Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes!

Urologist Diana Londoño discusses her article, “From healers to influencers: How fear took over health care advice.” Diana addresses the concerning trend of physicians using fear-inducing tactics on social media, which she argues prioritizes engagement over genuine patient well-being. Instead of guiding and comforting, this approach often leaves people feeling scared and confused about their health choices. Diana explores the potential motivations behind this shift, such as the pursuit of clicks, likes, shares, and a perceived sense of worth tied to follower counts, questioning if a “dopamine rush” fuels this behavior. She advocates for a return to the core principles of the medical profession: to heal and teach by sharing information constructively and easing suffering, rather than perpetuating a cycle of fear. The conversation offers an actionable takeaway for medical professionals to reflect on their communication strategies and for listeners to become more critical consumers of online health content.

Our presenting sponsor is Microsoft Dragon Copilot.

Want to streamline your clinical documentation and take advantage of customizations that put you in control? What about the ability to surface information right at the point of care or automate tasks with just a click? Now, you can.

Microsoft Dragon Copilot, your AI assistant for clinical workflow, is transforming how clinicians work. Offering an extensible AI workspace and a single, integrated platform, Dragon Copilot can help you unlock new levels of efficiency. Plus, it’s backed by a proven track record and decades of clinical expertise and it’s part of Microsoft Cloud for Healthcare–and it’s built on a foundation of trust.

Ease your administrative burdens and stay focused on what matters most with Dragon Copilot, your AI assistant for clinical workflow.

VISIT SPONSOR → https://aka.ms/kevinmd

SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast

RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today we welcome back Diana Londoño. She’s a urologist and a health coach, and her KevinMD article is “From healers to influencers: How fear took over health care advice.” Diana, welcome back to the show.

Diana Londoño: Kevin, thank you so much for having me again. It’s always a pleasure. I’m just so grateful to be here. Thank you.

Kevin Pho: All right, so your latest article, “From healers to influencers: How fear took over health care advice.” Tell us what it’s about.

Diana Londoño: Well, it’s really looking at our role as physicians, and I think our role truly is to be a healer and a teacher. It doesn’t matter if we’re inside the exam room or we’re outside the exam room, whether we’re giving a presentation or now we’re in social media because it’s a great tool to again, do those things.

But I think we have sort of blurred the lines of truly becoming a healer or teacher. I see so many influencers, whether you have 10 people because they’re still influencers or a million followers, where we’re leading and telling people and patients and anybody about things, but we’re doing the messaging with a fear-based premise.

So instead of teaching or telling people how to do things or what to do, we’re doing it with, “I’m Dr. So-and-so, and you should never touch this. You should never eat this, you should never put this on your face.” And those messages are fear-inducing, which go against healing and then go against being in a calm state, which we’re supposed to try to share and do for others. So it’s just time to step back and really look at how are we saying the message that we want to convey.

Kevin Pho: So, I love the fact that you brought up that doctors at their core, they’re teachers. I’m sure that you’ve heard many, many times the word doctor itself comes from the Latin to teach.

I think the fact that we have all these platforms, these social media platforms, it’s a double-edged sword. It gives physicians the platforms that they never used to have to really share information and spread that influence. But like you said, we have to wield these powerful tools in a responsible way. You said that a lot of these influencers are spreading health information in a fear-based manner. You gave some examples, but what exactly were you talking about? Is it really just a lot of negativity: don’t do this, don’t try these medications, be careful about this? What are some examples that you’re seeing from this?

Diana Londoño: Yes, that’s the language we are seeing, sort of like the lack or “we don’t have,” which is the same messaging that marketing does. Or politicians, they want to try to say what’s wrong, what don’t you have, what do you need, which is different than a loving premise of, this is what we should do. Just say things in a different way. And why that matters is because these 90-second sound bites, you hear them, but there’s no context. There’s no follow-up as you would when you’re in the exam room, where maybe you can say the same thing, but then you follow it up with more information, more understanding, and more conversation.

So when you hear this, and even myself as a physician, not a layperson, I hear these messages and I’m like, “Oh, I’m not going to touch that aluminum, or I’m not going to microwave my food or use this plastic spatula because now I’m going to get cancer and this and that.” So even though I may know the nuances or the science behind it all, it still sort of stays in my psyche. And then every time I touch this spatula, I get a little afraid.

