In the second part of their conversation, Alex McDonald, MD, and Jessica Gray, MD, discuss how physicians can navigate social media sponsorship opportunities responsibly and how to balance authenticity with privacy.
ContributorsAlex McDonald, MDProgram Director
Fontana Family Medicine Residency
Kaiser Permanente
Jessica Gray, MDFamily Medicine Physician
Co-Host, The Med Edit Podcast
This transcript has been edited for clarity.
Welcome back to PeerPOV: The Pulse on Medicine, a podcast series by Physician’s Weekly showcasing the latest insights from your peers across the medical community.
In the second part of their conversation, Drs. Alex McDonald and Jessica Gray talk about how they navigate paid partnership opportunities on social media and how they balance authenticity with privacy.
Dr. McDonald: You mentioned you never set out to be a “doc influencer,” if you will, but there’s a line between education and entertainment, between advocacy and self-promotion. So, where do you draw that line?
I think we all know people who were well intended to begin with, and they get sucked down a road, start getting sponsorship, and start promoting questionable products or treatments, and then they lose credibility ultimately. So, how do you find that balance? Where’s the line between entertainment, education, advocacy, and self-promotion? Help me understand this. I don’t know the answer myself.
Dr. Gray: I think it’s very individualized. I am not ever going to be the doctor that’s a TikTok dancer. That’s just not my thing. I can’t do it.
I don’t even like speaking very much on social media. You’ll see most of my posts don’t have me speaking. It’s usually something else, either a voiceover or some words or something, because I just don’t feel that comfortable in that setting. I can talk on a podcast, and I can speak in front of hundreds of people and give lectures, but for some reason that avenue doesn’t feel the most comfortable and that’s okay. Don’t force it because that’s not as authentic.
If you do grow—because this wasn’t a problem when you’re very small and only for followers—but once it does grow, you’ll start to be contacted nonstop. Every day, something comes into your DMs and says, “Hey, we want you to do this. We want you to do that. We’ll pay you money for this.” You have to sit there and decide, “Where are my personal boundaries? What am I comfortable with?”
I have two friends that I talk to, both physicians, quite often about this. We’re talking about the recent doc influencer debate that’s been going on around social media lately, and specifically, we’re talking about paid partnerships. I’m not opposed to paid partnerships, honestly. I think it’s fine if you can figure out that it is something justifiable that you personally believe in, and that it is evidence-based and there’s a benefit to your community from it. I’ve seen that.
There are some things that are more education-based. I can fully disclose I’ve worked with the AAFP and I love it. I’m like, “My family med people!” I think it’s great to promote our organization. I’m fine with that.
The other thing is, it’s your extra time. Yeah, it doesn’t cost you money to run an Instagram account, but if they ask you to travel or go to a speaking event, that’s time away from your family and the clinic, and you can actually quantify the loss of revenue from some of those things. So, I think it’s fine to get paid in a very organized manner.
I think where we come into some sketchy stuff is when people are saying, “Hey, I will send you a massage chair, and you can have this massage chair worth $5,000 and then you can post about it.” I’m like, “No, that’s not a line that I’m going to cross.”
I think that there are definitely some ways to do this. There are also some companies out there that you can partner with that can help vet some of these things, that have ethics boards and that are made up of physicians that will say yes or no. Because the other thing is, these people with these paid partnerships—some of them are really great. We want them to be more out there in the community and be well known because the opposite is happening, where somebody else that’s not a doctor is getting paid for their influence, and they have even larger outreach, and it’s for something that’s completely the opposite of what we want our patients and our physician colleagues to go for. Educating first is probably most important. I’m not a performer. I am happy to see the physicians who are funny and make little skits. I like it for entertainment value, but I don’t think that’s bad. I think you just have to be transparent about what you’re doing.
There are a lot of rules that you have to follow as well, like government-set rules. So, if you’re going to go down this avenue, you might want to make sure that you have a partnership with a company that can help you vet sponsorships because, again, we didn’t learn this in med school or residency, and I think this line can get blurred really quickly.
Dr. McDonald: To your point of it being individual, every individual physician needs to figure out where their line is, what their goals are, what their focus is, and how any potential partnerships help or hinder that. Then, I think the ethics piece is really important, including conflicts of interest and being transparent about it.
I think that’s the biggest issue: knowing that it’s a paid promotion or partnership. There’s nothing wrong with that. Last time I checked, we still live in a capitalist society. But, at the same time, that does also potentially open you up for criticism, which, for better or for worse, is part of it and comes with the territory. So, I love that point about how everyone has to figure out their own individual line and not do it by themselves.
