COMMENTARY: Social Distancing via TikTok: Education During COVID-19

What your doctor is reading on Medscape.com:

APRIL 15, 2020 — As doctors spend hours upon hours treating patients and the rest of the world spends their time behind closed doors, it’s hard to engage with one another. Social distancing has left many people feeling isolated and searching for answers about COVID-19.

One avenue I’ve found helpful, in both engaging with others and providing answers (as well as busting myths), is social media, particularly the TikTok app.

TikTok, launched in 2017, is a social media platform that has been downloaded over a billion times. Catering to teens and young adults, users make 15- to 60-second videos, often set to trending music or popular sound clips. The app is set up in a way that allows videos to go viral frequently. Often, millions of views can occur over just 24 hours.

When scrolling through TikTok, you are almost guaranteed to stumble across a medical video, especially these days during the COVID-19 pandemic. On the app, you might see registered nurses teaching proper handwashing while singing a popular song or a physician dancing while educating on social distancing. The spirit of the app is to create content that is creative, fun, and interesting.

The potential of TikTok as a public health tool is also being recognized by major health and news organizations. The World Health Organization and the Washington Post are using the platform to educate and inform about COVID-19.

But TikTok isn’t without controversy in how medical professionals are using the platform.

So how does this translate to medical professionals on TikTok? How do we convey important and sobering public health information on the app while also entertaining the audience—often our patients or prospective patients? And how do we do this now, amid COVID-19, when such a serious pandemic is causing stress among us all, including doctors?

My TikTok Journey

I downloaded the TikTok app in May 2019. I spent a few weeks scrolling through silly clips of kids making dances inspired by math equations, a young mom giving tips on couponing, and a college student drawing cartoon characters. The content was fun, silly, and often educational. I absolutely loved it.

However, I was surprised by the lack of health-related content. Inspired by my 6 years of work in health education before medical school and interest in health advocacy, I decided to create the educational content I felt was missing. I focused on content that I thought was relevant to the young demographic using the app: such topics as intrauterine devices, vaping, LGBTQ health, and basic anatomy.

The response was bigger than I would have ever expected.

My TikTok videos quickly garnered millions of views and resulted in lots of media coverage in the United States and other countries. When the COVID-19 pandemic started, I realized that the platform was going to be a critical tool for public health messaging.

Teens Trust Physicians on Social Media

As the COVID-19 pandemic hit the United States, a concern arose that younger generations are not taking social isolation or hygiene recommendations seriously. In fact, the US Surgeon General asked social media influencers to use their platforms to engage and inform younger Americans about COVID-19.

In response, I shifted my content to focus on COVID-19 and what each individual person can do to help prevent spread of this illness. And guess what? It is definitely working. After creating a video explaining why social distancing is so important, a follower replied, “I didn’t used to understand it. Thank you for taking the time to explain this!”

In response to a video on practical hygiene tips, a follower commented, “I was overwhelmed and anxious, but this made me feel a lot better.” People are looking for information about COVID-19 from trusted professionals and feel comfortable learning through social media.

However, TikTok also has the potential to spread inappropriate or misleading content to wide audiences. A few medical professionals have created videos that make fun of patients or are downright rude. (I’m not going to link to specific examples so that we don’t bring more attention to negative content.) Some accounts pose as medical professionals and spread false information about the COVID-19 pandemic. These videos create greater distrust between the public and healthcare professionals. As usual, a few bad apples can spoil the bunch.

This has sparked controversy, with many medical professionals asking whether physicians should use TikTok at all as an educational tool during the COVID-19 pandemic. Most of the doctors and other health professionals I follow, however, are just that—professional. Like any technological tool, if used correctly, TikTok is a venue to provide critical health information to the masses.

Advice to Medical Professionals on TikTok

TikTok is an extremely powerful avenue for health education and advocacy work for a few reasons. On the app, health content has the potential to reach hundreds of thousands of people within minutes. The audio and visual tools provide a unique educational experience.

Given that the spirit of TikTok revolves around comedy, goofiness, and dancing, however, medical professionals must take extra care to ensure that their COVID-19–related content is appropriate and professional. Having trouble getting inspired? Ask a colleague to help you with a video.

Here are the 10 most important lessons I have learned about professionalism and TikTok over the past year.

1. Determine your intention on the app. Professional social media accounts should be used for education, advocacy, and recruitment, not personal fame or get-rich-quick schemes. Especially during this pandemic.
2. Never create content at the expense of a patient or family. Jokes about patient care are never okay. Remember, the goal is engagement, not estrangement.
3. Do your research, use evidence-based information, and cite your sources. Not only is this the ethical thing to do, but it also helps users practice thinking critically about the information they see on social media. We need to give a united message during this time of uncertainty.
4. Speak to what you are an expert in. I, as a family medicine resident, should avoid giving medical advice about dental surgery, so I don’t. When I do make videos, they are on topics I’m well-versed in and discuss regularly with patients in the clinic.
5. Be aware of the music you select for your videos. Many popular songs contain vulgar messages that are not appropriate to be paired with medical information. Remember, this is a popular app for children of various ages. You don’t want to offend a young person or a parent.
6. Film in a location that respects the privacy of patients, staff, and coworkers. If you are filming at work, speak with your supervisor about an approved private location to do so.
7. Remember that if you discuss your profession on social media, you are representing that profession to the world.
8. Be very careful if telling a patient story. Patient stories can be powerful for education and advocacy, but no patient should encounter a post and wonder, Are they talking about me? Always, always either get patient consent or change the details enough so you aren’t reflecting a real person’s story.
9. Only post content you would be okay with being on the cover on the New York Times. Social media posts can go viral—for good and for bad. So be smart about your content.
10. Have fun and be yourself!