KevinMD on PermanenteDocs Chat [PODCAST]

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In this special episode, KevinMD is on the other side of the microphone as he’s interviewed by Dr. Alex McDonald, originally aired as a PermanenteDocs Chat presented by The Permanente Federation at Kaiser Permanente.

He shares his social media story, reasons why physicians should be involved with social media, criteria for reliable online sources, and tips for those interested in taking the next online steps.

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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Alex McDonald: Hey, everybody. Welcome to a PermanenteDocs Chat. Thanks, all, for joining today, both on Zoom and on Facebook Live. Today I’m very excited for our special guest. I’m going to fanboy a little bit here. I don’t think he needs any introduction, but Dr. Kevin Pho is an internist and the founder of KevinMD, who is going to talk about a topic near and dear to my heart: social media, and exploring physicians’ and other health care professionals’ role in and around social media. So it should be a great topic. Please feel free to drop your questions in the chat or in the Facebook comments as we go along here, and we’ll try to get to them too.

Dr. Pho, thank you so much for joining us today. Like I said, I’m a huge fan of your work and of how you really helped start, I think, a lot of the trend of physicians getting more active on social media. Let’s start off by just telling everyone who you are and what you do.

Kevin Pho: Sure. Well, thanks so much for having me. My name is Kevin Pho. I’m an internal medicine physician. I’m also the founder and editor of KevinMD.com, and it’s really just a platform where I share the voices of health care professionals across the spectrum so they can share their stories and be heard.

Alex McDonald: Fantastic. Tell us how you came up with KevinMD and the story of how this all started.

Kevin Pho: So I like to say I had a business plan back in 2004 and it went exactly according to plan, but that’s obviously not the case. Back in 2004, very few physicians had blogs, probably less than 50, maybe 75 or so. At that time it was a novelty for a physician to have a blog. It was like, “Really? Don’t you have anything better to do with your time?”

But I wrote an article once when there was a drug recall, an article saying what patients should expect. Then I went into the exam room a few days afterward, and he said, “Oh my gosh, I read your blog post this morning, and I was comforted by what you had to say.” That’s when I realized that with blogs specifically, and now of course with social media, physicians have the ability to connect with patients, to influence patients, and to inform and educate patients outside the exam room.

And certainly there’s been a fantastic evolution. Social media has evolved so quickly. There are so many different platforms that we can choose, and there are so many different ways that patients can consume health information. It’s been a fun journey along the way, just exploring social media and doing things that, frankly, none of us have been taught in medical school or residency.

Alex McDonald: That’s such a great point. Obviously, I’m passionate about social media as well, and I educate our residents and some of our medical students about that at my institution here. I always talk about expanding the voice. You can educate one patient at a time in the hospital or the clinic, or you can educate en masse, and I think that’s such a valuable tool, especially in this day and age when, as you mentioned, there are so many different ways patients can consume health information. And let’s be honest, not all health information is created equal. Can we just agree to leave it at that?

Kevin Pho: There’s absolutely no question about that. One of the most popular reasons why patients go online or do Google searches is for health information, and especially during the pandemic, there’s just so much misinformation out there. People get their information from Facebook, from Twitter, from YouTube, and they come to the exam room, and I have to spend time, and I’m sure you do too, dispelling that information.

I think it is certainly a responsibility for a lot of us in health care to also go on social media and either be sources of reputable health information ourselves or really act as a filter, so we can guide patients to better sources of health information. Because not just in health care, but in pretty much everything, misinformation is everywhere. I think that is certainly one of the downsides. Social media has a lot of pros, but there are a lot of downsides to social media. But this is the world we live in, and we have to adapt to it.

Alex McDonald: I completely agree with you. As a primary care physician myself, I think that building that trust and those longitudinal relationships over time, both in person with your patients in the exam room and also by cultivating a social media presence, has really tremendous value. So I think we’re preaching to the choir here. Tell us, what are some of the biggest learnings that you’ve had in the past 15, 20 years you’ve been doing this, and what do you think is the biggest real benefit for physicians to speak up on these platforms?