Why that matters is we are constantly running this fear in the background. We’re in a fight-or-flight cortisol state, and that doesn’t help anybody. So we’re more reactive. We get a little angrier. We’re on edge. So again, it is to understand we can say things, but how are we saying them? Just because everybody else is doing it in social media, we also have to remember we are teachers, we’re healers, and really everything we do should come from compassion, from love. I think we are getting a little bit lost in the shuffle because we want to be like everybody else, we want to be popular, we want shares, likes, and tweets. So, just maybe having a little bit of reflection on how can we do our role in and outside the exam room.

Kevin Pho: Now, are you seeing any specific medical fields where this is more prevalent or specific social media platforms where you’re seeing this more often?

Diana Londoño: Yes, I think definitely the shorter video ones like TikTok or Instagram because you have these 90-second or less, 30-second attention spans, where other platforms, perhaps, let’s say LinkedIn or others where you have more space to write things and have a bigger discussion, are a little bit different. But in the quick video platforms or even the retweeting world, sometimes we even retweet things that are also not accurate, but we just do it because somebody else did, and we sort of incite the fear.

So I think in those platforms I see it more. For specialties, I see it everywhere. It could be dermatology, it could be functional medicine, it could be emergency physicians. I see it all over. And there are also great ways to do that. I can think of platforms where people like, in my specialty, Dr. Rachel Rubin, things she talks about really affect people and women.

And there’s a risk of sepsis from the things that we’re not doing or are doing for a woman to help them, but we don’t do it in a fear-based manner. So there are many great examples of people doing it beautifully and people that maybe haven’t thought about it, perhaps. It’s just, again, bringing awareness. Can we step back a little bit? Can we continue our platforms, continue educating, continue getting followers and patients and people for a masterclass, but in a different manner?

Kevin Pho: I think you hit the nail on the head in terms of why this is happening. A lot of these influencers, of course, want to get more followers and clicks and likes. In these short-form platforms like TikTok and Instagram reels, you only have a limited amount of time to do so, and it’s been shown in studies that fear-based messaging tends to get shared more often and clicked more often.

Diana Londoño: Absolutely. I mean, you see that. I see their Instagram account, and then I see the one that was like, “Do not go here. Do not touch it,” and it has one million likes. And then the other one has a lot less. So of course, we’re human. Of course, we want that dopamine hit. We want to see those likes and shares, and also, we’re growing. Then we can rationalize, perhaps, and say, “OK, well I’m reaching more people.”

But again, at what cost? And again, you could do that, but do not then preface with, “I am Dr. So-and-so, and this is my message.” You can influence all you like, but when you start your message or your reel with, “I’m Dr. So-and-so,” just remember we have a Hippocratic Oath of doing no harm, and we are, again, teachers and healers. So just let’s respect our true identity that we have.

Kevin Pho: In your article, you give a powerful analogy of telling a child, “Don’t run, or you’re going to fall,” versus “Please walk slower.” So not just with social media, but in the exam room, when we’re trying to influence our patients, we’re trying to convince our patients, just talk more about the psychological impact of negative versus positive framing in health communication.

Diana Londoño: Absolutely. Whatever we put our attention to is where our mind, our energy, and everything happens and manifests. So, it’s just like if you have an idea of making an iPhone, whatever your idea is and what you say, it’s going to become that iPhone. So if we tell our children, again, “Don’t go so fast, you’re going to fall,” guess what’s going to happen? They’re going to fall, and they’re going to be like, “See? I told you.” But it’s a self-fulfilling prophecy.

Instead, why don’t we tell children what to do or how to do it or what to eat? Instead of saying, “Don’t eat the Doritos,” it’s like, “Oh, here is this. Let’s have this instead.” So again, patients, kids, our spouse, it doesn’t matter who we’re speaking to, let’s reframe how we say our words, because words are really, really powerful. And so it’s just understanding the power of words.

It’s the same message if you think about it. But what do we want? If we say what we don’t want, we’re going to get all of that. If we say what we do want, we’re also going to get all of that. So whether it’s our goals, our dreams, instead of telling me all the things you don’t want, tell me what you do want so we can start working towards that. So again, whether this is coaching your children, it doesn’t matter. It’s the same principle, and it’s a huge shift and a very powerful one.

Kevin Pho: Yes, I agree. I think that if we want to shift behavior in our patients, sometimes not doing it from a fear-based approach can be more effective. Now I want to ask you about paths forward, both from the influencer physician standpoint and from the patient standpoint. So we’ll start from a patient standpoint first. If patients are listening to this and they’re scrolling through various social media platforms, just give us a guide in terms of how they could critically evaluate the health information that they’re reading on these social media platforms.