You talked about this before, and this kind of goes a little bit with the ugly side, the nuances between entertainment and self-promotion: the authenticity, and navigating professionalism versus safety. I remember this very clearly, I felt like I had to be this Norman Rockwell physician—very professional, very proper. Then in residency, I think I was probably an intern or a second-year resident, I was like, I can’t do this.
I’m a goofy, outgoing person at baseline. So, when I started doing that in the exam room with patients, it just felt so much more natural. I felt like I enjoyed the practice of medicine more. And that extends to my social media. Some of my posts are a bit more serious, but a lot of them are a little goofy or silly because that’s just who I am and what feels right for me.
When physicians use social media, do they need to put on a persona? Do they need to be themselves? Do they have to perform? What are your thoughts?
Dr. Gray: I think that you said it perfectly. I think you have to figure out who you are and how much of your life you want to expose. I think setting some boundaries is really important. For me, I don’t want to show anything with my family. That’s my line. I do know that I probably would have a lot more followers if I showed pictures of my really cute kids and showed me going shopping or something. No offense to those that do that; that’s just my line.
I have really small kiddos. I don’t want them to be at school like—I mean, they already have. My sweet kid at school, one of his teachers is like, “I follow you on social media and I listen to your podcast,” which I think is great, but I’m also like, “Oh gosh, that’s the principal.”
So, I think there are some lines there. You want to be authentic, but you don’t have to show your entire life. I think showing some emotion and not acting like you have everything together is a good piece to let people in. I always say, if you’re going to talk to patients, you also have to consider who your audience is.
For me, it was interesting to learn that the majority of my audience is actually in the healthcare world, which is cool. I think the majority are physicians, nurses, med students, or something medically related, which is awesome. I do have a large number of patients as well, and I love what my patients say that they watch on social media. But if you’re talking to mostly the lay public that are not medical-based, you need to be able to communicate in a way that’s authentic to you and to them.
You don’t want to talk over their heads. You want to talk the same way you would talk to a patient in the clinic. It needs to feel unlike a true performance for them. I always tell people that if you wouldn’t defend what you’re saying in a room of your peers or the medical board, then definitely don’t post it either. You want to make sure that you’re being authentic.
I’m not going to swear. I’m even careful about what music I post. It’s still authentic to me; I just may find the nonexplicit version of that Nikki Minaj song. I think that there are definitely ways to tailor it to you without stepping over a boundary you’re not 100% comfortable with.
Like you, I did the same thing, where all of a sudden I started realizing I don’t have to be in the same box as everyone else. I can make medicine look the way I want it to look and feel better about it. When people come into my office, everybody loves it because the whole office is decked out in pink. I have white desks, and I have art everywhere, and it’s very calming. There are plants and it smells like eucalyptus.
People are always like, “Oh my goodness, this is such a cool place.” I tell them it started with a keyboard. I got a pink keyboard and then realized I don’t have to live in the world of brown, traditional, commercial-type decor and furniture. So, now I have a pink office with flowers. That’s just authentically me, and suddenly, I get to translate that into the social media world too.
Dr. McDonald: Yeah. I love a post you recently made about showing the physician I am and who I want to be and not necessarily conforming to stereotypes. You said it much more eloquently than that, but I love that post and I love that concept.
Dr. Gray: Thank you. Yeah, it’s been interesting. I think the other thing we’ve got to mention to people who are starting this journey, if this is your journey or you’re interested, is that you will grow and change over this time period as well. The person I was when I started this nine years ago is not the same person I am now.
I am a different physician. I work slightly differently than I used to. I have different opportunities. I do speaking and teaching engagements. I’m also now a mom and have two kids. You change, and it’s okay if your social media style changes with you. There are going to be people that love it and people that hate it. I think that’s fine. That’s the authenticity that comes with it as well.
Dr. McDonald: Yeah, I think that makes perfect sense.
Where are we headed? In five or 10 years, do we think that physicians still will have a role in social media? Do we think we need to do more education regarding how social media impacts patients’ perceptions coming and leaving the exam room? Tell me your thoughts.
Dr. Gray: I have lots of thoughts. I’m really hopeful. Lately, there’s been a viral post that people just keep redoing over and over. It’s the same reel that’s saying, “Why are doctors all trying to become influencers?” It’s because influencers trying to be doctors and give advice. I like to see that being a viral post that people keep reenacting and redoing. It’s great.
