Dr. Shikha Jain, a practicing physician based in Chicago, knows the difference between a good doctor and a great doctor.
Great doctors, Jain tells Inverse, are those who transmit sound science to the public on top of treating patients directly. It's an extension of ensuring "informed consent," she says. It reflects a core medical principle: Patients make the best medical decisions with accurate information.
Jain never expected that, in the process of meeting this standard by sharing her expertise online, she'd be intensely scrutinized, harassed, and threatened.
Jain's experience isn't atypical. According to a research letter she co-authored published in the journal JAMA Internal Medicine in January, one in four physicians reports being personally attacked on social media. The nationwide survey included 464 physicians.
Female physicians are twice as likely to experience online harassment. One in six reports being sexually harassed online.
Online harassment is nothing new, but for doctors who have been historically insulated from the public eye in their hospitals, clinics, and private practices, social media backlash is causing a field-wide cultural shift. This phenomenon is becoming alarmingly prevalent amid the pandemic and rising tide of misinformation.
Now, if a doctor speaks out on seemingly "hot-button" issues like gun control, reproductive rights, or even face masks, they may be met with a torrent of criticism and threats. Some doctors report their patient portals being flooded with negative reviews, or being threatened with rape or murder.
This harassment isn't just emotionally grueling. It can taint careers, and ultimately, drive people — especially women of color and underrepresented minorities — off the web. In turn, a vital, diverse range of voices is muffled online and people lose networking opportunities to connect positively across social media.
Inverse spoke with Jain, an oncologist at the University of Illinois Cancer Center, on what it's actually like to be a doctor online during Covid-19, and how to move forward without pulling back.
Why do you use social media as a science communication tool? When did you start?
I have been using social media to promote public health messaging and disseminating evidence-based information in medicine for about five years now.
When I was growing up, I was always told that as physicians, part of our job, and our responsibility is to educate our patients and educate our communities. Because you want your patients to be able to make decisions with informed consent. And informed consent requires patients to understand what they are signing up for and what they're doing with their healthcare.
"It's almost a public health crisis to have all this misinformation out there."
But for years, physicians were recommended not to go on social media. As a trainee, I was told not to put anything on social media, partially because of protecting patient confidentiality. You had your celebrity doctors, but social media wasn't a space that respected physicians saw other physicians engaging in.
Over the last several years, more and more physicians have found that they need to be on social media. It's almost a public health crisis to have all this misinformation out there, and patients making decisions based on incorrect information. We've seen this rise of alternative facts and people posting things for their own personal gain.
I'm an oncologist. I often see people utilizing and really capitalizing on people's fears for monetary gain, and promoting things that are really dangerous. With the rise of misinformation and this "infodemic," it's even more important now than ever to get our voices out there and make sure that our patients, our families, our communities are hearing the evidence and science behind what is going on.
Have you faced backlash or negative responses for sharing this type of medical messaging?
Yes. Four years ago, I was advocating for the importance of getting your flu vaccine. Every year, I take a picture of myself getting my flu shot, and I post about it. I didn't have many followers at the time, so I never really thought anything I posted was going to get much traction. But a woman started attacking me and she insulted, of all things, my eyebrows. Then she started attacking my physical appearance and my medical background.
The nice thing that's happening in this day and age is we have physicians and other health care workers who then come to amplify positive messaging. So other people came and started sharing more evidence-based information.
There have been times I've taken a break from social media because I feel like I'm spending my free time doing this and I'm already working crazy hours with the hospital and with Covid-19, and all the other advocacy and education work that I do. Sometimes I feel like: Why am I doing this?
As physicians, we didn't sign up to put our families in danger by promoting positive health messaging. But we did go to medical school to treat people, take care of people, and to educate people on what is best for health, based on science and facts.
I almost feel like it is a responsibility. So even when I was getting overwhelmed or burnt out, I still felt the need to put that stuff out there because if I wasn't putting it out there, then people were going to be getting their information from other places.
How often are physicians being bullied, harassed or threatened online? What are the downstream effects?
Based on our data, one in four physicians are harassed and one in six women are sexually harassed. The saddest thing is that the things they were talking about were things like vaccines, or advocacy for equity, or gun control. A lot of public health messaging has become so polarized, especially in the last year.
"The people who we see harassed the most are those whose voices we need to hear the most."
There are a lot of physicians and people who have been harassed who have left social media altogether. And it's sad because we lose those really important voices.
The people who we see harassed the most are those whose voices we need to hear the most—those who have intersectionality, women of color, or underrepresented minorities. When they advocate for things that are basic human rights, oftentimes they are attacked, and oftentimes they leave social media because they already get harassed enough in real life.
We're missing out on these really important voices and dialogues that need to be happening with people who are experiencing things that other people may not understand.
How can physicians and the public move forward in this hostile social media environment?
It's important to note that there is a lot of good that does come out of being a physician on social media. I've been able to network with other health care workers from around the world. A lot of the research I've been able to do have been collaborations with people that I've met through social media.
For physicians on social media, we need to be very transparent about what we know and what we don't know. Number two is putting out messaging that's based in fact and backing it up with articles and with statistics.
For patients and the public, it's important to stay educated by reading but also asking: Who are the messengers that you are listening to?
Make sure the information you're reading is true. And you can only really do that by doing your own research— not only researching the data but also researching the person who's presenting the data.
This interview has been edited and condensed.