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Table 2 Participants’ perceived benefits and barriers of using social media

From: Social media use by physicians: a qualitative study of the new frontier of medicine

  Benefits Quotes Barriers Quotes
For Providers/ Institutions Forward Career/Research
 Marketing, Publicity, Branding
 Networking/ Sharing ideas
 New Research/Career Opportunities
 Low Cost
 Repository for Information
 Improvement in Clinic Efficiency
It “doesn’t cost much in terms of money… and it can lead to other opportunities (for the provider). It can lead to more media outreach, speaking engagements, opportunities to teach, promotion for your practice, i.e., ‘free’ publicity.” Time/Work requirements
 Keeping current with content
 Researching content
 Composing/posting content
 Listening to/responding to comments
 Needing to update regularly
“Time is a biggie. And training to some extent, although I think that most people these days get how to use social media. Using it well to communicate health information and thoughtfully so you’re not misunderstood and get in medical or legal trouble, that’s different.”
Self-improvement
 Learning (staying current)
 Listening to patient views/ understanding patient needs
 Teaching (medical education)
“As soon as the new blood pressure guidelines came out, people started tweeting about them. I know about it ‘cause I’m following people who pay attention to that on twitter. It’s a good way to keep up with what thought leaders are talking about.” Skill requirements
 Social media know-how
  Unfamiliarity with tools
  Unfamiliarity with etiquette/rules
  Constantly evolving environment
 Communication skills
 Media skills
“When I started, I literally had never heard of a blog before… and so the stumbling block was going from never even using it to being it (social media).” “Number two is that it’s an evolving field.” “Another barrier is knowing how to write. People go to college to learn how to do this. Most doctors don’t know how to do this.”
Increasing Reach
 Providing accurate information to more people (correcting misinformation)
 Amplifier effect (physician ‘voice’)
 Amplifying ideas
 Where patients are at, especially kids
 Where patients get information
“We realized that each of us could see maybe 20 to 25 patients a day, but on social media, we could reach hundreds or thousands of patients a day.”
“It seems that everyone turns to social media for information. When I go to google something, I almost always end up on a social media site.”
Lack of institutional support
 Lack of reimbursement
 Ignorance of benefits
 Oldschool mentality
 Lack of models/guidelines
 Lack of reimbursement
“People are old in the healthcare system. They’re scared and don’t know how to use the medium…There is a 19th century mentality at the level of academic medicine. I think it’s an old world-new world mentality. Healthcare’s been stuck in this 19th century rut.”
Independent/Unregulated Venue
 Place to express opinions
 It’s FUN
 Camaraderie
“I found that I really enjoy twitter for learning and connecting with people and building relationships. There aren’t many of us, the physicians in this space. This is the best and easiest place to find them (other physicians).” Fear of saying the wrong thing
 Saying something unprofessional
 Breaching patient privacy (HIPPA)
 Negative response
 Providing misinformation
“Barriers like if you post something that you shouldn’t have. You can take back something you’ve said, but to have something out there that can be re-tweeted or re-purposed.”
   Lack of models/guidelines  
For Patients/ Communities Source of health information
 Source of ‘accurate’ health information
 Source of ‘trusted’ health information
 Source of ‘understandable’ health information
 Source of ‘current’ health information
 Source of ‘targeted’ health information
 Source of information outside the clinic visit
“It can provide accurate information from evidence-based research. I can provide a summary of an article in terms that parents can understand instead of them just reading information from the latest celebrity.” Poor access
 Language barriers
 Mental disability
 Older generation
 Lower SES (Medicaid patients)
 Literacy/Education barriers
“The main reason I don’t use it in my own patient care is because the patients I care for have problems with access. For the most empowered, educated patients, it might be useful. That’s not the kind of people I take care of in an urban underserved hospital.”
Low cost for patients The benefit “to the patient is that it’s free healthcare.” Lack of physicians with similar backgrounds  
Community Outreach/ Input/ Engagement “It increases the reach of the message and allows me to interact better. It’s not about broadcasting, it’s about being there and being more accessible for people” Distinguishing credible information “the general public not being able to distinguish what’s credible on the internet”
Accessible “Just today, I’ve gotten emails, pings, hits, likes from 8 different countries. It runs the gamut. I have people from India or Malaysia who probably make dollars per day to presidents of companies who ask for second opinions. It helps to level the playing field.”   
Health Behavior Change “We’re trying to educate people who are misinformed. For good or for bad, social media is very good at changing opinions.”   
Both It’s fast (quick exchange of information) “When you email them, you don’t get a response. When you tweet them, it’s literally a one min response.” Lack of social media know-how “Honestly, I am my own barrier. I’d never heard the word blog until 5 years ago. I’m still learning. My 14 year-old to tells me how.”
Improved doctor-patient relationship
 Breaks down professional barriers
 Increases communication
“It also allows you to maintain a relationship with your patient population on an ongoing basis. About half your patient population is only going to come in once a year or twice a year. How do you stay in touch with that population, make sure they come back, make sure you can provide them information? It helps them and helps them appreciate you as a physician.” Lack of privacy “You can almost trace everybody back. What’s that they say? ‘On social media, it’s written in pen not pencil.”