COMMENTARY

Should Docs Steer Clear of TikTok?

Alok S. Patel, MD

Disclosures

March 20, 2020

This transcript has been edited for clarity.

Alok S. Patel, MD: You've heard of TikTok by now, right? Maybe you've at least seen a news headline about it. Well, doctors are using this app to make catchy 15- to 60-second videos filled with health information, and they are reaching a huge audience base.

Teens are reporting that from TikTok they have learned about everything from reproductive health to substance abuse. One teen even said that the app helped him get a cancerous mole diagnosed and eventually removed.

Given that teens are addicted to this app, some early pioneers use it to talk to them about health. One famous example is Dr Rose Marie Leslie, a family medicine doctor, who is better known as Dr. Leslie on the TikTok app. Her videos have reached millions of teens.

Healthcare professionals are using it to talk to teens about everything from vaping to safe sex to injury prevention to mental health—all of it.

The app's algorithm really favors those creative, high-energy videos, so you can go on the TikTok app and see doctors using every creative trick they can to reach teens.

It hasn't all been positive news. Some videos came out where people appear to be mocking patients and making jokes about really serious health issues. This is not okay! #unprofessional.

We still don't know if there are privacy or cybersecurity issues with the app. Some people even think that the Chinese government is using TikTok for censorship or surveillance.

A big debate has started about whether doctors should even be using this "juvenile platform."

What TikTok Docs Have to Say

We can't take a couple of bad headlines, make generalizations, and take away from all the potential good.

In order to learn more and get some perspective, I recruited a couple of all-star TikTok doctors, Dr Danielle Jones and Dr Austin Chiang, to answer a few questions.

First, why did you join TikTok?

Danielle Jones, MD: I like TikTok because it's a fun and creative way to reach a new, younger audience who are particularly susceptible to misinformation, which has a habit of going viral on that platform.

Austin Chiang, MD, MPH: Personally, my patients who are following me on TikTok seem to be very encouraging and have reacted very positively to the messages that I've been conveying on the app. I think we will have to see what more people have to say about the use of this platform to amplify health messages.

Patel: This is awesome in theory, but do you think your content is truly reaching teens? Do you have any proof that you've really helped anyone on this platform?

Jones: I get a message almost every day that says something like, "Something you shared on the Internet gave me the courage to reach out to my doctor, or my advanced practice provider, and bring up a question or problem I was having."

Patel: Last question: What are some downsides to this app?

Jones: You want to be careful with TikTok because that endless scroll is super-addictive. It's really fun and allows a lot of creative processing to go on. You want to make sure you're comfortable with their terms of service and how they do their business practice. Overall, I think it's a really great way to reach a new audience.

Chiang: Just like any other social media platform, I think that there have been concerns about TikTok, especially when it comes to privacy issues.

There's also been some concern over how TikTok is managing the content that's being put on their platform. Some groups have come forward saying that TikTok is potentially censoring their material, so it makes me wonder whether certain messages are purposely being amplified whereas others are being suppressed.

In terms of health messaging, I think the debate is still ongoing about whether the way these health messages are being delivered on TikTok is appropriate. I think we do need more guidance, and we potentially may want to even solicit feedback from patients to see what their thoughts are about this.

Patel: There are a couple other things to consider. First, teens may not be vetting the credentials of all of the healthcare professionals using TikTok. This could be an open door for people to spread misinformation, pseudoscience, or for quacks to try to sell things to teens. This is something we need to pay attention to.

Second, TikTok has made some physicians open for attack. For example, Dr Nicole Baldwin, a respected pediatrician, made a very engaging and informative video about vaccines, the diseases they prevent, and that they don't cause autism. She received death threats, experienced cyberbullying, and people made fake reviews about her online. It's horrible.

Several other doctors have reported the same thing after posting videos.

As we move forward and learn about all of the potential good, these are some concerns that we need to pay attention to.

Share Your Thoughts

Regardless of all of the headlines, no one can deny that there's real potential here to get health information out to millions of teens. I've even seen some health campaigns take over TikTok completely, including one about HIV awareness and another to help teens quit vaping.

You should check the platform out for yourself. The videos are engaging, and be warned—it's kind of addicting.

More importantly, I want to hear from all of you. Do you think this is brilliant public health messaging? Do you think it's effective? Do you think the benefit outweighs the risk? Are you going to become the next TikTok star? Comment below.

Dr Alok S. Patel is a pediatric hospitalist, television producer, media contributor, and a digital health enthusiast. He splits his time between New York City and San Francisco as he is on faculty at both Columbia University/Morgan Stanley Children's Hospital and the University of California San Francisco, Benioff Children's Hospital. Alok hosts The Hospitalist Retort video blog on Medscape and is a medical producer at CNN.

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