Central Line

Episode Number: 133

Episode Title: Inside the Monitor – Social Media

Recorded: June 2024

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VOICE OVER:

Welcome to ASA’s Central Line, the official podcast series of the American Society of Anesthesiologists, edited by Dr. Adam Striker.

DR. KEYA LOCKE:

Welcome to Central Line. I'm Dr. Keya Locke, your host for today's episode. I'm joined today by Dr. Elizabeth Malinzak, guest editor for July's ASA Monitor, which offers a deep dive into the subject of social media, also the topic of today's episode. There are many prisms through which we might view the value of social media. So I'm excited to hear your point of view and thank you so much for being with me today.

DR. MALINZAK:

I'm happy to be here.

DR. LOCKE:

Can you kick us off by sharing a little info about your pathway, your role, and your current engagement with social media?

DR. MALINZAK:

Absolutely. So I am a pediatric anesthesiologist at Duke University. I also serve as the associate dean for student affairs in the Duke University School of Medicine, so I work very frequently with medical students. I have always had an interest in social media since college when Facebook started for me, and I was one of the first people on Facebook. But it very much grew as I got more into medical education and establishing my academic career. I began to find that a lot of the things that I was interested in, in terms of academic interests, including education and equity, diversity and inclusion, I wanted to learn more about outside of my institution. And so partnering with social media allowed me to connect with other people around the world and in anesthesiology and outside of anesthesiology to learn more about those areas and collaborate in those areas. I have to be honest, I wasn't super active on it until an ASA annual meeting, I believe about maybe 7 or 8 years ago where I started my Twitter account, and since then I have branched more into using Instagram in addition to X as it's now called. And I'm very excited that I get to serve as the social media editor for the ASA Monitor.

DR. LOCKE:

Thanks so much. So in talking about using social media professionally, how would you say it's most beneficially used by anesthesiologists? And how does the specialty, both anesthesiologists and patients, benefit from the ubiquitous form of communication?

DR. MALINZAK:

Excellent question. I mean, I think social media offers way, way, way more benefits than risk, uh, for physicians and for anesthesiologists in particular. It's been shown that physicians tend to use social media for building professional networks, learning about new research topics or clinical topics, educating the public about what we do on a day to day basis, making collaborations on research and other projects, and, you know, just being able to engage in scholarship and lifelong learning. So there's a lot of benefits to it. And it kind of depends on what you want to do with it in order to know which direction to go. So several years ago, Ed Mariano published a really nice article on his website about the reasons that anesthesiologists should be on on social media. And the three things that he says are: research and practice exposure. So being able to alert peers when new publications or other projects come out from your group. Being able to do kind of real time feedback and peer review. And share information that can engage and benefit a greater number of patients. It's also wonderful for that lifelong learning. You can follow certain accounts to make sure that you are always up to date on whatever the breaking science is, and there's people out there offering great educational materials that allow you to keep up with your continuing medical education and a really easy way. And then last, for those global interactions, you can, you know, connect with individuals who have similar interests around the world and were to share ideas. You can follow along at conferences that you can't attend live because people are putting information about the talks out there on social media. And there's other ways to participate on chats or other educational sessions in order to connect with people and expand your audience.

So really, it's kind of like the sky is the limit in terms of the benefits of it for professional use. And I certainly think one of the things that's important about anesthesiologists and patients is that a lot of times, people don't know what we do as anesthesiologists. The general public doesn't even know we’re physicians or what exactly we do behind that drape. So social media gives a great way for us to connect with our patients before they come in for surgery, to give them an idea about why we're important, who is part of their care team and what might occur. So I think, you know, it's a great way for us to brand ourselves as the leaders of patient safety.

DR. LOCKE:

All really, really great points, especially about branding in my opinion. And and talking about all the pros, how would you say the tool is currently being used for professional development and career advancement, if it is at all?

