Some Tips on Successful Conference Tweeting

Recently, I have heard disappointed comments about the lack of conference tweet activity for given healthcare conferences. On each occasion, it seemed fairly obvious as to why this was the case.  Having participated in quite a number of conferences by the way of Twitter, I have made a number of observations of what seems to make the difference.

1. Must Be Good WiFi

This is perhaps the greatest impediment to the success of conference tweeting. Frequently, the systems are tested when the conference centre is empty and of course everything works fine.  As soon as the conference commences and people are using the system, it comes to a grinding halt.  Once again, there is no greater impediment to conference tweeting than the lack of adequate WiFi.

2. Conference Twitter Account

This account would help define to observers what the conference is and what official conference hashtag has been assigned. This account should tweet out updates, announcements as well as interact with key twitter accounts through replies, favourites and retweeting.  This account can also act as a catalyst for activity if the twitter stream is quiet.  With this comes the assigning of a person to look after this account during the course of the conference.

3. Appropriate Hashtag

The hashtag should appear relevant to the conference and should use the minimum number of characters.  Ideally the number of characters should be no more than 6 or 7 characters.  Any more detracts from the precious 140 character count and would limit the information that can be shared to the hashtag audience.  Only one hashtag should be assigned.  Sub-hashtags only lead to confusion and in combination with the main hashtag, chew up valuable characters.

An example of a misleading hashtag was when the #uro12 was assigned to the American Urological Association meeting when the hashtag of #AUA12 would have made much more sense.  An example of wasted characters is the Royal Australasian College of Surgeons using #RACS2014 when #RACS14 would have been more appropriate.  With the RACS meeting this year, there were no fewer than 4 hashtags being used by various conference tweeters and the twitter stream from this meeting was a disaused the hashtag #CFAConf14.  A long hashtag hampers expression and detracts from participation. Including the space, #CFAConf14 chewed up 10 characters when a simpler #CFA14 would have been appropriate. With the 2014 RACS meeting mentioned above, there were no fewer than 4 different hashtags being used by various conference tweeters and the twitter stream from this meeting was a total mess.  

4. Engage KOL Twitter Users

Conference organisers should seek out the key opinion leaders who are active on twitter in advance of the meeting.  Organisers could consider requesting specific accounts to be assigned to tweet proceedings from specific sessions.  Having predetermined users involved creates a core group of participants.  People are reluctant to be a sole or one of only few tweeters for a conference. 

5. Twitter Boards

Strategically placed monitors showing the twitter feed are often a magnet for the attention of conference attendees.  The most organized meetings will have such monitors outside every meeting room as well as in the registration and trade exhibition areas.

6. Twitter Instruction

At the American Urological Association annual meeting this year, opportunities for small group or one-on-one instruction on twitter basics and how to conference tweet.  Alternatively having a course or conference session on social media as was the case at the European Association of Urology congress (#EAU14) and Urological Society of Australia and New Zealand ASM (#USANZ14) respectively was particular done well. These sessions were not only well attended but also created an explosion of activity on the conference hashtags during these sessions.

7. Publicity

The role of social media at the conference needs to be publicized and prominently implied.  The hashtag should appear on all background slides that appear at the beginning of conference sessions as well as all publications such as the conference proceedings and conference badges as examples.  Such publicity adds negligible if at all any cost to the conference but is returned many times over by increasing the engagement of those attending as well as reaching a much larger global audience in virtual attendance.

8. Register on Symplur

Registering a health conference hashtag with the Symplur Healthcare Hashtag Project is free.  This provides access to basic twitter statistics.  Tweeting these during the conference often generated interest when enormity reach of the conference tweets is realized.

There are probably other ideas that would enhance conference twitter activity that I have forgotten about so please feel free to add your comments.  One example is to allow participants to ask questions via twitter - on occasions I have actually offered this to the audience when I have chaired sessions. A few questions do come in although this is not a deal breaker for twitter engagement at a conference. I look forward to your comments.

Creating One's Own Luck

I’ve been inspired to write this blog piece after seeing the wonderful Prezi presentation constructed by Dr Marni Basto on Urology Social Media 101.  It really is a fantastic presentation that has gone viral throughout the international urological community.  Although she is yet to commence formal urological training (she deferred commencement by a year to work on her Masters of Surgery), she now has an international reputation for her skill and understanding in the area of social media and associated technology.  When you look at her presentation, it is obvious that she is an individual who has great clarity of thought and able to develop depth of understanding of a given topic – these types of skills are easily translated to any area of medicine.  One can only sense that she has a bright future ahead of her. 

I’ll now move onto what her Prezi has got me thinking about.  Over the years, I have observed a number of young urologists returning to Australia after completing post FRACS (surgical qualification) training.  I commonly see this expression of despair that they cannot find a coveted public teaching hospital position, which is always the best way to kick-start a new practice in surgery.  Here you have access to multidisciplinary care, senior collegial mentorship, teaching of surgical trainees and medical students as well as research opportunities.  These positions are in limited supply and only come about when they are to replace a surgeon who has either resigned or retired or if the waters have parted to create a new position. 

