Social media use by physicians: a qualitative study of the new frontier of medicine

Probably not a substantial claim: may not pass S3 (load-bearing).

Most participants were pediatricians (76%).

“In terms of specialty, most of the participants were pediatricians (76 %) (Table 1).”

May combine two claims.

Participants expressed disparate views regarding the time involved in participating in social media; some felt that time spent on social media was unproblematic to fit into their day while others felt that it was an impediment to patient care.

“Finally, participants expressed disparate views regarding the time involved in participating in social media; some felt that time spent on social media was unproblematic to fit into their day while others felt that it was an impediment to patient care.”

May combine two claims.

Participants perceived barriers to patient engagement in social media including language barriers, poor literacy/education, lack of internet access, and worries about lack of online privacy.

“Participants also perceived several barriers to patient engagement in social media, including language barriers, poor literacy/education, lack of internet access and worries about the lack of online privacy.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Around one third of participants were compensated for at least some of their work on social media.

“Around one third of participants were compensated for at least some of their work on social media (Table 1).”

Probably not a substantial claim: may not pass S3 (load-bearing).

Five participants also engaged in traditional media such as radio, newspaper columns and magazines.

“Five of the participants also engaged in traditional media such as radio, newspaper columns and magazines (Fig. 1).”

Probably not a substantial claim: may not pass S3 (load-bearing).

Seventeen physicians participated in this study.

“Seventeen physicians participated in this study, including 35 % females, 76 % pediatricians and 76 % bloggers.”

• Also stated in: § Participants · plain

  “Seventeen physicians participated in this study, only one blogger responded and declined participation.”

May combine two claims.

While participants were conscious of their role as physicians online and the responsibility of the information they promulgated, the majority still described their social media page as a personal platform.

“While participants were conscious of their role as physicians online and the responsibility of the information that they promulgated, the majority still described their social media page as a personal platform.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The majority of participants had been in practice for eleven to twenty years (41%).

“Only one of the participants had practiced medicine for less than five years, with the majority (41 %) having been in practice for eleven to twenty years (Table 1).”

May combine two claims.

Perceived benefits of social media use included forwarding career or research endeavors, self-improvement through reading others' tweets and keeping up with the literature, increasing reach, and providing a space to openly express opinions.

“The perceived benefits of their social media use included forwarding their career or research endeavors, self-improvement through reading others’ tweets and keeping up with the literature, increasing their reach, i.e., their audience, and providing a space for them to openly express their opinions.”

May combine two claims.

Almost all participants engaged with multiple social media platforms, including Twitter (10), Facebook (7), Pinterest (3), YouTube (2), Tumblr (2), and freestanding blogs (13).

“Almost all of the participants engaged with multiple social media platforms, including Twitter (10), Facebook (7), Pinterest (3), YouTube (2) and Tumblr (2) as well as freestanding Blogs (13) (Fig. 1).”

May combine two claims.

Participants identified mutual benefits for patients and providers including increasing communication options and speed of communication and breaking down traditional professional barriers.

“These included increasing communication options and the speed of communication as well as breaking down traditional professional barriers.”

May combine two claims.

The majority of participants had been involved in traditional media or communications prior to engaging with social media and enjoyed interacting in this new sphere personally as well as professionally.

“The majority of participants had been involved in traditional media or communications prior to engaging with social media and enjoyed interacting in this new sphere personally as well as professionally.”

May combine two claims.

The majority of participants spent three to six hours per week working on social media platforms, while a few spent less than two or greater than ten hours per week.

“Although the majority of participants spent three to six hours per week working on social media platforms, a few spent less than two or greater than ten hours per week on social media (Fig. 2).”

Classified as probably not a substantial claim. May combine two claims.

Participants perceived patient benefits of social media for health information including increased access to an accurate, trusted and understandable source of health information, general accessibility, and a way for patients to engage with providers outside the office.

“They perceived that patient benefits may include having increased access to an accurate, trusted and understandable source of health information, that social media is accessible in general and that it provides a way for patients to engage with providers outside the office.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Of the seventeen participants, the majority were male (65%) and Caucasian (82%).

“Of the seventeen participants, the majority were male (65 %) and Caucasian (82 %) (Table 1).”

May combine two claims.

Participants identified barriers to social media participation including time/work requirements, skill requirements, lack of institutional support, fear of saying the wrong thing online, and lack of models/guidelines.