DR. MALINZAK:

Yes. So I think the physicians who use it really well for professional development are the ones who create a brand around themselves. So they're the ones who they identify how they want to advance their career or what the roadmap is for that, what is important to them about their career that they want to get out to other people and make connections for. So example, I'll use myself in that realm. Um, so I like to be on social media platforms discussing gender equity. That's one of the areas that I am most passionate about. So you will notice in my profiles and in a lot of the posts that I put out, are about being a woman anesthesiologist, new research about gender equity in medicine and in our specialty, even personal stories about being a mother and medicine. So most of my posts relate to that kind of brand. And through that aspect, it other people end up following me who have similar interests, and I end up following them. And we can have discussions on various platforms about current issues that are going on or things that we are experiencing, and it starts to develop a relationship that can eventually blossom into things like speaking engagements, collaboration on research activities. And honestly, it's just really opened up my professional networking ability. So I think just using my personal experience, it is the new way to network. You don't necessarily need to go to every single professional conference in order to meet people. You can start making those connections on your own time across the country. And then when you actually do meet in person, it makes the relationship even that much stronger. And so for me, that's really helps with the opportunities that have come my way in terms of my career.

DR. LOCKE:

Yeah, it's always really great to have your social media friends, and then you go to a conference and you're like, oh my God, it’s you in real life. So I agree that brings a lot of value to a new relationship.

Um, my next question gets at social media being leveraged for inclusivity. So for underrepresented minorities, social media brings additional layers of value. Can you talk about how social media is being leveraged more for inclusivity?

DR. MALINZAK:

Yes. The great thing about social media is that it gives everyone a voice. So for groups that have been traditionally marginalized, or maybe individuals who don't have a lot of people of their identity group in their own institution or where they live, it gives them the ability to connect with other people in their identity group, and to recognize that they experience similar issues, or being able to develop mentoring relationships, being able to make these connections that they otherwise wouldn't have been able to make in person. Depending on the social media platform, it can start to create communities as well, where they can discuss issues that maybe historically would have been shared only privately.

An example that I use is I'm part of a Facebook group called physician anesthesiologist moms group. This goes along with my interest in and gender equity in medicine. And, you know, there's so many posts on there about harassment or other issues that people may experience, such as having trouble pumping in the workplace. And it allows these experiences to be shared and validated so that you know that you aren't alone. Um, it also allows you to provide coping mechanisms for each other, or ways to suggest how to improve that issue at your own institution. So it's making the fact that there are smaller groups who might, before social media, not be connected. They can come together in the virtual world and support each other. They can also give more voice to issues that maybe otherwise wouldn't be recognized by the majority, through the use of hashtags, or through the use of being able to promote personal experiences that other members. Of groups that maybe are more majority groups may suddenly realize, wow, I never knew that happened to someone else. You know, this is changing my perspective. I'm learning about new things that haven't been presented to me before, so I think it's a great way that it just kind of lowers the hierarchies and the divisions between people. It allows people to connect more and to share and validate their own experiences. And that's my hope of how it is being leveraged for more inclusivity.

DR. LOCKE:

Thank you so much, I appreciate that. Moving on. How do you feel, if at all, it is effective towards advancing advocacy goals and when it is successful, what exactly does that look like?

DR. MALINZAK:

Social media can be a really wonderful tool. Again, it allows information about our specialty to go out to a wider audience, to allow more people to learn about who we are, what we do. And in all the realms of advocacy that we do for our patients, it lets the public know that we are here for them and we're here for patient safety. So certainly our professional organizations use it very effectively for advocacy.

In this month's edition of The Monitor, there's a particular example about how the California Society of Anesthesiologists really did a targeted social media campaign in order to put out strategic messages about what anesthesiologists do, why it's important for our profession to be understood by administrators and policy makers, the benefits that we bring to the table in organizations and for our patients. And so it's really a great article that goes into how they just did an amazing job to target specific groups.

It can also be really great for advocacy in the sense of if there's any sort of crisis communication. So, you know, sometimes we have events that happen rapidly that there's a lot of unknown about. The biggest, best example is the Covid pandemic, when, you know, this unknown disease was coming about and people didn't know anything about how to manage it, how to manage their patients. So social media was actually the way that we learned the quickest about how to care for our patients and for patients to learn about what we were dealing with in the pandemic as well. It allowed for organizations like ASA and the Anesthesia Patient Safety Foundation to release guidelines about care and management of Covid 19 patients. And so it made the information travel faster, which is great in terms of how effective it is for advancing our advocacy goals.

