You should not, as VanWingen initially suggested, wash your produce in soap and water—it’s better to just rinse fruits and vegetables in cold water because soap residue can cause digestive issues. And his suggestion to leave groceries outside or in the garage for a few days before bringing them into your home needed a clarification that this would not be a safe procedure for perishable goods.
VanWingen lobbied YouTube to let him edit the video and remove the portion with potentially harmful advice, but there wasn’t much he could do aside from take the whole thing down. He decided against that, instead littering the video’s description with updates linking to new and more accurate information. But, he says, he still stands by the majority of the advice in the video.
“If you associate Dr. VanWingen with misinformation, that weighs on me extremely heavily,” he says. Compared to others, he says, his mistake was innocent and would be unlikely to have dire consequences. “There are doctors that I’ve seen that are promoting, like for instance, hydroxychloroquine and maybe even promoting fear,” he says, referring to the unproven and, according to the FDA, potentially dangerous covid-19 treatment that was promoted by President Trump. “That is certainly not where I would see myself coming from. ”
And the people who can get views for a medical message on social media aren’t necessarily the ones most qualified to craft it. Eric Feigl-Ding, an epidemiologist who now has a large following on Twitter thanks to his evocative tweets about Covid-19, has found his expertise and analysis questioned by other epidemiologists.
Varshavski, that is Doctor Mike, became YouTube’s go-to medical expert after a 2015 Buzzfeed article about his Instagram account dubbed him the “hot doctor.” And although he often stresses to his audience that “expert opinion,” including his, is “the lowest form of evidence,” his viewers fans are more likely to trust what he says in his videos than they are to track down and read a randomized controlled study on the same topic. That’s not necessarily a bad thing, if the information is sound and clearly presented—and he described his role during the pandemic as essentially turning himself into a mouthpiece and platform for the CDC, WHO, and leading experts in the field.
But it’s easy to lose that balance.
“If you are a doctor and you’re popular and people look to you for guidance, and you believe your expert opinion without any kind of research to substantiate it outweighs that of the guidance from the CDC and WHO, you’ve crossed the line,” he says.
And that’s the central challenge: people will turn to the internet for information during a health crisis, whether it’s their own or one facing the entire world. But the best, most accurate information isn’t always packaged and optimized in a way that is appealing to a curious public searching for certainty. For every CDC video about the latest studies on the coronavirus, there’s someone out there claiming to be the one person out there willing to tell you what “doctors don’t want you to know.” That gets combined with a president who is amplifying potentially dangerous ideas so that they become significant news stories.
Doctors becoming brands
There’s another challenge faced by these doctor-influencers, too: branding and money. Personalities like Doctor Mike can make accurate information interesting by becoming influencers, but they also have to figure out a way to do that without falling into ethical quicksand.
People become famous online by becoming human brands. But “turning ourselves into brands can also drive people in a different direction,” said Chiang. “Some people out there are aligning us with big pharma already. The last thing they want to see is that we are selling a product or idea.”
Varshavski, like many content creators, takes sponsors for his Instagram and YouTube accounts, but said he has to make sure that those sponsorships don’t look like medical endorsements. Chiang, who also serves as the Chief Medical Social Media officer for his hospital, has to carefully screen which TikTok challenges he participates in, and the songs he uses with them, to avoid associating his image and that of his profession with something offensive or tasteless. Chiang is informative on TikTok, but he does it while engaging effectively with how people already use the app. And that’s not always something doctors are capable of—or interested in—trying to learn how to do.
“Historically there’s never been any sort of teaching in medical training in how to communicate on a public level with our communities and our patients,” said Chiang.
Online fame takes maintenance and skill to a degree that most people underestimate. And, especially for doctors and other people who work in fields that are targets of disinformation, there are some more serious risks. Chiang points out that some companies will simply steal content from medical professionals on social media and use them to sell their products. And, battling medical misinformation online can make those who believe it angry, potentially endangering the personal safety of doctors who try to take it on.
But Chiang and Varshavski say thesay that the risks are worth it, especially if having more doctors online helps people find better information about their health.
And, as doctors who are both on the internet and treating real patients, they can see how misinformation impacts their patients first-hand. Varshavski treated five covid-19 patients in one recent weekend with mild symptoms, and each asked for hydroxychloroquine, a risky possible treatment that can cause serious heart issues in some patients. Some told Varshavski that they heard about the treatment on TV.