“We’re doomed” was the familiar catch phrase of Private Fraser—the dour, Scottish ex-undertaker turned home guardsman from the popular BBC television series Dad’s Army. According to his Wikipedia page, Fraser was also president of his local Caledonian Society but was the only member.
I was reminded of Private Fraser during my daily ritual of perusing the overnight musings of various pharmaceutical and medical device companies on the social media site Twitter. One giant Pharmaceutical company manufacturing cancer drugs tweeted the other day “One-third of estrogen receptor positive #breastcancer patients see their cancer return,” which is probably not the message that anyone just receiving the diagnosis would want to hear. Women with a recent diagnosis of breast cancer have to make difficult enough decisions about the pros and cons of embarking on unpleasant and mutilating therapies without being told that they have a one in three chance of disease recurrence. Presumably due to the 140 character limit imposed by Twitter, the author of the aforementioned tweet was unable to add the additional comment “unless you take our drug.” Astonishingly this is an identical Twitter faux pas to the one committed by a rival company back in the autumn of 2011.
In fact bad news on Twitter and other social media is surprisingly rare when it comes to medical topics. This is in sharp contrast to the traditional approach to news in the British media. Our newspapers and television thrive on bad news stories—the grimmer the message, the more likely the story is to make a headline. Tales about the poor patient care, underperforming hospitals, medical disasters, and dodgy doctors are standard fare and not exclusive to the tabloid press.
In contrast the social media output from the pharmaceutical and medical device companies is invariably upbeat and positive. The same goes for comments from medical charities who, unsurprisingly, want to send the message that their hard-earned cash is being spent to the benefit for their particular section of humanity. The usual format on Twitter consists of a few characters to define the target group e.g. #diabetes #breastcancer with a shortened link to a specific website or recent press release with articles or images favourable to the companies or charities core business.
Social media has the potential to turn the black art of marketing into a science and thus may be valuable as an intervention especially in public health. It is now possible to analyse the impact of social media by tracking how many people are reached by a tweet, how often the original tweet has been resent or replied to as well as how influential the recipients of the tweet are they are in terms of their impact on the thinking of others.
Like Private Fraser, the medical establishment has currently a pessimistic approach to social media and medicine – doubting its value and sowing the seeds of unease despite the phenomenal growth of the genre. Many medics still don’t “do” social media at least for professional purposes (Caledonian Society membership). We now need traditional medical research funding bodies to start funding applications examining use of social media as a “medical” intervention in its own right.
Private Fraser also had the loudest voice of condemnation or criticism for any given situation but if things actually turned out well he instantly altered his position with a hasty “I never doubted you for a second”—research funding bodies take note! The onus now is for resources to be made available to investigate the potential value that social media could have in medicine especially in pursuit of the most elusive goal—population behaviour change.
David Kerr wears many hats, sometimes at the same time—diabetologist, editor of Diabetes Digest, researcher, and founder of VoyageMD.com, a free service for travellers with diabetes and Mylyfe.me a service for women surviving breast cancer. He also believes that social media has the potential to be of huge benefit in improving medical care and practice. He also holds a small amount of stock in CellNovo (a new insulin pump company) and Axon Telehealth.