The Influence of Social Medial Influencers on Urology Information: Where Are All the Urologists?

Patient and physician–shared decision-making is an important part of the practice of urology. To actively take part in shared decision-making, patients need access to medically accurate, easy-to-understand, and up-to-date information. The growth of social media platforms has made it possible for patients to easily receive and share medical information with others around the world. Social media platforms, however, are also actively being used to promulgate misleading medical information, false medical information, and medical disinformation. Medical misinformation can lead to confusion, physician distrust, avoidance of evidence-based treatments, use of unproven treatments, and patient harm[1].

Researchers have previously uncovered the presence of medical misinformation on a variety of different social media platforms. Public discourse about vaccine safety, the COVID-19 pandemic, and mask mandates, however, have increasingly put a spotlight on the issue. Dr Anthony Fauci, former head of the United States National Institute of Allergy and Infectious Diseases and former member of the White House Coronavirus Task Force, has previously observed and lamented, “We’re living in many ways in a sea of exaggeration and a sea of lies”[2]. “It is terrible how we’ve gotten into a situation, and I think it is the phenomenon of social media”[3].

Social media differs from other types of media in a couple of important ways. First, not all social media users have the same influence or the same reach. For example, celebrity figures, politicians, and other influencers often have millions of followers. In addition, not all content on social media is treated equally. Content that is shocking, scandalous, or salacious tends to be viewed and shared more frequently[4]. When medical misinformation is posted on a social media account with millions of followers, the impact can be astonishing.

A notable example is a tweet made by rapper and songwriter Nicki Minaj on September 13, 2021. At the time, with more than 22.6 million followers, Minaj tweeted, “My cousin in Trinidad won’t get the vaccine cuz his friend got it & became impotent. His testicles became swollen. His friend was weeks away from getting married, now the girl called off the wedding. So just pray on it & make sure you’re comfortable with ur decision, not bullied”[5].

Nicki Minaj’s tweet, fueled by tens of thousands of retweets and likes, spread rapidly on Twitter. The inaccurate information contained within the tweet was quickly called to Twitter’s attention. The company elected not to place a warning label on the tweet, or remove the post, as the content reportedly did not violate the company’s COVID-19 misleading information policy[6]. Screenshots of the tweet were shared on other platforms, and the scientifically baseless information content of the tweet was reported by mainstream media. Urologists on social media tried to repudiate the misinformation contained within the post[7]. The performer’s massive following, and loyal fan base, however, made this an almost impossible task.

As the response to Minaj’s tweet demonstrates, social media companies are struggling to safeguard their users from inaccurate and misleading medical information. Urologists have an opportunity to help address this issue by regularly sharing medically correct information on their social media accounts. Fortunately, high-quality digital resources, covering a wide range of urological conditions and treatments, are readily available and easy to share.

The Urology Care Foundation (www.urologyhealth.org), the European Association of Urology (www.uroweb.org), and the Canadian Urological Association (www.cua.org), for example, each offer a wide variety of medically accurate patient education materials on their websites[8]. These materials are guideline based, physician vetted, and available in a growing number of languages. Many institutions, hospitals, urological societies, and collaboratives have created quality resources of their own, and a growing number of urologists are producing materials of their own, posting them, and becoming social media influencers themselves[9].

Exploring new ways of disseminating medically accurate information is another way we can help educate the general public and our patients. Toward this end, the Urology Care Foundation has created bundles of condition-specific, QR-coded educational materials that can be readily accessed by patients with the swipe of a smartphone[10]. These codes can be electronically shared with patients during their visit or added to their after-visit summary. Many patients experience anxiety between the time they make their appointment and the time they are first seen. To help address this, Dr David Canes, associate professor at the Lahey Institute of Urology, recently launched WellPrept, an online tool physicians can use to gather, collate, and customize patient educational materials[11]. WellPrept gives patients the opportunity to educate themselves about specific urological conditions, and treatment options, before their visit. Providing patients with medically accurate educational materials before their office visit can help relieve anxiety at a time when they might be vulnerable to medical misinformation. This “flipped classroom” approach makes it possible for urologists and their patients to have more time for discussion during their office or video visit.

Patients need access to medically accurate information to effectively participate in shared decision-making. Medical misinformation on social media presents a challenge for both patients and urologists alike. Urologists can help address this problem by calling attention to and refuting inaccurate information when we see it, sharing medically correct information, and incorporating new technology into our practices.