Kevin Pho: Let’s start with the biggest benefit first. I think it is what I alluded to before. Physicians are able to share their stories and advocate for the profession, because, as we know, there are a lot of issues that affect the profession today. We talk about physician burnout, right? Fifty percent of clinicians are experiencing the symptoms of burnout, and that’s even before the pandemic. Now I’m sure that number is higher. A lot of the decisions that physicians make are outside our control, and I think that’s one of the biggest factors leading to clinician burnout: There’s a loss of clinician empowerment, right? We sometimes lose control of our schedule, and we have all these bureaucratic obstacles that we have to deal with. Especially in the primary care setting, there’s a lot of bureaucracy, and that impedes our care with patients.

So I think that by sharing these stories on social media, whether it’s through a webinar or a podcast like this, or writing on a blog, or even going to mainstream media, we can share those stories. That’s important because health care decision-makers, and it could be health care administrators, it could be politicians, listen to us. And most importantly, patients read these things too. If patients are on our page and they understand some of the trials and tribulations that physicians go through, that’s going to impact the care that we give to patients. So I think social media’s biggest role is really elevating our stories and letting everyone know what goes on behind closed doors and some of the difficulties that physicians face when treating patients.

In terms of the biggest learnings over the past decade or so, I think being online, there’s obviously a certain amount of animosity, to say the least, right? We just live in such a divisive society. Everything is politicized, so that’s something that’s a little bit difficult to navigate. Whenever one has a strong opinion, you’re going to have half the country disagree with what you say. So I think it is important to acknowledge, especially with health care, that there are always several sides to whatever point you’re trying to make, and in health care, as we know, there are a tremendous number of shades of gray, so to speak.

So on social media, I think it’s important to acknowledge different points of view and acknowledge when you’re wrong. One of the things that we talk about is building trust online. There’s a lot of distrust in our health care institutions, and there’s a lot of distrust of the medical profession that has been magnified, certainly during COVID. So I think trying to find a way to navigate that context has been tremendously challenging, and it remains challenging going forward.

Alex McDonald: You touched on three things, but two especially. That trust is so important, and I think that’s almost like the biggest value-add: We are trusted messengers, and we don’t want to do anything to undermine that trust. And to your point, we should be admitting when we’re wrong, admitting when information changes, admitting when our opinions have just shifted. Heck, who would have known that bloodletting ended up being a bad idea 100 years ago? Medicine evolves and changes, and I think we need to make sure that we continue to speak up and advocate for what is general consensus and what is scientifically evidence-based at that moment, right? Which obviously changes too.

The other thing you touched on is podcasts, which are a relatively new medium. I know you have launched your own podcast. Tell us more about podcasting and how that sort of fits into that role as well.

Kevin Pho: I think it goes to what I said earlier in terms of consumers having so many different streams of information to absorb, right? Ten, 20 years ago, you maybe read a newspaper, or you turned on the television and watched the nightly news. But now we have so many options in terms of consuming information, and health information, of course, is part of that as well. It could be an email newsletter, it could be the New York Times online, it could be, of course, podcasts and YouTube and LinkedIn and all these social media sites. So I think it’s important for clinicians to use these platforms, again, to propagate reliable health care information.

Specifically with podcasts, it’s been tremendously impactful for me because it’s something that I’ve always wanted to try. I started my own podcast two years ago, and it’s a daily podcast where I’m able to elevate voices across the health care spectrum. It’s not just physicians. I also have advanced practice providers, I have patients, and really everyone in health care should learn from each other. I have KevinMD.com, where they have their stories in written form, but on a podcast I’m able to talk to them directly, and they can share in their own voices and their own words.

I’ve learned so much, because my job is really easy. I just ask questions and sit back. These are experts from across the country, experts whom you would have a hard time talking to under normal circumstances, but on my podcast I have 20 minutes of their undivided attention, and I can ask any question I want. It’s just been a tremendous learning experience over the last couple of years, and it’s, again, a powerful way for voices across the health care spectrum.

Alex McDonald: So you guys heard it here directly from KevinMD: “My job is really easy. I just sit back and ask questions.”

What would you say to people who maybe think that physicians shouldn’t enter this space right now, which is very messy, with an overlap of science and social media and politics, and can be overwhelming to some degree? It can’t be very messy. What do you say to people who think that the physician, or the trusted health messenger voice, really doesn’t have a place there?