DR. LOCKE:

Yeah, I definitely agree. I understand you to be saying social media really allows us to get small bits of information that are highly valuable in real time, and that has been a real change. Uh, speaking of that, anesthesia education looks a lot different today than it did likely when we were both in training. What role do you feel social media is playing in the lives of our trainees, and what role should it play?

DR. MALINZAK:

It's a great medium for education. Yes, it is a lot different from when I was in medical school and in residency, when textbooks were how you learned and taking notes from textbooks. But now use of social media and other virtual platforms gives residents more opportunity to find information, to learn via their particular learning style. So, for example, they might learn best by listening to a podcast. And there's a lot of great anesthesia podcasts out there talking about various issues. It can also be really wonderful for those who are more visual learners and want to watch videos. So YouTube is the most accessed social media platform for all Americans, and it certainly is extremely helpful for our residents when maybe they're learning a new procedure or a nerve block and they can just pull up a video before they perform that procedure on a patient and review it really quickly and know just in time, in that moment, that they can remind themselves of the proper steps. So it's just very fresh in their mind when they're taking care of these patients. It's also really wonderful for disseminating educational materials from great educators. And they distributed it freely, which is really nice that people don't necessarily have to pay to learn about anesthesiology.

So one of my favorite things that my colleague Jeff Gadsden does is that he creates these really amazing videos every day in the month of October and calls it blocktober. And he has written a lovely article in this month's monitor about the role of anesthesia education on social media. But it's great. It's like an account that I definitely want to follow every single day of October. It gets me on the platform, it gets me learning. It's exciting. It's cool to see what he does with these videos. He does like a really fun one. At the very end of the month, where it's all my colleagues from our regional anesthesia division who are doing a parody on a song. And so it makes learning fun, but it also makes it really accessible and efficient learning to.

DR. LOCKE:

Thank you so much. I want to get your advice on how we can each engage responsibly and what to look out for. But first we need to take a short patient safety break. Stay with me.

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DR. SENTHILKUMAR SADHASIVAM:

Hi this is Dr. Senthilkumar Sadhasivam with the ASA Patient Safety Editorial Board.

Postoperative opioid-induced respiratory depression, or OIRD, continues to be a costly and potentially fatal problem. Reducing the incidence of OIRD requires effective preoperative screening. Patients with obstructive sleep apnea are at particularly high risk of OIRD, and preoperative symptom questionnaires such as STOP-Bang can help identify patients who would benefit from advanced respiratory monitoring. For patients at high risk, use of non-opioid analgesics or the lowest effective dose of opioids can help prevent postoperative OIRD.

For monitoring, pulse oximetry may not be sufficient to catch early signs of postoperative OIRD, and techniques such as capnometry and chest impedence monitoring may be needed. The PRODIGY risk score, which combines oximetry and capnography, is useful for predicting the risk of postoperative OIRD and identify patients who need closer monitoring. Early identification and advanced monitoring of patients at risk of postoperative OIRD is critical to ensure patient safety.

VOICE OVER:

For more patient safety content, visit asahq.org/patientsafety.

DR. LOCKE:

For our listeners who don't use social media much but are looking to drive more engagement, this can be a little bit intimidating or overwhelming. Are there platforms the anesthesiology community is engaged in that are a good first starting place? And any other tips for newbies?

DR. MALINZAK:

Yes. So it's a little bit overwhelming how many social media platforms there are out there. And all of them are a bit nuanced in terms of their use. So for people who like visual things, Instagram is full of photos and videos. For people who want to be more in communities and groups, Facebook is great for that. For people who really are into job search and networking, there's LinkedIn. For people who want to have discussions, there's Twitter or X, um, and there's even these new platforms that are coming out that I don't even know how to use yet. So there's there's so much choice that it can be overwhelming.

