Futurist Kevin Kelly, the founding executive editor of Wired magazine, has suggested that where there’s attention, there’s money. And, of course, where there’s money, there’s influence. Just as the pharmaceutical industry has co-opted physician key opinion leaders (KOLs), you as a public physician will have new avenues of conflict. Personal technology, products, and services for doctors or patients will represent the parties looking to buy your digital influence.
To date, professional organizations and institutions have been blind to digital influence and the potential conflict of interest among doctors on social channels. But that will change.
Real-time communication puts us at risk for undisclosed conflict
The faster we move the easier it is to forget disclosure. With traditional media we go through a pre-publication process that allows for thinking before publishing. Even with blogs there is some opportunity for reflection before hitting publish. But speedy, real-time communication that happens on Twitter creates a challenge. Conversations are part of the public record and it’s easy to forget disclosure when connected through fast moving conversation.
New modes create challenges for disclosure of COI
Traditionally doctors have communicated with words. As sharing with mobile technology has become easier, many of us are now communicating and sharing with images. This creates challenges since it’s harder to describe your connection to a product or service with a picture. Instagram has a free text field that, if it’s used, should allow for clear disclosure.
How should doctors handle conflict of interest on Twitter?
Disclosure on short-form platforms like Twitter creates a problem due to space. It’s what we call a constrained media. There’s only so much space to go into detail.
And so solutions for disclosing COI on places like Twitter are hard to find. Many doctors use what I like to called ‘veiled disclosures.’ These are the vague things that we do to resolve our guilt without clearly defining a relationship. There are hashtags that you think might disclose a relationship. Often these are ambiguous and hard to understand. Some use bitly links to connect to pages conflict of interest statements. But we know that the clickthrough rate on links is dangerously small.
Where Twitter bio disclosures fit in is less clear in my mind.
On any form of digital media it should be clear to the typical user at the point of engagement that a doctor has a relationship with the stakeholder. Ideally, the consumer should be able to understand that relationship. If a physician doesn’t have the room to properly disclose their conflict of interest in the topic under discussion, they probably need to be careful talking about it. They should save the discussion for a place where they can spell things out.
If you have a financial relationship with anyone or anything that you discuss in public, make the appropriate disclosure. If it’s a blog post, state at the beginning or end in clearly identifiable type that the company or product discussed is a sponsor of your blog, research, or whatever. This is not only professionally sound and reflective of the obligation you have to your audience, it’s the law as defined by the Federal Trade Commission.
Digital influence will emerge as an important issue for health professionals
In 2012 I first described the rise of the digital thought leader. And as more physicians draw followings we’re seeing new ways to exert influence. And this is far more evident now than in 2012 when I first identified this issue. Digital influence will require special attention both from those who create media and those who consume it.
Dr. Matthew DeCamp deconstructed social media and conflict in long form over on JGIM.
This page is part of a bigger project: The Public Physician, a field guide for life online. To read more check out the Public Physician landing page. Happy reading!