Abstract
There are many reasons to rejoice in our Health Service: our capitalist country has demonstrated socialist tendencies and the NHS, despite its difficulties, remains (as Churchill might have put it) as the least worst option. As the modern world goes on around it, our army of NHS workers incorporates all aspects of modern life to inform and enhance their working lives.
Nowhere is this so obvious as with Twitter (or as the BBC insists on coyly putting it ‘Social media’). Here are the things to love and hate about Twitter (sometimes simultaneously)
Everyone has their Twitter account: For trainees, the Twitter account offers combined chances to discuss work issues and enhance learning and training. Older lags will use it largely for work, with occasional pictures of the latest cake baked. Setting up the account should be done with care; followers should be chosen to provide a spread of the personal and professional. Overdo the formal journal-based accounts and you’ll look like a dry nerd; focus too much on the idle transfer speculation of the football sites and you look like a lightweight; indulge too many of your fellow Prosecco-drinking mums and it might look a bit twee. Be sure and provide a mix of the national, international, and regional causes and personalities to avoid looking too parochial. In short, imagine that you would be taken to a room with all the people you follow; if this would leave you with a night chatting to your mum, 13 Alloa supporters, two journal editors, and a Kardashian sister, then you’re not doing Twitter right. Competitive number games: Doctors are by nature competitive, and like a Social media Olympics, Twitter has a range of ways to prove yourself. The kudos of the Tweeter is ‘proved’ by the number of followers, number of retweets (when others send on your tweets), and number of ‘likes’ other people have given your tweets. The only number that can reflect badly as it increases is the number of tweets you make – you don’t want to be too Tweeter-happy or then everyone wonders if you’re neglecting your real job. Basic calculations can be used for the slightly nerdy, ensuring you are more followed than following (proves that others are hanging on your every character). If the unspoken competition is big between individuals, it gets even bigger with organisations like Royal Colleges, Universities, NHS trusts vying to demonstrate who has the most effect in our digital age. It won’t be long before these numbers are prominent in the annual reports of big organisations. Boasting: The devoted tweeter will never pass up an opportunity to let the world know of their achievements. This may simply be a shout-out to the world that there has been a paper published, a grant awarded, or a presentation recently completed in outer Uzbekistan. Craftier ones will mask the boasting by showcasing an educational element, perhaps by providing a link to allow rapid access to the paper itself (see below). Or, less usefully, including a hashtag – a way of allowing an instant search for tweets on a particular topic. Extra subtle points are awarded for self deprecation (e.g. #everydoghasitsday). The worst kind of boasting is that which is dressed up as praise or deference. People who tweet that they are honoured to be presenting alongside Professor X or speaking at a certain conference are really just showing off that they are in that position (#yaboosuckstoyou). Praise of individuals is, of course, usually just an invitation to get others to respond in equally glowing terms, all the while embossing your twitter presence. Fundraising: It used to take a degree of difficulty to get all of your colleagues to sponsor you for poverty relief, football club strips, or some voluntary sector organisation. Now a mere 140 characters can induce that strange mixture of guilt (at being so lazy and uncaring), fear (that life is passing them by), and envy (at your three weeks walking the Great Wall) in all your followers in a matter of seconds. But, hey, it’s for charity, right? Letting go of emotion: Showing how much you care is one of the easiest things to do on Medical Twitter. Whether it’s highlighting health inequalities, African poverty, or the effects of medical care, you can guarantee a fair few ‘likes’ by retweeting or quoting something worthy. This shows evidence of the rounded and warm personality you tried to espouse back when you were being interviewed to get into medical school. The capacity of some to care passionately for so many causes on so many continents at the same time is remarkable and, to be honest, should be a lesson to us all. There are limits, though, and increasing strength of emotion should be considered indirectly proportional to the appropriateness of a Tweet. That 12:30 am alcohol-enhanced support of one of the Republican candidate’s more grandiose rants will not feel so good next day when the wrath of Twitter-righteousness is heaped on your head. Promotion of Health Service initiatives: In the positives column for any assessment of Twitter, this is the prime benefit. A number of significant initiatives have found their global voice thanks to twitter: Hello My Name is … and What Matters to Me have been handily compiled into hashtags and found a ready and easy platform. Looking into these is easy, and the well-meaning and effective messages have been hugely boosted by the Twitterati. The benefits of these initiatives are clear, and twitter allows an enormous audience ready access. There has been an emergent Scottish Medical Twitterocracy which has been active in pushing health improvement incredibly effectively in the last 10 years. Jason Leitch, Craig White, Gregor Smith, Andrew Murray, our current and past Chief Medical Officers, have all been forces for good, crossing boundaries of healthcare and bringing health messages across the NHS into mainstream. If all other aspects of Twitter were lost but this, it would remain a useful addition to our lives. Free education: Provision of links to published work in tweets is becoming increasingly common, and a quick way of getting a flavour of advances in other specialties and disciplines. Ok, we know that it’s just grandstanding by the Tweeter, but it does at least have the benefit of providing something positive.
So after all that, is Twitter a good thing in the medical world? I am convinced it is. It’s less time-consuming and solipsistic than Facebook and appears to be a form of social media more in the user’s control, everyone determining their own level of immersion. Despite the sanctimony on show, the way of briefly communicating a series of ideas and concepts to colleagues, while getting a measure of the support or derision is a good thing. Exposure to ‘Hello My Name Is …’ or ‘What Matters to Me’ would have been square rooted without Twitter, and my knowledge of health benefits of physical activity, multimorbidity, and over-prescribing would be much less. Sometimes, it even makes me laugh. Education that’s fun, inventive, and free? – What’s not to like?
Now, let me see, how many Kardashian sisters are there exactly …?
Pratticus