Darcy E. Broughton, M.D. (a), Serena H. Chen, M.D. (b), Natalie M. Crawford, M.D., M.S.C.R. (c), Eve C. Feinberg, M.D. (d), Eric J. Forman, M.D., H.C.L.D. (e), Natalia Grindler, M.D. (f), Amanda Kallen, M.D. (g), Rashmi Kudesia, M.D., M.Sc. (h), Candice O’Hern Perfetto, M.D. (i), Lora K. Shahine, M.D. (a), Mark Trolice, M.D. (j), and Kenan R. Omurtag, M.D. (k)
(a) Pacific Northwest Fertility and IVF Specialists, Seattle, Washington
(b) IRMS Institute for Reproductive Medicine and Science at Saint Barnabas, Livingston, New Jersey
(c) Aspire Fertility, Austin, Texas
(d) Northwestern University, Chicago, Illinois
(e) Columbia University Fertility Center, New York, New York
(f) Conceptions, Reproductive Associates of Colorado, Denver, Colorado
(g) Yale Fertility Center, New Haven, Connecticut
(h) CCRM Houston, Houston, Texas
(i) Center of Reproductive Medicine, Houston, Texas
(j) Fertility CARE: The IVF Center, Winter Park, Florida
(k) Fertility and Reproductive Medicine Center at Washington University in St. Louis, St. Louis Missouri
Darcy E. Broughton, M.D.: @Debrough27 (IG)
Serena H. Chen, M.D.: @drserenahchen (IG)
Natalie M. Crawford, M.D., M.S.C.R.: @nataliecrawfordmd (IG)
Eve C. Feinberg, M.D.: @drevefeinberg (TW)
Eric J. Forman, M.D., H.C.L.D.: @ericformanmd (IG)
Natalia Grindler, M.D.: @nataliagrindler_md (IG)
Amanda Kallen, M.D.: @AmanadaKallen (TW)
Rashmi Kudesia, M.D., M.Sc.: @rkudesia (IG)
Candice O’Hern Perfetto, M.D.: @infertilitydrperfetto (IG)
Lora K. Shahine, M.D.: @drlorashahine (IG)
Mark Trolice, M.D.: @drmarktrolice (TW)
Kenan R. Omurtag, M.D.: @drkenanomurtagmd (IG)
IG = Instagram, TW = Twitter.
The online fertility community is a robust and growing sphere of influence (1-3). The community is comprised of patients and providers, including physicians, nurses, embryologists, private and academic fertility practices, third party agencies who provide donor egg and surrogacy services, mental health practitioners, acupuncturists, and many special interest groups. Social media provides a “virtual billboard” (personal communication Peter Klasky 5/5/2019) from which one can disseminate information, increase visibility, and connect with others. Fertility medicine is ideally suited for exploration into this realm as there is a predominance of digitally literate female patients under the age of 45 (1-3).
The fertility community has embraced social media as a place to connect and provide support for one another. The types of support range from educational to social/emotional. Some ambitious professionals provide regular online educational content through blogs, white papers, videos, and podcasts. As a result, several “social media influencers” (SMIs) have emerged. This elite status of SMI was first defined in 2011 as “a new type of independent third-party endorser(s) who shape audience attitudes through blogs, tweets, and the use of other social media” (4). SMIs have established credibility in their specific industry and have tens of thousands of followers. The surge in SMIs appropriately coincides with the public’s use of social media as it is estimated that people access their social media accounts 17 times per day (5, 6). Instagram (IG) has emerged as the leading social media app for brand engagement and is the second largest social network in the world (2), hence why many fertility SMIs have consolidated around the platform.
The emergence of influencers has created a new question: will the next generation of reproductive endocrinology and infertility (REI) physicians be expected to create and maintain a social media presence as a means of differentiation, outreach and marketing? Particularly as emerging data suggests that professional physician social media use may be associated with better online reviews and fewer visible negative comments by adjusting search position (7, 8).
In order to understand the impact of social media on the patient-physician relationship, we interviewed several key SMIs who have invested in a professional presence on social media The SMIs maintain a robust online presence and invest a considerable amount of time and effort in addition to their clinical practice. We sought to understand more about these SMIs and to describe their strategies and motivations.
This article is Part 1 of a two-part series that provides a window into how physicians in our profession are using social media to influence, inform, and craft both professional and personal narratives within the fertility community. Part 1 focuses on the influencers themselves. Part 2 focuses on elements of best practices. An upcoming American Society for Reproductive Medicine Practice Committee opinion on social media use will provide a compliment to this work.
