• Why Neurosurgeons Tweet

    Authors: Jordan Amadio, MD
    Nathan R. Selden, MD, PhD

    Internet-based social media networks have changed the world. For physicians, social media can serve as a powerful resource for education, communication, and branding. How can neurosurgeons best put social media to work on behalf of our patients and our profession?

    Twitter is one of the best-established social media networks today, boasting over 300 million monthly active users worldwide. Basic Twitter use is easy: posting 140-character or shorter messages, accompanied by photos or small video files if desired. Signing up using a smart phone or laptop computer takes less than five minutes and is free. One connects to other users by tweeting messages, news items, web links, and hashtags (#) identifying trending topics.

    Dr. Nathan R. Selden, MD, PhD, is a past-president of the Congress of Neurological Surgeons 

    Dr. Nathan Selden

    In 2012, colleagues asked me to join a small cadre of physician social media representatives of Doernbecher Children’s Hospital at Oregon Health & Science University, where I practice neurosurgery. Hospital public relations staff support our group of eight or so physician volunteers and post our periodic blog entries on a university-organized website.

    The university also asked us to open and use Twitter accounts. Other than conforming to the university’s “fundamental standard” for employee communication, they imposed no restrictions on our Twitter feeds and gave little specific advice.

    From the start, I have mixed tweets about hospital events and announcements with more personal notations. For example, when a surgeon in my division or department publishes an interesting new paper, I share the e-pub link on Twitter. At the same time, when I have a great experience at a sports or arts event in my community, I share that. When I find a quote or piece of Twitter wisdom that makes an impression on me, I “retweet.” If I capture a beautiful image of a sunrise out the hospital corridor window, that goes out too, as do the latest antics of my beloved golden retriever, Angus.

    Why does this matter? More specifically, who is watching? One of my first followers was a retired neurosurgeon and strong friend and philanthropic supporter of our program. When he learned I was on Twitter, this octogenarian opened an account and chose only two feeds to follow: one belonging to his daughter, and mine. When one of my activities or a notable success by our division came across his home computer on Twitter, he often sent me a congratulatory card or email. Using Twitter, he was able to closely follow the results of his philanthropy and play a more engaged and continuous role in our work.

    I am also followed by (and follow) a grateful patient who survived a life-threatening motor vehicle crash and now makes hand-crafted blankets for kids at Doernbecher each year. Many other community members also follow, and connect us to local political groups, the media, and other organizations.

    Through Twitter, colleagues at OHSU and across the country keep abreast of our academic and programmatic activities, and not infrequently reach out in the “real world” to interact. In one example, Dr. Atul Grover, the national policy director for the American Association of Medical Colleges, and I exchanged extensive information and links through Twitter. Eventually, I invited Dr. Grover to speak at the 2015 CNS Annual Meeting, where he addressed thousands of neurosurgeons about U.S. medical and surgical manpower needs, and also met and collaborated with our national advocacy leadership. When I had the honor to serve as CNS President in 2015, my Twitter community expanded greatly to welcome neurosurgical colleagues from around the U.S. and the world, and the subject of my tweets expanded to include celebrating the hard work of CNS committees and leadership on behalf of our members.

    Finally, personal posts of a sunrise view or a puppy’s antics also humanize and connect me with patients, professionals, supporters, and philanthropists who tune in on Twitter, deepening connections and helping to build community.

    Dr. Jordan Amadio, MD, MBA, is a PGY-6 resident at Emory University and a social media ambassador for the Congress of Neurological Surgeons

    Dr. Jordan Amadio

    Much like neurosurgical training, Twitter emphasizes brevity and efficiency of communication. A quick daily scroll through my newsfeed allows me to stay abreast of news, research findings, and the opinions of thought leaders. This can be done on the way to rounds, in the hospital elevators, or in between cases. It is an effective method for making use of interstitial time, those minutes of the day that might otherwise go to waste.

    The neurosurgery community is well represented on Twitter. My newsfeed includes public figures such as @drsanjaygupta and @RealBenCarson. It includes professional societies such as @CNS_Update, @AANSNeuro, and @youngneuros. I have come to enjoy updates on emerging research publications from peer-reviewed journals such as @NeurosurgeryCNS and @thejns, as well as from online blogs such as @neurosurgery and @neurocirurgiabr. Most importantly, perhaps, I use Twitter to interact with dozens of neurosurgery friends, peers, and mentors around the globe.

    A beautiful aspect of social media is that it democratizes the sharing of information. Every user is free to serve as their own publisher, sharing their thoughts with the world—whether in the form of text, multimedia, or simply the act of retweeting an item of interest. Some believe that medical specialists have a responsibility not simply to practice, but also to share their voice of knowledge with society. Although not every neurosurgeon will choose to accept that mission in the same way, for those of us who do, Twitter can be a convenient tool. A wellcurated presence on social media can help educate oneself and one’s colleagues, lead to more engaged patients, and make thoughtful connections between seemingly disparate ideas. In a recent Wall Street Journal op-ed, Dr. Jeffrey Flier, dean of Harvard Medical School, wrote that he tweets because “it makes every day an adventure.”1

    As a neurosurgery resident, I have used Twitter to record my reflections on surgical training, technological innovation, and medical ethics. Writers have long recognized the therapeutic value of keeping a diary, and social media fulfills this role. Crucially, it has also facilitated countless rewarding interactions with clever and interesting people, many of whom are not neurosurgeons. It is hard to overstate the value of this interdisciplinary learning. At the same time, I have been able to gain a heightened perspective on my own daily work by seeing the viewpoints of other neurosurgeons and neurosurgeons-in-training, including those living thousands of miles away. Since 2013, I have served as a Social Media Ambassador for the Congress of Neurological Surgeons. In this role, I have worked with other neurosurgeons who are active on social media to promote live-tweeting at the CNS Annual Meetings through the sharing of key educational content and personal observations. From 2012 to 2014, I produced a Journal Club podcast for the Neurosurgery journal that used social media to disseminate interviews with leading neurosurgical researchers. It has been an honor to contribute to our professional community in these ways.

    Of course, there are pitfalls to be avoided. When launching an online social media presence, every neurosurgeon must face one key decision: Will your account be professionally oriented only, or will you mix personal and professional content? Professionally oriented accounts are common for organizations, for individuals who are most concerned with marketing their practice, or for those who prefer to keep a separate personal account for friends. Posts tend to be factual and adhere to a narrow range of topics. Mixing professional and personal content often makes for a more engaging online presence, but neurosurgeons should be cautioned to follow the same (or greater) standards of professionalism online as we would offline. This includes avoiding any semblance of violating patient privacy or engaging in unprofessional behavior. Once a controversial post is viewable online, it may be difficult to fully eradicate. Neurosurgeonsin- training ought to be particularly cautious in how they are representing their institutions and should adhere to the ACGME core competency on professionalism. Above all, being an effective social media user requires sound judgment.

    Ultimately, leadership in medicine requires the highest standards of vision and communication. When used properly by neurosurgeons, Twitter can serve as one useful tool for advancing public awareness, advocacy, community building, and education.

    1 Flier, J. Why the dean of Harvard Medical School tweets. The Wall Street Journal. http://blogs.wsj.com/experts/2015/09/29/why-the-dean-of-harvard-medicalschool-tweets/. Published September 29, 2015. Accessed December 15, 2015.

    Please join us in the Twitterverse! Follow us @nateselden and @AmadioMD

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