I think we need to have our physician voices be expected and not optional. I want it to be that we are supposed to comment on it. It’s kind of the same way in the news: if they were talking about the measles outbreak, we would expect that they interview a physician. At some point in time, they would ask a physician, “What’s your opinion on it?” I’m hoping it’s the same way with social media, that we are expected to be involved and not optional.
I have noticed recently, at one of the fertility centers that I utilized, one of their physicians who is a little more mature was using social media. I was like, “This is awesome. I’m so excited to see one of the founding members of this great institution join the social media conversation.” I think we need to start this from education in medical school. I would love to teach in medical schools about the ethics of social media, the legal parameters, and partnerships.
Unfortunately, we had another viral moment this last 90 days with a medical student who crossed some pretty big lines. Then he had every doc influencer out there commenting and reposting his thing and telling him how terrible he was. Yes, his stuff was awful, but I also think it’s on us as a physician community on social media to go to the medical schools.
And the medical schools need to be inviting us. That’s the other problem. They have to open the doors, be understanding, and let us in to have these conversations. Hopefully, we can help them and prevent some of these things. Because when you’re a starving med student, loaded in student loans, those paid partnerships, even for the massage chair, are going to be really hard to turn down.
I think that if we can meet them there and help train them and make this the best education possible starting there, it would be amazing. And we’ll have way better content creators than you and me by that point. It’ll be awesome for us to learn from them.
Dr. McDonald: Yeah. I think the piece here is that our current undergrads, medical students, and even a lot of our residents grew up with social media. They’re used to it. It’s just part of who they are and what they do. Understand the ramifications, that once you post something online, even if you take it down two minutes later, it’s still out there and it’s still forever.
Smartphones didn’t exist when I was a teenager, thank goodness, because there are some moments that I’m not really proud of as a teenager. I think we can all think back to those moments. Helping educate even our teenagers in high school about the potential ramifications long-term is a huge need. I completely agree with you.
Who knows what’s going to happen next, but I love the idea that if we can take all the physicians in the country, and we can either like and share, repost, or comment on good content, or we can create our own content—if we all do something, we can make a huge impact.
I use the analogy of Finding Nemo. My youngest is nine years old. In that scene during Finding Nemo when all the fish are caught in the net, and they’re all swimming around and freaking out, Nemo says, “Everyone swim down. Everyone swim down.” They all start swimming in the same direction, and they almost tip over the fishing boat, and they break the net open. Individually, yes, we have a tremendous amount of responsibility and authority, but if all the physicians in the country start speaking up and sharing, I think we can have a tremendous impact.
Dr. Gray: I love that analogy. I want to see us break that net open, have all of us swimming in the same direction, and then our message is just going out to the rest of the ocean. I think that’d be perfect.
Dr. McDonald: This has been a phenomenal conversation. We could go on forever, but we’ll try to wrap it up here just for time purposes. If you could give one piece of advice for a doctor who’s thinking about social media, is in the contemplative stage but feels overwhelmed or doesn’t know where to start, what would that piece of advice be?
Dr. Gray: I count two things. You’re never going to be 100% ready, so maybe start before you feel ready, but do it responsibly. Pick a topic you care really about, speak clearly, be consistent. Consistency does not mean posting every single day. It means being consistent that you’re there and not leaving it alone for two months, but also, set those boundaries ahead of time. It’s harder to walk them back than it is to expand something later. Then, you really don’t need to go viral to make an impact. You just need to be credible.
Dr. McDonald: Yep. I think that’s wonderful advice. Just pick something. There are so many platforms and so many things out there. Just picking one little thing can really, really helpful. Stick with that one piece and start small. I think that’s great advice.
Remind us again where people can find your work, where they can learn more about you, and where they can follow you.
Dr. Gray: Yeah, of course. You can find me on Instagram, TikTok, Facebook, whatever your preference is, @DrJessicaGrayMD. That’s where I’m going to share some evidence-based health content, some behind-the-scenes looks at medicine. And then, of course, The Med Edit Podcast—you can find that wherever you listen to podcasts as well as on Instagram and TikTok. We talk about complex topics and how to make them into practical real-world conversations.
Dr. McDonald: Awesome. Thank you so much for your time today. I really appreciate your insights, and I love what you do. Keep doing it. I know I love learning from, watching, and sharing your content personally. I hope that all of our listeners do the same.
Dr. Gray: Thank you.
Dr. McDonald: Lastly, thanks to all of you out there listening. I appreciate it. It means a lot to us that you’re listening and sharing. Tell your friends. Have a great day.
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