“Examples of these included the time/work requirements, skill requirements, lack of institutional support, fear of saying the wrong thing online and lack of models/guidelines in how to conduct themselves online in their role as physicians.”

Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing).

Others believed that social media use decreased efficiency by distracting providers from direct patient care.

“others believed that it decreased efficiency by distracting providers from direct patient care.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Several physicians discussed that the amplification effect was the reason more physicians need to add their voice to social media, especially to counter vaccine misinformation.

“Several physicians discussed how this amplifying effect was exactly the reason why more physicians need to add their voice to social media, especially in terms of countering vaccine misinformation.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Participants debated whether using social media for health promotion improved or decreased efficiency in the office.

“Participants also debated whether using social media for health promotion improved or decreased efficiency in the office.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Some participants insisted that more physicians should be involved in social media.

“While some participants were insistent that more physicians should be involved, most were equivocal, stating that physicians should only participate if they feel they would enjoy it and are equipped to do so.”

Classified as probably not a substantial claim.

Participants voiced that they generally felt their audiences were most likely middle-upper class Caucasian readers.

“Participants voiced that they generally felt that their audiences were most likely middle-upper class Caucasian readers.”

May combine two claims.

Many physicians concluded that the time and effort required to establish a partnership was too great a barrier and that they would rather continue alone.

“Many of these physicians concluded that the time and effort required establishing a partnership was too great of a barrier and that they would rather continue alone.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Several participants felt they were 'digital immigrants.'

“Several participants felt that they were “digital immigrants,””

May combine two claims.

Participant responses suggested that they felt unaware of who was listening or what their audience was saying.

“However, participant responses suggested that they felt unaware of who was listening or what their audience was saying.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Most participants were equivocal, stating that physicians should only participate in social media if they feel they would enjoy it and are equipped to do so.

“While some participants were insistent that more physicians should be involved, most were equivocal, stating that physicians should only participate if they feel they would enjoy it and are equipped to do so.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Other participants felt their time spent on social media could easily fit into downtime at meetings or 15 minutes before bed.

“Conversely, other participants felt that their time spent on social media could easily fit into downtime at meetings or 15 min before bed”

May combine two claims.

While participants were recognized as forerunners in the field, many still underutilized the full power of social media tools.

“Finally, our third theme illustrated that while our participants were recognized as forerunners in the field, many of them still underutilized the full power of social media tools.”

• AssumptionRests on an assumption: Social media allows participants to listen as well as communicate back, unlike traditional media which is one-directional.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

A few physicians noted anecdotally that patients would mention topics they had posted about online, but they had no data on behavior change.

“A few physicians noted anecdotally that patients would mention topics that they had posted about online; however, they had no data on behavior change”

Probably not a substantial claim: may not pass S3 (load-bearing).

Several participants felt that the 21st century conception of time was one of the most pressing reasons for physicians to expand into social media.

“Several participants felt that this was one of the most pressing reasons for physicians to expand into the realm of social media”

Probably not a substantial claim: may not pass S3 (load-bearing).

Participants debated whether time spent on social media was feasible.

“Our participants described numerous benefits and downsides of using social media, viewed themselves as pioneers in the field facing much uncertainty, and debated whether time spent on social media was feasible.”

May combine two claims.

Participants expressed disparate views regarding the concept of time; some felt time spent on social media was insignificant and easy to fit into their day while others felt it was an impediment.

“Finally, participants expressed disparate views regarding the concept of time; some felt that time spent on social media was insignificant and easy to fit into their day while others felt that it was an impediment.”

Classified as probably not a substantial claim.

Time was discussed in terms of a '21st century conception of time,' where clinical conversations, questions and updates happen immediately, not only in a 15-minute office visit.

“Time was also discussed in terms of the “21st century conception of time,” where clinical conversations, questions and updates happen immediately, not only in a 15 min office visit.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Participants expressed uncertainty about whether it is the duty/obligation of all physicians to provide health information on social media.

“Finally, participants expressed uncertainty around the issue of whether or not it is the duty/ obligation of all physicians to provide health information on this new accessible medium.”

May combine two claims.

Two physicians working primarily in low-resource settings were less enamored with social media's prospects of reaching their patient populations or the idea that every physician should be involved.

“Two physicians who reported primarily working in low-resource settings, such as with Medicaid patients, were both less enamored with its prospects of reaching their patient populations, or the idea that every physician should be involved in social media.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Time was a thematic element that diffused itself through every part of every interview.