Explain your motivation to create and maintain a personal professional social media presence
These influencers express a desire to connect with patients and guide the narrative surrounding infertility and even more broadly women’s health. Some endorse an ability to give patients a sense of who they are as a provider to help them compete.
"My motivation is that I think the existing infrastructure around women’s health is
insufficient. Women come to us every day completely oblivious to age-based
decline in natural fertility and the basics of procreation…I try to use my social media presence to help women feel some level of control over their reproductive lives, and to me that starts by being informed." @rkudesia (IG)
“I wanted to create a safe space for a patient/couple to sit down to read about different diagnosis, treatments and possible outcomes. They can use my account to clarify general infertility, TTC or pregnancy questions that they may have. There is an incredibly high amount of nonsense out there. “Medical” posts that are NOT supported by research, nor are they the standard of care. I started and now maintain my [INSTAGRAM] IG account to share evidence based fertility education, which patients and other practitioners repeatedly remind me is incredibly helpful and valuable.” @infertilitydrperfetto (IG)
“I wanted people to know that I am more than just their doctor. I am a father, a husband and a person trying to do their best every day and serve those under my care. I created it to be a place to share, help and connect with people around the world, as well as provide a “voice” for content the practice may not share.” @drmarktrolice (TW)
How do you respond to the criticism that your social media presence is self-promotion?
Respondents acknowledged their desire to expand their reach to a broader audience, but most identify goals beyond advertising or marketing. Furthermore, there appears to be an emerging impression that the “millennial” generation coming into the fertility services market, at the minimum, will come into contact with fertility messaging and information through social media channels. Social media is just the next iteration of “having a clinic website.”
“…The potential patient can get to know you a little from your content. My patients often tell me that my social media content helped them to feel a more comfortable about taking the step to come in to get advice about sensitive issues like infertility.” @drserenahchen (IG)
"The reality is that patients do have to choose an REI, and wanting to find someone who
will be transparent, explain treatment plans and not be overly aggressive is a goal for
many. I feel that conveying my vibe to patients ahead of time is helpful for them to
feel comfortable choosing to see me, and in actual clinical encounters as well." @rkudesia (IG)
“A presence on social media humanizes me as a physician and allows me to connect with patients and share information and support. I think patients, especially younger, more connected patients, expect a certain accessibility and social media presence from their physicians.” @AmanadaKallen (TW)
“…we also post “behind the scenes” photos and videos so followers can ask questions and get answers; as well as see what our office culture is like, ultimately letting them know we’re a team of like-minded medical professionals that have come together to help patients achieve their goals.” @drmarktrolice (TW)
“Our current patient populations wants to know more about the physicians treating them, particularly with millennials.” @nataliagrindler_md (IG)
What are the benefits of maintaining an active social media presence?
Many respondents identified a connection with the larger fertility community as a benefit. Providers find it rewarding to get positive feedback in this forum. It also allows them to stay abreast of current topics and trends beyond their practice walls.
“Patients and colleagues can always find me. I have had new patients find me because of social media.” @ericformanmd (IG)
“I connect with other professionals and patients and have deepened relationships through outreach.” @drevefeinberg (TW)
“It helps me get a quick snapshot of what is going on in the fertility community both from the patient and physician side.” @drkenanomurtagmd (IG)
Estimate the percentage of your new patients that are self-referrals from following you on social media
Some influencers did not have a sense of how many referrals were related to social media. The remainder estimated a huge range - from 1% to 40%. Some did note that their social media presence augmented their self-referral rate.
Estimate the number of individuals and/or organizations related to fertility that you follow on social media
Most influencers endorse following as many REI physicians as possible. Many also follow fertility advocates in the larger community. There were a few REIs that were identified by the majority of respondents as doing an exceptional job, this correlated closely with those that have a large number of followers on social media. Some providers choose not to follow their own patients.
“I currently follow around 400 accounts, about 50% are fertility specific. I try and follow a mix of MDs, NPs, RNs, counselors, #infertilitywarriors and other educators. I have chosen not to follow any of my own patients.” @infertilitydrperfetto (IG)
“I follow many infertility related organizations and individuals struggling with infertility because they inspire others, promote awareness and create community.” @nataliecrawfordmd (IG)
How many hours per week do you spend researching, composing and responding to your posts?
There was a huge amount of variation in how much time is spent on posts, from less than an hour per week to up to 10 hours per week. Some use that time to plan content in advance.