I think if you're a newbie starting out, you probably just want to look at things and learn and read. So figuring out your learning style and how you best can pick up that information will help you pick a a good platform to start with. And I would suggest if you're using it for professional reasons and you want to use it to learn more about things ongoing in our specialty, a great place to start for whatever platform that you're picking is following ASA, Anesthesiology, the ASA Monitor. A lot of professional organizations will put out really good, curated information that has been peer reviewed, and it's it's just excellent to learn from. It's quite appropriate to just learn and read from social media and not necessarily feel like you have to engage or create content for it. There are certainly more people out there who are doing what's called lurking, which is just kind of looking at the accounts rather than engaging with them, then those who are creating content and networking with it.

I'd also like to put in a plug for the ASA community as well. That's a great social media platform that is just for anesthesiologists and the ASA. That's a good way to post things about topics that are of interest. If you have patient questions that you are unsure about or cases or something unusual that you read about that you want to ask how other people do these things at other institutions. It's a really good way to start for someone who might be new to social media.

DR. LOCKE:

Thank you so much. I really enjoy some of those ASA socials. Beware those those conversations get, uh, really excitable, really quickly. So it's out there. But it's always fun to see how many people engage on, you know, a platform that's not typically at the front of my mind. So there's a lot of opportunities, I think, for people to get involved. And as far as those folks who are more just consuming the information, is there any way that we should really think about how the information we're exposed to on social media platforms should be digested by us?

DR. MALINZAK:

Great question. So yes, I think, you know, a lot of people hear in the news about social media spreading fake news. So it is important to make sure that you have reliable sources on social media for when you are trying to engage intellectually. So great places to start are the official journals, the official societies, large institutions and large hospitals, academic centers. These are the ones that are typically going to be putting out information that is relevant to the topics that you're interested in, and that you know it's reliable as well. From there, there's definitely certain influencers on social media who have a bunch of followers for various reasons, but there's a lot of anesthesiologist influencers who put out really, really great content in various social media platforms. Some of them might be confirmed and have a way to indicate that they're a reliable source in other ways to figure that out. Often those larger institutions or professional organizations will profile some of those people. And so that's how you can know they're good people to follow, and that they might have some really great information. That being said, there's so many people out there, it is tough to verify everything. And definitely social media is not a place where there's strict peer review. So making sure that you're doing your due diligence by checking in other sources and engaging in constructive conversation can be good for figuring out if this is information that's important to consume.

DR. LOCKE:

Wonderful. And I think you touched on this a little bit. But strictly speaking, when it comes to social media, are there any sort of red flags, anything that we should especially look out for?

DR. MALINZAK:

Yes. Uh, as much as I love social media, and I think it's a great way to connect with people, certainly there are the people out there who, uh, they're going to have differing opinions from you or have an opinion about what you post or, you know, might be a bit antagonistic. So it can be a place where there might be some bullying or harassment. That is certainly a really big pitfall. In order to prevent some of those things from happening, it's important to look at your privacy settings, make sure that you've set them appropriately for what you feel comfortable with, in terms of how people engage with you and how you engage with them. There are definitely ways that you can take any sort of a disagreement offline and away from the whole social media, uh, stratosphere, where many people might start chiming in or participating.

There's definitely the pitfalls of professionalism, too. So as physicians, we are often looked at at a higher level that we're on a pedestal, that we're in the public. And so if you espouse your own personal views, sometimes that might be confused with how you are professionally as well. So it's important to maintain both personal and professional accounts if you're going to do that.

When it comes to professionalism on social media, everyone's institution and professional organizations have social media policies, so it's important that you are familiar with those and follow them. You want to make sure that you're not violating any rules or HIPAA regulations. So you don't want to post anything about patients, not even hypothetically, because that still can be traced back to a patient and their private information overall, in order to avoid some of these pitfalls of social media, I like to follow a few different rules. I say, when you're in doubt about something, just don't post it. Remember that people act differently online. Remember that everything is archived, so once you put something out there, it's there forever. It can never be taken back so people can find that 20 years from now. Even if you put a disclaimer that says that your views don't represent your institution, you can still be connected to your institution, be considered the public face of your institution. So just make sure you have really high standards with what you're putting out there on social media, in terms of what your voice is.

