Doctors Are Now Becoming Influencers—And Lines Are Becoming Blurred

Doctors Are Now Becoming Influencers—And Lines Are Becoming Blurred

Just before the pandemic, ob-gyn Heather Irobunda, MD, noticed an odd trend in her New York City clinic. “I was seeing a lot of patients talking about how they heard something about how to take care of their vaginas from Instagram,” she says. And it wasn’t just vaginas they were talking about. Irobunda says women would come in spouting misinformation about pregnancy or specific medical conditions after following social media influencers. She quickly realized professional action needed to be taken.

As a pandemic project, Irobunda started a blog and created Instagram and TikTok accounts and now, two years after embarking on that project, has more than 100,000 followers across both platforms and hosts a podcast called Dr. Heather’s Advisory Cervix. Irobunda is just one example of a uniquely current phenomenon that has improved access to accurate medical information but also resulted in the dissemination of dangerously erroneous health claims: meet the medical influencer.

As journalist and author Jo Piazza says on her podcast, Under the Influence, “Everywhere we go, there’s an influencer for that.” She was prompted to explore the medical facet of this in an episode when, stuck in the hospital for a week following her son’s concussion, she noticed off-duty nurses constantly consuming nurse influencer content on their phones.

“​​One of the most shocking things I learned is that medical providers are now looking to find out what information people are getting on fertility and chronic diseases, and they’re using that to figure out new ways to talk to their patients and improve their bedside manner,” Piazza says. “But there are also those putting out misinformation about vaccines, COVID, autism, different kinds of diets—and the general public trusts them. That’s what creates such murky territory on social media.”

Here’s the thing about the medical influencer landscape: There are very few official checks and balances to ensure that: (1) the information shared is medically accurate, and (2) the sharer is, in fact, a licensed professional. While the American Medical Association has dedicated a specific section of its code of ethics to “professionalism in the use of social media,” these best-practice tools are not hard-and-fast rules. As for the social platforms themselves, regulations are even more opaque.

“As we saw with the pandemic, there are doctor or nurse influencers with big platforms sharing messages they may have received from literally one class during medical training.” —Dr. Heather Irobunda

“It’s the Wild, Wild West—anyone can say anything they want to. And that is incredibly dangerous,” Piazza says. “If the FCC is regulating television and radio, then there has to be somebody regulating what is said on social media if that is going to be a primary news source for the majority of people in this country.”

Facebook (which owns Instagram) has a single set of Community Standards governing what users can and can’t post, including a section on misinformation, stating the company will remove false content “likely to directly contribute to the risk of imminent physical harm.” TikTok has a similar set of guidelines stipulating the removal of medical misinformation. But the process for flagging, documenting, and removing this content isn’t perfect, and plenty of dangerously inaccurate claims are still floating freely in the social media ether—even from licensed professionals.

The abundance of false medical claims permeating social media is in part what inspired Irobunda to throw her hat in the ring as a specific-subject expert. “As we saw with the pandemic, there are doctor or nurse influencers with big platforms sharing messages they may have received from literally one class during medical training,” she says. “It also highlights the fact that we don’t necessarily do a good job helping people figure out what’s good information and what’s not.”

While this essential free-for-all of opinions can have consequences, Irobunda also sees the upside of this evolving frontier in influencing. “If there wasn’t democratization of how we get medical information, I wouldn’t be having this conversation with you,” she says. “I’m not on TV, I’m not classically trained to be a medical media specialist who does segments on local news about diabetes and hypertension—I probably wouldn’t have done that or chosen to do that. It’s allowed us to reach people in a different way, which is really cool.”

Celebrity doctors aren’t necessarily novel—Drs. Oz, Ruth, Phil, and Weil all come to mind. But the modern medical influencer isn’t confined to the limitations of TV, radio, or print. They’ve built their following on platforms like Instagram and TikTok, communicating directly with followers and taking full control of their content and messaging.

One early example of this new generation of medical influencers is Mikhail “Mike” Varshavski, DO, whose Instagram account went viral after BuzzFeed picked it up in 2015 and People named him the Sexiest Doctor Alive later that year. He now has over 44 million followers across Instagram, TikTok, YouTube, Twitter, and Facebook.

“There are pros and cons to this digital world, sure,” Dr. Varshavski says. “One of the positives is that people have access to a wide variety of resources. A patient with what might be defined as a ‘rare’ medical condition can join a social media group where the condition is shared by many members. This can build support structures they might find elusive in their own families or localities and help them manage a certain condition, cope, or even communicate better with their doctor.”