Kevin Pho: I think that’s a common perception. A lot of physicians are busy. We obviously have to see patients or do procedures, go to the hospital, and then you come back and do all this paperwork. There’s enough going on in our professional lives: “Why do I need another headache? Why do I need to be on social media? All I hear about is physicians getting fired because of what they post on Facebook.” They just hear the negatives, right?

So my biggest response to that is that if physicians aren’t on social media, someone else is going to go online and propagate potentially false information and propagate misinformation. I think that’s been seen with childhood vaccines, right? You have that false connection between vaccines and autism, and I don’t think physicians were fast enough to go online to dispel those myths. And what happens? You have all these pseudo-practitioners propagating myths about vaccines and undermining the public perception of vaccines, because I think we in the medical profession have been too slow to embrace going online.

So I do think that physicians have a responsibility to be in that public space, to be where patients are, and to be reputable sources of health information. Because if we don’t do it, if we don’t go online, it’s not like patients are going to stop going online to look for health information. Someone else is going to replace us, and that’s going to further undermine the trust that they have in the medical profession.

Alex McDonald: That’s so well said. I agree with those sentiments 1,000 percent. There was a question here in the Facebook comments. At this point there seem to be thousands of bloggers and podcasters. What do you think a consumer of health information should look for in a health podcast, and what types of things would probably be more impactful than others and make people want to listen and learn?

Kevin Pho: There are so many different types of health podcasts out there, right? A lot of physicians have a podcast, so it certainly depends on whatever their niche is. There are podcasts specifically about COVID. What I do is share stories. There are podcasts by someone like Sanjay Gupta on CNN, who is kind of a higher-profile physician. So I think it depends on what you’re looking for.

I also want to say that when it comes to finding trust online, it’s important to know what to look for and who to trust, because there are, of course, a lot of physicians who are also not always accurate in terms of the medical information that they have. So what are some of the things that you look for? A few years ago I would have said look for traditional health care institutions, look for .gov websites, look for hospitals and academic medical centers. But now, as you can see, everything’s been so politicized that even trust in those institutions has been undermined over the years.

So just to expand on what we talked about earlier, how do you know who to trust? To me, the biggest characteristic I look for is really just humility, right? If the podcaster, or whoever is giving the health information, is willing to admit mistakes, admit when they’re wrong, and sometimes even admit that people from the other side of the political spectrum may have a point at times, having that humility, to me, is one of the biggest signs of trust. So that’s really the biggest thing that I recommend.

Whenever someone asks me who you can trust online, I think: Look for someone who has that humility, someone who is willing to sometimes reach across the political aisle, someone who sometimes admits when they’re wrong, or sometimes admits when political opponents have a point where they don’t. Look for people who have that humility, and I think those, especially in this day and age, are some of the more trustworthy options.

Alex McDonald: One thing that I always look for is people who are trying to stay more positive or more collaborative, as opposed to just black and white, or attacking other individuals as well, which happens a lot, unfortunately. So those are the other things that I look for: people who are trying to take a balanced approach and have more of a discourse, as opposed to

Kevin Pho: Absolutely. You don’t want people who are just so dogmatic in their thinking, right? So, people who are willing to be flexible, because, let’s be honest, science is changing. Health care is changing. COVID has shown that the science of the pandemic changes by the week, and these opinion leaders that we have in health care, it’s OK that they adopt that changing science.

Alex McDonald: So now that we’ve convinced all of our listeners and all the physicians out there to join social media, what are some tips or advice that you have for people who are interested but aren’t quite sure how to get started? I sort of think about the three stages of social media use. There are the people who are there, looking and learning; those people who can maybe comment; and those people who create their own content as well. So what would you say to people who want to get more involved and do more social media work but aren’t sure how to get started?

Kevin Pho: You alluded to this in your lead-in: You want to go in a stepwise progression. But even before that, you want to ask yourself why you want to go into social media. Never just go into social media because someone told you to, just because the marketing department told you to, because that’s never a good reason to go into social media. You always want a purpose.

The three main purposes that I see are, number one, the education piece we talked about. You want to be a reputable source of health information for the patients you see, and an influence outside the exam room. The second piece is the online reputation piece, right? Because patients do Google their clinicians online, and sometimes going on social media to proactively create an online reputation is one of the best ways you can define your online footprint and not be defined by these third-party rating sites. And the third way is what I talked about earlier, about clinicians having a voice so we can advocate for the profession. So generally it falls into those three buckets.