“It varies a lot. I do not spend a lot of time on research but do spend about 15-30 min a day on most days thinking about and composing relevant content. Most of my content is about the things I talk about with patients every day in my practice…” @drserenahchen (IG)
“Time spent on posting (researching, creating, engaging) will vary based on the week or the number of posts, but on average 5-10 hours per week. Most posts are planned out for certain days, but some are spontaneous. Research varies based on the nature of the post, sometimes summarizing articles, but more often dispensing textbook level medical knowledge in a simpler format. Other posts which are personal or opinion based and require no research.” @nataliecrawfordmd (IG)
Do you also manage your clinic’s social media platforms?
The majority of respondents do not manage their clinic’s platforms, at least anymore do to the time requirement and in most cases, the desire to focus on their own messaging. However, clinics often repost or modify their material with permission.
“For years I have done the social media posts for my practice but felt like I had more to say. Having my own account, I can be more personal without reflecting on the brand of the practice. I do a lot outside of work including writing a blog, authoring books, speaking engagements – posting all of this to my practice page would look unbalanced.” @drlorashahine (IG)
“We work with a team of marketing pros to manage the clinic’s social media platforms. Advantages include their content creation, scheduling, responsiveness to patients, reputation management software to monitor and enhance our directory scores and their extensive list of tools. As a client, we are plugged into their software partnerships, reporting and analytic tools we would otherwise have to pay for and train someone to use and monitor. It’s a great relief knowing they will take care of the heavy lifting, listen, engage, and tweak as needed.” @drmarktrolice (TW)
I still brainstorm and create content as well as admin our division’s Facebook and Instagram accounts. We do have an OBGYN department employee that assists but I still enjoy the creative process and being an admin allows me the freedom to express that.” @drkenanomurtagmd (IG)
“I used to. I do not anymore, because the time commitment was too great. It’s something I would like to do, because I feel I can do it well - but no time.” @AmanadaKallen (TW)
“I did for a little while but the clinic’s needs are more regimented, need to be more vanilla and therefore is much less fun to manage than my own platform, so I now leave that to the marketing agency. When they come up w/ good content I repost and of course they repost my content as appropriate.” @drserenahchen (IG)
How do you measure the return on investment of your social media presence?
Most seem to have subjective measures of the benefit of social media involvement, primarily adding satisfaction to their professional lives.
“How I feel about it. If I ever don’t enjoy it – I’ll stop.” @drlorashahine (IG)
“If I like it and it makes me happy, I keep doing it. If I’m feeling burned out, I step back.” @AmanadaKallen (TW)
Has your involvement in social media helped you to network with other reproductive endocrinologists?
The response to this question was universally positive- this is a main benefit of social media for many REIs.
“Yes, I have gotten to know some of my colleagues better through their posts, both personally and professionally.” @drevefeinberg (TW)
“100%. I have found co-authors for publications this way as well as personal communications for advice.” @nataliagrindler_md (IG)
“Yes, I have received personal messages with clinical questions and referrals” @ericformanmd (IG)
“Yes. One of the biggest benefits of this platform has been connecting with others in our field. Instagram “friends” have turned into real friends, colleagues and collaborators. I have sought personal and professional advice, organized gatherings, and been offered opportunities I never would have without this platform. Social media as a networking opportunity is incredible.” @nataliecrawfordmd
Does your social media presence make you a better doctor in your mind?
Most responded, “no,” but many think their patients feel the use of social media makes them a better REI.
“This is true in your patient’s mind. I do think it keeps me in touch with what my patients are seeing online and gives me more empathy. It also keeps me up to date with what patients will be asking about when they see me – new diet, new supplement, et cetera.” @drlorashahine (IG)
“I think my new interest in social media has made me a better physician. I honestly feel like I have a better understanding of Eastern medicine, food and fertility/endo/adeno and how important strong counselors and support staff are for patients with infertility. I truly think I am a more sympathetic as well. Patients reach out to me during the most difficult time of their lives and now I am better able to understand what they are going through outside of the clinic walls.” @infertilitydrperfetto (IG)
“Yes on both fronts. It makes me a better doctor because it provides real-time feedback to myself and my team. It also allows me to hear things from patients and participate in their care in a way that wasn’t possible before social media.” @drmarktrolice (TW)
“Social media is a type of language for an entire generation and refusing to engage in this type of communication on the part of many physicians is a kind of cultural incompetence. You do not have to be the one posting, but your practice should have someone who knows how to communicate with social media, so your patients that use social media can access you and access the information you want them to have and understand.” @drserenahchen (IG)
Next month we will learn common practices for curating publishing and engaging with content.
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