“I feel that physicians should be more in the media because we actually know what people need.” —Dr. Drew Pinsky

While providing science-based facts to the public is a benevolent service, it doesn’t make medical influencers impervious to cancel culture or backlash. In late 2020, Dr. Varshavski was on the receiving end of internet outrage sparked by his maskless birthday party that took place during the height of COVID. According to the New York Post, one Redditor wrote to the doctor, “I know it’s your life and you can do what you want, but you have chosen to be a public figure. And because of that, and your profession, you are held to a higher standard. You are supposed to be the example. I admired and respected you. Now that is all lost.”

Dr. Varshavski is following in the footsteps of medical influencers who gained fame from traditional media outlets and translated it to today’s social media platforms. Drew Pinsky, MD, got his start on the popular call-in radio program Loveline and went on to spearhead several reality show projects and author numerous books. Along the way, he amassed more than 3 million followers. Like Dr. Varshavski, “Dr. Drew” sees value in the abundance of licensed medical professionals in the spotlight.

“I feel that physicians should be more in the media because we actually know what people need,” Dr. Pinsky says. “Physicians have to be more out there…so long as they don’t quit their day jobs. If you’re not having a broad, profound, deep experience in the practice of medicine, I’m not sure you should be in the public eye so much.”

The problem is, social media in and of itself can be a full-time job. Shilpi Agarwal, MD, started using social media in 2012 to share wellness tips but has ramped up content production to keep pace with other influencers. “I found it tough to be as active as many other physicians who post multiple times per day and endorse products,” she says. “I never want social media to be a chore—only a fun way to connect with my audience and friends.”

Juggling the frenetic pace of the algorithm and the news cycle with real-life responsibilities means that even licensed, reputable medical professionals can get things wrong. When Dr. Pinsky made comments downplaying the severity of COVID in April 2020, he faced intense backlash and subsequently issued a lengthy apology. “I got some things wrong,” he says. “I have no problem correcting course—in fact, that’s how medicine works.” Did the pressure of keeping up with the immediacy of social media impact his decision to speak out prematurely? “Yeah, 100%,” he says.

“We can’t be there to individualize advice for every person, and even more importantly, we can’t follow up with somebody and make sure that the advice wasn’t misconstrued or caused harm.” —Dr. Ellen Vora

It’s impossible to ignore the other enticing elephant in the room: money. From brand deals and product endorsements to self-promotional posts that eliminate the need for a PR team, doctors are now able to use Instagram, YouTube, and TikTok, to sell their own books, speaking engagements, and podcasts. And that’s not even touching the controversial land of supplements, which—as Dr. Oz fans discovered in 2014—may not always be reliable or safe, even if they’re endorsed by a medical professional.

While many doctors who advertise products will abide by the unofficial influencer rule of labeling those posts with the hashtag #ad, the practice is just that: unofficial. While the Federal Trade Commission encourages transparency about advertisements and endorsements, the decision to divulge details about compensation is ultimately up to the influencer. And according to one examination of hundreds of social media accounts, “health care professionals virtually never note their conflicts of interest, some of them significant.”

This lack of transparency can extend to innocuous content like TikTok videos regarding skin exfoliation which can lead to adverse effects. As we know from television and radio ads that are regulated, individual results may vary.

“We can’t be there to individualize advice for every person, and even more importantly, we can’t follow up with somebody and make sure that the advice wasn't misconstrued or caused harm,” says psychiatrist and author Ellen Vora, MD. “I don’t think it’s ethical for doctors to comment on people in the public sphere. That’s unfair. I don’t think we can truly diagnose anybody that’s not our patient.”

Dr. Varshavski encourages followers to seek out personalized information. “I always make it clear to my viewers: Talk to your doctor, because my presence on social media is to help spur those discussions,” he says.

On Dr. Varshavski's YouTube homepage, he includes an overarching disclaimer stating that the information presented “is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment.” He is one of the few medical influencers to include such a disclaimer on his channel. It's time others followed suit.

“These days, you can’t get in touch with your doctor unless you make 50 phone calls and send 30 encrypted emails,” says Piazza. “Medical influencers are so accessible. You feel a closer bond to them, and you can develop parasocial relationships through their social media accounts—that can be incredibly dangerous when you’re treading this line.”

Originally Appeared on Glamour