I settled comfortably into the couch, eyes fixed on Parks and Recreation. Bzz, bzz, my phone went off. “Wow! They really hate you on Twitter, you ‘oncology medical student!’”
I blinked, confused.
“Don’t worry about it. Most of them dislike doctors as a rule anyway and make jokes at our expense.”
A few moments later, I plunged into the Twittersphere to survey the damage. An hour later I emerged with an increasing sense of anxiety, horror (and a desperate amusement).
I am a child of the millennium. I have always loved social media – from MSN Messenger in high school, MySpace in university to the inevitable Facebook account. I embraced the ‘sharing’ culture of the internet and have always been ‘that friend’ who checked the group into a fun venue on a night out, uploaded the photos of weddings and birthdays first and shared my thoughts – from inane to deep – via Facebook.
Twitter was a natural progression. I discovered a new way of networking with oncologists and trainees, following conference hashtags and staying up to date with the latest oncology research. I laughed at the Game of Thrones instant reactions and found myself enthralled with the twit-storm of American politics. Twitter kept me at the cutting edge of events and helped me learn through witty bite-sized posts.
It started with an innocent medical journal article shared by a doctor. A prospective cohort study suggested that although rates of obstetric intervention was similar between groups (one with a birth plan, the other without), those with birth plans reported that they were less satisfied with their birth experience.
Without thinking, I replied with a well-known joke about Caesarean sections and birth plans. A few doctors replied in a similar vein. A lone responder piped up “this is all very anti-woman” to which we explained – of course we don’t take those jokes seriously! We simply agreed that creating a plan for something inherently unpredictable and dangerous (i.e. birth) sets women up for disappointment – which was borne out through the literature.
The end, I thought.
Not even close.
The texts alerted me to the fact that the Tweets had been discovered by a group of natural birth advocates (many of whom were based overseas). A few Retweets later and the mob had assembled. Screenshots of the offending Tweets were taken and shared on a Facebook page. Someone had gone to the effort of looking up my LinkedIn profile (with a different name to my Twitter account) and had added my place of employment to the original Facebook post with calls for AHPRA to review my registration. A hashtag was created. Enquiries were being made by a reporter from a popular website. And my head of department had called me in for a chat, because someone had contacted the CEO of my hospital to inform them that I needed to be disciplined for my comments online.
I deleted the comments, my LinkedIn and Twitter accounts and deactivated Facebook.
My head of department could not have been more supportive as she informed me of the events – she referred me to the hospital’s media director for advice and reassured me that this in no way impacted on my position at work. My medical defence organisation reassured me this was highly unlikely to result in a legitimate complaint to the Health Care Complaints Commission but that they would continue to monitor the situation.
The fracas slowly petered out over the coming weeks but the damage had been done. The internet lynch mob had been unleashed and I would never forget the anxiety and fear involved with being the target of a trolling campaign.
The moral of the story, to quote Mad-Eye Moody, is “CONSTANT VIGILANCE!” Remember all posts are public, especially on a forum like Twitter. Certain topics – such as vaccination and birth – are highly emotive and controversial in such an arena. Do not, and I repeat, do NOT Tweet anything that could possibly be misconstrued. Got a bad taste joke your friends might like? Text it to them. Thinking of a witty comeback? Write it out, then consider what you would like your future employers, colleagues and patients to see. Then press delete.
As a long-time debater, I know all too well the feeling of going out to bat for a cause you believe in (such as vaccination or fighting against chiropractic) – but be honest, when was the last time you saw anyone change their minds because of a Tweet? Think about whether the consequences of being trolled and doxed are really worth having your two cents. An article recently published in the Washington Post (1) outlined the barrage of online abuse experienced by a paediatric clinic that had the audacity to recommend vaccination on its Facebook page. While this is of course reprehensible (and thankfully Facebook has decided to take anti-vaxxers to task), the stress of being at the centre of a twit-storm may override the benefits of saying your piece.
My strong suggestion is that if you are using any form of social media for work purposes (such as following conference hashtags or sharing medical news) – keep it professional and positive. Remember your comments are public.
If you truly must use social media for recreational purposes in order to engage in controversial debates – I would strongly suggest you use a pseudonym and ensure there is no link between your professional life and your online escapades.
The AMA (2) and Avant have prepared helpful guidelines when dealing with social media which also cover important ground such as:
Social media is a brave new world, and as Jacinda Ardern eloquently put it, can be used powerfully for good as well as evil. It is wonderful to learn from conferences, network with colleagues and support one another – but it is also fraught with danger and filled with trolls. Learn from my mistake and keep your boundaries tight!