they call it, was provided by Demi and Cooper. It's an advertising company, and they put this together in 2017. You can see it says 26% of hospitals are using social media. As the goals in health care reform start shifting more to patient satisfaction, patient engagement, and population health, I think you're going to see institutions using social media more. A more engaged patient has more trust and a stronger attachment to the institution or to the provider, and that translates to better patient satisfaction scores. A more engaged patient also tends to be a more healthy patient, and that's going to translate back to possibly better outcomes. One other interesting point in looking at this graphic, too, is you can see 84% of the hospitals participating in social media used Facebook. 64% used Twitter. So again, Facebook, it's the most commonly used social media platform, biggest bank probably. Well, given what your goal is, right? So this last article, I was really excited to see this. Dr. Curtis Whitehair, who was my former program director, as well as, and then Dr. Barato, they both put this article together. And so they were talking about networking, how physicians can use social media to network. And so 44% of physicians use Sermo. Sorry, of the social media platforms to network, 44% of them are Sermo. So that's a physician-only platform where you can network with each other. LinkedIn is big on that, 42%, and other forums, such as the Fizz Forum, which AAPMNR has put together. So that's a place that you can share questions and comments and ideas. Yeah, so there are definitely options for networking as well. So I wanted to end with just how to grow your presence. So you've decided, you've targeted your patient demographic that you're going to go after. You've made the decision, yes, social media is the way I want to do that. You've also decided which platform now, you've kind of weeded through the different options, and you're like, hey, I'm going to use this platform. How do you grow your presence now? How do you grow that platform? So consistent posting is really key. Your followers want to keep seeing things from you. They want to know that they are investing in someone who's investing in them. So consistent posting is important. Also, you want to engage with your followers, and you're going to like, you know, like comments that they make on your page. You are going to comment back to them. You're going to answer their questions. If it's Instagram and they send you something, you know, in your DM, you're going to respond to that. So really engaging with your followers is important. And timing of posts. I thought this slide was also quite interesting. This was put together by Buffer. So Buffer is an application that you can enroll into. You give them your posts. You've created all of them. You've handed them over to Buffer, and then Buffer takes it over and strategically posts your content based on which platform you're using. And so there are multiple of these applications out there. But so timing of your posts are also really important. In addition to consistency and engagement, timing of your posts. So being efficient and strategic. But really, at the end of the day, you need to know your audience. It is some trial and error. There are some very good practices, best practices out there. But you also really want to enjoy it. This is something that that can provide a lot of fun and entertainment and just, you know, really fire up your passion for your field. So definitely enjoy it. If you have any questions, please feel free to reach out to me. I am on Instagram and Twitter as well. My handle is modern.strong. So hopefully that was some pieces of information you guys wanted to hear about. Thank you.

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