My EM News column from last February, 2019.


The internet allows us to access the latest treatment recommendations for our patients while listening to Mahler’s symphony. And, wonder of wonders, it brings us an infinite supply of cat videos. Of course, the same thing that gives us access to the sum of the world’s knowledge also brought us social media, the apple in the garden of Eden if ever there was one.

Sadly, social media has successfully turned previously balanced, staid physicians into immature high school children. It is staggering to watch the level of vitriol, anger, condescension, pettiness, and immaturity that physicians bring to the table when any controversial topic shows up on a social media site.

We need unity now more than ever in the history of modern medicine. Yet we let argument drive a wedge between us. Social media is toxic. Researchers seem to consistently note that rather than making us kind and connected, social media reduces our quality of life. Likewise, social media algorithms drive things before our eyes that anger us, thus clicks and likes and ad dollars. Does the dear reader distrust the financial imperatives of Big Pharma? Now apply the same logic to the site where you spend your down time clicking, linking, and arguing.

Why else have we rushed headlong down the rabbit hole? Because likes and reposts give us a steady rush of pleasing neurotransmitters. We are social animals. We like connection. Acceptance and agreement make us feel validated. I’m not throwing rocks in a glass house: As a writer and early social media adopter, I get it. The positive reinforcement of connection can be intoxicating. Social media allows us to dwell safely in our own echo chambers where all feedback is positive. When this happens, exposure to disagreement feels like an attack on truth, on our identities.

Discord Everywhere

This may be deeply connected to our development as professionals. Our educational process is arduous. Many of us learned to forgo the standard high school and college drama in exchange for more serious things like grades and test scores. We seemed, to observers, to grow up.

Perhaps we didn’t. Surrounded as we were by many like-minded, hard-working people and teachers, we didn’t often meet people that different from us. Typically, we dated and married people from similar groups. We were sheltered, and on social media we often remain.

The recent political climate has certainly turned up the burner on discord. This contentious climate bleeds over into the internet, where everyone on a social media site tries desperately to make a point. This attracts socially engaged physicians like moths to a bug-zapper.

Whether it’s gloating over victories, posting research to confirm a viewpoint, or attacking detractors, the lure of politics and culture is pretty tough to resist. Again, I’ve been there. I’m in recovery. I still use it, but I try to avoid arguments that won’t change minds.

To become physicians, most of us had supportive friends and family members who spoke hope and confidence into our lives. Occasionally, they went overboard, and we began to believe we were exactly as awesome as our parents, grandparents, and friends said we were. That was nice but dangerous to our maturity.

‘Trust Me; I’m a Doctor’

Humility can also wither as we develop true and valuable expertise. Because it’s difficult to become a physician, we are treated as respected experts on many things, and we can fall into the trap of believing that our intense knowledge of medicine confers expertise in politics, culture, and religion.


We may be well versed in other fields, but it’s easy to fall into the old “trust me; I’m a doctor” paradigm and blow our own egos out of proportion. When this happens, it’s quite easy to think that those who are different are idiots even when they had the same education we did.

It’s obvious that physicians have hot-button issues. We all have something about which we feel intense passion. But why can’t we keep it in perspective? We like to think that we get upset because we’re right. We go to social media, however, for reasons far more complex and toxic than we think. Whatever our personal issues, here’s the real shocker: Almost all of our colleagues are smart people who have decent reasons for their beliefs, and they aren’t monsters.

Maybe we can take a break from teen crazy 2.0. Maybe we can learn to share an idea and walk away when we get our feelings hurt. Perhaps we can grow beyond, “I’ll make sure everyone knows how evil you are and eject you from polite company!”

More importantly, maybe we can log off and focus our eyes, minds, speech, and bodies on activities more enduring and uplifting to those around us than one more click, one more post, one more insult.

Life is short. Who knows better than we? Let’s live that way.

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.


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