I woke up at 4 am and couldn’t sleep.  So I checked my Twitter feed and found that my friend Ronan Kavanagh had pondered a question: Can you trust a doctor who bought followers on Twitter?  Then I really couldn’t sleep.

I don’t have an answer.  And I don’t know how to quickly sniff out a contrived audience.  But the idea that we can do this introduces a new truth for physicians:  there are many ways we can present ourselves.  This is the blessing and the curse of the physician as publisher.

How we are seen is combination of

• Who we actually are
• How we choose present ourselves in the public space
• How others represent us.

In many cases manipulation of the footprint overpowers prevailing public opinion.  We can be who we want to be.  As the old cartoon in The New Yorker suggested, on the internet nobody knows you’re a dog.

Going forward, the challenge for the patient is to figure out who a doctor really is and whether she represents an element in the solution to their problem.  The better question is, can you trust a doctor, independent of her audience.

Dogs on the computer via Wikipedia.