“Time was a thematic element which seemed to diffuse itself through every part of every interview.”

Classified as probably not a substantial claim.

Participants viewed social media as a powerful tool for reaching patients with important medical information, especially public health messages.

“Participants viewed it as a powerful tool for reaching patients with important medical information, especially messages concerning public health.”

May combine two claims.

Participants expressed that institutional backing was lukewarm at best and that their organization had other priorities.

“Participants expressed how “institutional backing is lukewarm at best” and how, “apparently, according to our organization, we have other priorities.””

May combine two claims.

Most physicians were able to track how many hits they had on their site and where the hits were from geographically.

“Although most physicians were able to track how many hits they had on their site and where the hits were from geographically, where a “hit” is a click on a page, they could only guess at the demographics of their followers and responders.”

Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing).

Some physicians postulated that their posts on social media may increase clinic efficiency by decreasing unnecessary patient calls and visits.

“While some physicians postulated that their posts on social media may increase clinic efficiency by decreasing unnecessary patient calls and visits”

May combine two claims.

The study identified multiple perceived benefits and barriers for both physicians who create content and readers who consume this content, as well as several themes.

“In this study of social media use by physicians, we identified multiple perceived benefits and barriers for both physicians who create content and readers who consume this content, as well as several themes.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Participants defended their views on whether time spent on social media was a serious impediment versus easy to fit into their day.

“Participants adamantly defended their views on whether or not time spent working on social media was a serious impediment versus an easy to fit into their day.”

Probably not a substantial claim: may not pass S3 (load-bearing).

In a 2010 study of 921 health-related blogs, 43% of bloggers were physicians.

“In a 2010 study of 921 health-related blogs, 43 % of bloggers were physicians [20].”

• cites [20] Miller EA, Pole A. Diagnosis blog: checking up on health blogs in the blogosphere. Am J Public Health. 2010;100(8):1514–9. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Physician-bloggers have used social media to share health information, network with colleagues, disseminate research, market their practice and engage in health advocacy.

“Physician-bloggers have used social media to share health information, network with colleagues, disseminate research, market their practice and engage in health advocacy [14].”

• cites [14] Chretien KC, Kind T. Social media and clinical care: ethical, professional, and social implications. Circulation. 2013;127(13):1413–21. sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

In a 2008 study analyzing 271 weblogs written by health professionals, weblogs offered the opportunity to share narratives but also risked revealing confidential patient information or reflecting poorly on the author or profession.

“In one 2008 study which analyzed the content of 271 weblogs written by health professionals, researchers found that weblogs offered the opportunity to share narratives, but also risked revealing confidential patient information or reflecting poorly on the author or profession [21].”

• cites [21] Lagu T, Kaufman EJ, Asch DA, Armstrong K. Content of weblogs written by health professionals. J Gen Intern Med. 2008;23(10):1642–6. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Studies on social media have found that African American internet-users are more likely to use social networking sites than their non-Hispanic Caucasian counterparts and that seven of ten households earning less than ten thousand dollars a year are using the internet.

“However, studies on social media have found that African American internet-users are more likely to use social networking sites than their non-Hispanic Caucasian counterparts and that seven of ten households earning less than ten thousand dollars a year are using the internet [13, 38].”

• cites [13] Chou WY, Hunt YM, Beckjord EB, Moser RP, Hesse BW. Social media use in the United States: implications for health communication. J Med Internet Res. 2009;11(4):e48. sourceNot checked yet

  Not checked in the free run.

• cites [38] Zickuhr K, Smith A. Digital differences. Washington, D.C: Pew Research Center; 2012.Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

Interview questions were revised on the basis of feedback from participants.

“Questions were further revised on the basis of feedback from participants.”

May combine two claims.

Limitations of this study include the small and purposeful study sample, and the predominance of pediatricians in the sample.

“Limitations of this study include the small and purposeful study sample, and the predominance of pediatricians in our sample.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Interviews were transcribed verbatim by the interviewer via hand-typed notes.

“Interviews were transcribed verbatim by the interviewer via hand-typed notes.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Previous studies have found that physicians may be early adopters of other ideas and products, such as pharmaceuticals.

“Previous studies have found that physicians may be early adopters of other ideas and products, such as pharmaceuticals [34].”

