Surgical Tweeting: How does it work, and why does it matter?Neil Floch MD, FACSDirector of Bariatric Surgery, Norwalk HospitalWestern Connecticut Health Care SystemAssociate Professor University Vermont School of MedicineAssociate Professor Quinnipiac University School of MedicineFairfield County Bariatric and Surgical Specialists, P.C.

Disclosures

• No active business relationships• In past paid consultant for: Ethicon,

Allergan/Apollo, Tyco/Covidien/Medtronic• Never purchased Twitter followers• Own 100 shares Twitter stock• Personally tweet @NeilFlochMD since Oct.

2013 – 102,000 followers• Professionally tweet @ASMBS 3 to 13,000

Why Twitter for the surgeon?

• Twitter is less a clinical tool• It is a way to communicate clinical evidence• A real time educational vehicle for the masses• Preach your message or opinion• It is mobile• Unlimited ability to follow anyone• Not weird to follow someone you don’t know• Less time consuming• Can be performed throughout a busy day and night

But we are limited by how many people we can see, talk to and ultimately influence

The Best Social Media Is Face To Face

Social media is the new “WORD OF MOUTH” for patients

• (Picture of a tree)

Is the medical evidence read by doctors and the public?How can surgeons communicate medical evidence better so they are heard?

Unfortunately “EMINENCE OVERULES EVIDENCE”

“EMINENCE OVERULES EVIDENCE”

“RESPONSIBLE” medical evidence authority

We must be MORE effective “INFLUENCERS”

Twitter to support Bariatric Surgery

• Social media is used to fuel politics and social uprisings• Then why can’t physicians use social media to influence

beneficial change?

• There is an obesity stigma• …and a worse bariatric surgery stigma• There is no insurance mandate...• ...yet the medical evidence is overwhelmingly favorable• How can we improve access to care?

Twitter experiment: Three sites

Twitter sites three years later

Patients respect eminence “the doctor” because they don’t always understand or trust evidence

Establish authority and influence

• Maintain honesty and integrity• Uphold HIPAA• Support statements with facts and articles• Defend opinions

• Read tweets• Follow back• Read articles• Follow influencers• Retweet• Like• Learn• Watch• Communicate -doctors• Be influenced!

• Write tweets-Microblog• Follow aggressively• Tweet articles• Engage people (tweeps)• Collaborate• Comment• Promote• Teach • Communicate-public• Influence others!

Anatomy of a Tweet

• Register on twitter website

• Username• Headshot no egghead• Write a tweet• 140 characters

excluding pictures

Anatomy of a Tweet

• Y• Tweet -emotion

inducing

Anatomy of a Tweet

• Y• Tweet -emotion

inducing• A good picture

Anatomy of a Tweet

• Y• Tweet -emotion

inducing • A good picture• Attach a strong article

• Y• Tweet -emotion

inducing• A good picture• Attach a strong article• @Copy to increase

exposure

Anatomy of a Tweet

• Y• Tweet -emotion

inducing • A good picture• Attach a strong article• Copy to increase exposure• #Hashtag to categorize

Anatomy of a Tweet

Anatomy of a Tweet

• Y• “Retweet” your own or

others’ tweets• “Like” saves to your

likes file • Both are a measure of

the interest in the tweet

Retweet and viral spread

Tim Mauri Video: The Obesity Set Point

Follow & create lists

NETWORK VISUALIZATION• 60% Doctor • 13% Advocacy• 8% Media• 8% Journalists• 5% Industry• 3% Patients• 2% Hospitals

• Tweet a meeting• Immediate global spread of information• Research and meeting message

exposure• Register meeting with Symplur #OW2016

#OW2015 Tweet Activity

Market the medical evidence amongst

professionals

• Reach both doctors and laymen

• Tweeting articles did not increase citations

• We must make information attractive easy to understand

#VisualAbstract

• 7/4/16 birth of the #visualabstract

• By Andrew Ibrahim MD• Key points• 10x increase exposure-

retweets and likes

#visualabstract

• To improve SOARD articles

• Increased exposure• Easy to read• Easy to remember• A winner for journals• Still need to read the

article

Twitter poll: Awareness Measurement

Twitter poll: Education and Influencing

Awareness measurement: Opinion changed from 36% to 51%

Tweet a movement

Twitter Analytics

3,500 to 12,300 followers since March 2016