I think that once you find your purpose, then you can take that next step, and you talked about the progression, right? You could dip your toes in social media first and maybe have a profile on, say, LinkedIn, for instance, and that’s a fairly benign thing to do. But if you have a presence on a site like that, when people Google you, at least you control that site, and you show up in a Google search, and you’re not defined by these third-party sites. At least you control that information.

Then, if you get comfortable, you can take the next step. Like you said, you don’t necessarily have to create content, but at least you share content. So if you have a Facebook page or a Twitter page or LinkedIn, maybe you could just link to or share reliable health information. If a new study comes out, you can maybe share a perspective on that, or if a new drug comes out, or if there’s a drug recall, again, share things. You want to use your network to propagate reliable health care information. You don’t want to share things that are pseudoscience or things that are proven to be unreliable.

And the third part, once you get comfortable with that, will be content creation, and there are so many avenues in social media that fit one’s strengths. If you’re great on camera, of course, there’s YouTube. If you’re a great writer, there are blogs. If you want to do more short-form things, you can do that on LinkedIn and Facebook. So you want to find a platform that really suits your personality and suits your strengths, and then create content that fits into some of those goals that we talked about earlier, whether it’s educating patients or commentating on the news or advocating for the profession. So find your purpose first, and then take your stepwise progression based on your comfort level with being online.

Alex McDonald: I think the other thing I always tell people is just pick maybe one, maybe two platforms to start with. You don’t have to be all things to everyone. One of my good friends, Dr. Vicki Chan, does these TikTok and Instagram dances, which are amazing, and she’s great at it. That’s her thing, versus people who are much better at blogs, for example. So I always tell people to pick one, maybe two avenues and start there, and then you can expand as you feel comfortable. That’s great advice.

We have a question here in the chat also. Physicians, particularly those working for large institutions, can sometimes run into some struggles with the public affairs department or the comms team, which is so used to controlling or understanding or putting out the narrative. And whether we say it or not, if we work for a large institution, we are a representative of that institution too. So how do physicians navigate that responsibility to their organization and their institution, but also their own personal brand and reputation on social media as well?

Kevin Pho: I always advise physicians to be transparent, right? You want to be transparent with your organization, and there are so many organizations out there with varying policies when it comes to social media. I can say that for many large organizations, the marketing team is very eager to partner with clinicians, right? They actually want more physicians to partner with them and create videos to promote the hospital or their practice or whatever procedure they’re doing. So I think that, first off, partnering with the marketing team would certainly be the first step in terms of branching out.

And if you want to do your own brand outside of your employer, you always have to be transparent, because you work for your employer first. Make sure that contractually it’s OK. I always advise transparency first, before going out and doing something that your employer may find out about later and may frown upon. So I always advise transparency first. And again, if your personal brand runs counter to what the organization wants, that’s another discussion to be had. But I think that, in general, you do want to be transparent, and you want to make sure contractually it’s OK. In most cases, I would just say if you have a marketing department, partner with them, because a lot of times your goals and motivations may be aligned.

Alex McDonald: For me personally, I can speak to having been a Permanente physician and being part of a massive health care organization. I did a lot of work ahead of time and spoke with my local comms team and my regional comms team to let them know who I am, what I’m about, and how I can, again, like I said, really partner with them on this work. It’s been a fantastic relationship that I’ve been able to foster and grow with many individuals across our organization, including the folks who help produce this podcast, so shout-out to Ben and Maria. Thanks, guys.

This has been fantastic. We could probably go all day long, but I know your time is short. Tell us again how people can find you and find your blog and your podcast.

Kevin Pho: Everything is at KevinMD.com, to find the blog, and it’s not just me. It’s really stories from across the health care spectrum, and you really learn a lot just from reading your colleagues and reading people who are adjacent to you in the health care spectrum. I’ve learned so much just from reading the stories on KevinMD. In terms of my podcast, it’s the KevinMD.com podcast, and you can hear the KevinMD authors share their stories in their own voices. So those are the two places that I would go to.

Alex McDonald: Fantastic. Dr. Pho, thank you so much for joining us. I really enjoyed this conversation, and it means a lot to us and all of our viewers that you took the time today.

Kevin Pho: Thanks for having me.

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