• cites [34] Dybdahl T, Andersen M, Sondergaard J, Kragstrup J, Kristiansen IS. Does the early adopter of drugs exist? A population-based study of general practitioners’ prescribing of new drugs. Eur J Clin Pharmacol. 2004;60(9):667–72. sourceNot checked yet

  Not checked in the free run.

Classified as probably not a substantial claim. May combine two claims.

After 17 interviews were completed, investigators reviewed transcripts and noted repetition of benefits and risks and saturation of themes.

“After 17 interviews were completed, investigators reviewed transcripts and noted repetition of benefits and risks and saturation of themes.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Transcripts were first read individually by three investigators to identify key codes and themes.

“Thus, a formal coding was conducted at that time using an iterative process [32], transcripts were first read individually by three investigators to identify key codes and themes.”

• cites [32] Glesne C. Becoming Qualitative Researchers. Hawthorne, NY: Longman Publishers: Reading, MA; 1999.Not checked yet

  Not checked in the free run.

Classified as probably not a substantial claim.

Since the study design was qualitative, causal inference was not the goal.

“Furthermore, since our study design was qualitative in nature, causal inference was not the goal.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Interview questions were developed by study staff and reviewed by several experts in qualitative research.

“Interview questions to meet these objectives were developed by study staff and reviewed by several experts in qualitative research.”

Classified as probably not a substantial claim.

According to participants and general trends, social media is only going to continue to grow its presence within medical care.

“According to our participants and general trends, social media is only going to continue to grow its presence within medical care.”

May combine two claims.

Several medical associations have produced guidelines for social media use among physicians, but few have taken into account the goals and needs of physicians who are engaged in social media.

“While several medical associations have produced guidelines for social media use among physicians, few have taken into account the goals and needs of physicians who are engaged in social media.”

• cites [25] AMA. In: Association AM, editor. AMA policy: professionalism in the use of social media. 2011.Not checked yet

  Not checked in the free run.

• cites [35] AAP. In: Pediatrics AAo, editor. Social media resource kit for AAP chapters. 2010.Not checked yet

  Not checked in the free run.

• cites [36] AAFP. In: Physicians AAoF, editor. Social media for family physicians: guidelines and resources for success. 2013.Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

The idea of the loudspeaker may be an artifact of the fact that many participants had previous experience in traditional broadcast media, marketing or communications.

“The idea of the loudspeaker may be an artifact of the fact that many of our participants had previous experience in traditional broadcast media, marketing or communications.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Snowball sampling is particularly effective in studies of early adopters because there are usually few individuals involved and they are usually the best resource for determining who else is involved in the field.

“This technique is particularly effective in studies of early adopters since there are usually few individuals involved: they are usually the best resource for determining who else is involved in the field.”

Probably not a substantial claim: may not pass S3 (load-bearing).

A preliminary evaluation of transcripts was completed after ten interviews.

“First, a preliminary evaluation of transcripts was completed after ten interviews.”

Probably not a substantial claim: may not pass S3 (load-bearing).

As the first generation of physicians using social media, it may not be surprising that these participants value their independence, ability to make autonomous decisions and importance in the field.

“As the first generation of physicians using social media, it may not be surprising that these participants value their independence, ability to make autonomous decisions and importance in the field.”

Classified as probably not a substantial claim.

Transcripts were re-assessed and investigators deliberated until consensus was reached on the common themes and concepts expressed by participants using the constant comparative method.

“Transcripts were then re-assessed and the investigators deliberated until consensus was reached on the common themes and concepts expressed by participants using the constant comparative method [28].”

• cites [28] Glaser BG, Strauss AL, Strutzel E. The discovery of grounded theory; Strategies for qualitative research. Hawthorne: Aldine Transaction; 1967.Not checked yet

  Not checked in the free run.

Classified as probably not a substantial claim.

Interviews encourage open information exchange and targeted follow-up questions.

“Interviews were selected as the primary method of data collection because this approach encourages open information exchange and targeted follow-up questions.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The study did not include longitudinal assessments, so it did not assess whether participants' usage or attitudes changed over the study period.

“We did not include longitudinal assessments in this study thus we did not assess whether participants’ usage or attitudes changed over the study period.”

Probably not a substantial claim: may not pass S4 (based).

This study is the first to evaluate physicians' perceptions, goals and challenges in using social media.

“Our study is the first to evaluate physicians’ perceptions, goals and challenges in using social media.”