DR. LOCKE:

All really great tips. In addition to guest editing this issue, you are also the Monitor’s social media ambassador, which means you're typically sharing articles and your perspective on why readers should care. How do you see your role, and do you have tips on how to engage personal networks with high value content?

DR. MALINZAK:

I really love being the Monitor's social media editor. It's really fun to be able to go through each month all the articles, and I learn new things all the time from it. So that's one of the reasons that I enjoy doing it, because I like putting out there what I have learned and what I think might be important for other anesthesiologists to pay attention to. Each Monitor article has a great theme. So, you know, I'm a pediatric anesthesiologist. A lot of times I'm not familiar with things maybe going on in critical care or in regional anesthesia, and knowing that the Monitor typically has relatively short articles that can get me up to date, I find it fun to review them and then to put it on social media and let other people know. There's definitely posts that people like to engage with more or have more opinions about, and that's fun to see what everyone's perspective is about certain topics. When I am posting about these articles, I try to always tag people either who authored the article to give them recognition of doing such a great job, and putting out such an excellent piece that they worked hard on, and make sure that their institution knows that for promotional purposes. But I also try to tag any other organizations that might be interested or any other specific people. I know where this might be something that they are interested in learning about. Sometimes I'll ask questions and opinions about the various articles to see if people are going to chime in to engage a little bit more and and bring some discussion.

So it's just it's fun for me. It's also a great way to advertise various events that might be coming up, such as the ASA annual meeting or new things that are going on in the organization, like the use of child care at last year's ASA annual meeting. And it's good to get the feedback, too. I tend to get a lot of people who do respond back and let me know what they're excited about, or what they think ASA should be doing better.

DR. LOCKE:

Thank you so much. So when you guest edit an episode like this, you don't always know in advance what our contributors are going to say. Is there anything that surprised you or what were some sort of golden nuggets or unexpected stories that emerged? Really anything, any little tidbits that our readers should look out for?

DR. MALINZAK:

Oh, so all of the articles in this issue are just fantastic. We have Jeff Gadsden writing about education and anesthesia on social media, and he does a really good job of talking about how to augment learner engagement. And one of the things that I really liked that he discusses is the democratization of medical education and how it's become more available and decrease the hierarchy. We have John Patton, who's talking about mentorship in the use of social media and how that makes people engage more with each other and improve their connections. Elopie Patel talks about networking, how that helps with resident recruitment, which may be really important for our medical students who are thinking about applying in anesthesiology and how to put forth a digital CV, which was a little bit of a nugget that I didn't really think about considering social media that way. Dr. Mariano talks about the California Society of Anesthesiologists. And then last, Amy Pearson does a really great job of talking about different social media platforms that maybe aren't traditionally used, like Mastodon or Threads, and how algorithms can work on social media in order to get information across. So I think, you know, reading her article was helpful for me. I must admit, I am less educated about algorithms on social media, and so that was some new information that I learned myself.

DR. LOCKE:

I'm looking forward to reading that article. I learned more and more about social media, and what I realized is that social media, by very definition, it's all an algorithm, right? And some of them are do a really, really good job. So you will literally only see the things that are most important to you. So some do a better job than others. But I feel like if you can even get a little bit of mastery of some of those algorithms, you can really leverage that platform, you know, in the best way for you.

DR. MALINZAK:

I totally agree. When I was on Instagram, my kids started looking at, uh, videos of pandas and other animals and now, like, it totally changed my feed. So it was all about animal videos. And so I've really had to work hard to get rid of that and start getting back to anesthesia related topics. Right?

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DR. LOCKE:

Right. It's interesting because on the other side of that, though, you know what other people are looking at may be something that related to you that you always pop up for them. So it's just a really cool thing to play around with.

So, this was a great conversation. Thank you for joining us and sharing your wealth of expertise. For listeners who want to learn more, please check out the ASA Monitor online at asamonitor.org and join us again for more central line.

VOICE OVER:

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