Diana Londoño: Well, I think that is the nuance and the difficulty. To have discernment, even as a patient or a physician herself, like a colleague, is really challenging, especially because then we’re trusting the name, we’re trusting that MD is there, and then we’re like, “Oh, well they said that, so definitely I’m not going to do that.” So it gets so confusing, and I do have compassion for patients and colleagues alike because maybe a dermatologist is saying something and I don’t know, I’m not a dermatologist, so I am trusting that what they’re telling me is what’s really going to be helpful.

But also, again, remember people are affiliates. People have monetary incentive to push this product or the other, which may not be disclosed. So understand that: why are you recommending this product that maybe you haven’t even tried, but you were paid for it very handsomely? There’s nothing wrong with being paid for your expertise, but it has to be transparent and be disclosed what is behind your recommendation. So I do have, again, a lot of compassion, and it is a difficult place as a patient to read and say, “OK, is this who I should follow? Is this the right stuff?” because then this other person is saying something else.

What I think could be helpful is, OK, if you see something, then bring that to your physician that you trust and you have a relationship with and say, “OK, I saw this. What do you think?” So I think it can open communication and it can make the patient informed, but again, always with a conversation, with follow-up, with the trust that is your physician.

Kevin Pho: So as a urologist, do you find yourself talking to patients about what they’re finding on, say, TikTok or Instagram reels from a urological standpoint? If they saw some urologic piece of advice and they come and discuss it with you in the exam room, how does that conversation go?

Diana Londoño: Yes, this is very important because sexual things, which is what we do in urology, are clickbait. That is going to be pushed and passed with false beliefs, especially concerning pornography. The damage of pornography is so important as a urologist, and 30 percent of all internet traffic goes to pornography. That is huge. There are 56.2 billion monthly visitors to Pornhub, the biggest hub of pornography. So how is that influencing my patients about what normal is, what intimacy means, and then the really serious effects of porn-induced erectile dysfunction that is real, that happens to young men and older men because they get addicted to this because, again, dopamine is getting hijacked.

They come with shame and guilt and difficulty saying what’s happening, and the answer is not to give a 23-year-old Viagra. The answer is to be compassionate, have an open communication, and ask these open-ended questions like, “How many times a day or how many hours are you watching porn?” because it’s not saying yes or no. It is saying, “OK, give me the answer.” But not at the beginning. After you establish some rapport and, of course, go through a physical exam and labs if needed, all that. But we need to establish that trust. We need to look at people in the eyes and be compassionate and then have a conversation.

But of course, when my patients come in seeing pornography and seeing all these things that can give false expectations of what’s normal, then it is going to be normal to have this guilt and shame and all these emotions that are truly going to impact them, including anxiety, depression, and suicide. So this is really, really important, especially in things that are sexual because, again, there’s so much out there. Thirty percent of people are going to these sites for education, for curiosity, or it just fell in their lap, and now they’re stuck with this addiction. So this is critical.

Kevin Pho: Now, how about from the physician standpoint? You have a platform. I have a platform. To a lot of physicians who have these platforms, how do they balance fear-based messaging with something more constructive, knowing that sometimes fear-based messaging is needed to grow their platforms? How can they balance those two different forms of messaging?

Diana Londoño: Yes, at the end of the day, it’s like, how do you sleep at night? What is true to you? What feels right to you? Icannot tell you how to choose to grow your platform. You can slowly do it organically, or you can do it fear-based, or obviously, you can hire people or buy followers. You can do it in many, many ways, and it’s just up to you and up to your own personal belief system and your personal ethics of how you want to do it. It’s not right or wrong; it’s just how you want to do it.

Again, I’m just trying to bring some awareness, some consciousness. Maybe you do sprinkle it here and there, and you’re not the devil for doing that either. But do you always want to have that, or do you want, like you say, balance? I think life is a balance. Sometimes you may need that fear one, or maybe it’s kind of funny and there’s a little fear in it, but it’s real and it’s true, and it does get attention. So again, we have to be real. It’s not like we’re purists, but let’s bring some balance.

Kevin Pho: We’re talking to Diana Londoño. She’s a urologist and a health coach. Today’s KevinMD article is “From healers to influencers: How fear took over health care advice.” Diana, we always end with some take-home messages you want to leave with the KevinMD audience.

Diana Londoño: Lead with love, lead with love, and lead with love. That’s the most important thing we can think about.

Kevin Pho: Diana, as always, thank you so much for sharing your perspective and insight, and thanks again for coming back on the show.

Diana Londoño: Thank you.