Some of these young surgeons feel a sense of entitlement that they should be able to just walk into such a position.  I recall one surgeon who complained that he was a subspecialized surgeon who had done his special post fellowship training and could not understand why no teaching hospital was making any particular effort to find space for him within their units.  Another said to me that he was technically a much better surgeon than some others who had received teaching hospital appointments. When I thought about their achievements, they had not made a single presentation at a major urological meeting, had not published a single paper whilst away and since returning home, had contributed little to the profession (eg could do volunteer work or perform committee work with the Royal Australasian College of Surgeons or Urological Society of Australian and New Zealand).   

And here lies the point that people can create their own luck.  I can usually make a prediction before one of our trainees goes overseas or interstate for post FRACS training, as to who will literally walk back into a teaching hospital position. When I look at trainees who have done research with me, the ones who reliably kept to deadlines and completed their assignments were the same who did such when abroad and the same ones who eventually found positions in teaching hospitals.  These were individuals prepared to go the extra mile and create their own luck.  The trainees where I had to repeatedly provide gentle reminders to complete tasks to help their own careers have more often struggled.   The ability to create luck had already been defined early in their careers.

Back to Marni.  She has already passed the hurdles to be selected for urological training and is yet to commence whilst she does her Masters of Surgery.  You know that Marni has already begun to create her own luck and I am excited that we will have a future urologist who will be more than just ordinary.

Twitter Wars on Anonymity of Doctors on Public Social Media Networks

The discussion on the GMC-UK guidelines on doctor behavior on social media has proved to be most controversial and divisive.  I think that the vast majority of doctors really could not care less but most of these are those are probably not participating in social media in any form.

I have watched with great interest, the arguments put forward by those who oppose Point 17 in particular.

It is also interesting to see how the debate has those in opposition discussing the policy as if the word “should” is “must”.  There appears to be some paranoia that the ‘should’ could become a ‘must’ over time but my own thoughts are that the GMC are unlikely to be bothered or would have the resources to police such a rule.  If doctors do behave themselves professionally on social media and provided there are no regular reports of unprofessional behaviour on the front pages of newspapers, it is unlikely that the ‘should’ would ever become a ‘must’. 

The debate has become quite emotive.  It was implied to me that I was being hypocritical in my views and sending mixed messages on the basis that my avatar on twitter has an image of me wearing loupes and a headlight and therefore obscuring my face.  I totally disagreed in that the picture perfectly reflects what I do in my work and that my name and details in my bio are totally unambiguous as to who I am and what I do and where my interests lie.  Additionally, pictures of me without the ‘theatre armour’ are easily found on a simple Google image search. 

Some of the arguments I have seen include:-

Doctors will disappear off Twitter and interaction will be lost

One argument put forward is that without the anonymity option, doctors will disappear off social media and interaction will be lost. I disagree totally.  We only have to look at conference tweeting – at the recent 2013 Social Media and Acute Care Conference (SMACC), over 1200 users contributed to the hashtag for the meeting and the substantial majority were using their real name or at least had a link that would identify who they were.  The interaction was outstanding and the comraderie associated with knowing with whom individuals were interacting and the excitement with tweetups was palpable for anybody following the hashtag.  This data does not suggest that doctors on twitter are going to disappear.

Tweet Metrics from Symplur of the 2013 SMACC Conference

A similar interactivity was seen with the 2013 European Association of Urology Congress – again, almost all users being identifiable.   Additionally, we only have to look at weekly twitter discussions where doctors are significantly involved and again the substantial majority are using real names – good examples are #hcsm, #hcsmanz, #meded. More recently, a highly interactive twitter journal club has been in operation and this has been a perfect example of doctors interacting and again, this is not likely to go away - incidentally, all doctors involved in the #urojc are using real names. What about doctors interacting with patients and other health professionals? this will continue and a great example of this is with #hcsmanz and #healthychat

Can doctors be trusted to exercise professionalism online?

Largely yes.  Sadly, we need regulations to ensure that doctors understand what constitutes unprofessional behavior.  Doctors could easily argue that we do not need to have a regulatory body to tell them not to have a sexual relationship with their patients – whilst having such regulations does not always work, I have little doubt it has made many doctors think twice before embarking upon such a path.  Doctors can be trusted but a guidance on appropriate behavior can make a difference to those wavering on taking a wrong path.  That said, remember that the guidance says ‘should’ and not ‘must’.

That doctor anonymity will help protect identification of patient cases being discussed.

What the ...?  Patient histories should not be discussed in a public forum FULLSTOP.  There are plenty of other avenues (including online) to discuss patient histories amongst colleagues and twitter and facebook are in my opinion inappropriate. 

Suggestions have been made to run two accounts - If one account is anonymous and the other under a real name, then the user is bound to get them mixed up

This is the user's problem.  Many of us have a private and work email.  Many of us have a work and private mobile phone number.  This is an irrelevant argument.

Why, when patient safety is not an issue?

As recently as last week, I have seen anonymous doctors on twitter giving personal medical advice without so much of a less than 140 character history and without even cursory view of imaging.  The lowest common denominator factors into why there is a need for professional guidance documents.

That doctors should have the right to be anonymous in their social media activities just like any other profession.

Doctors are NOT just like any other profession.  There is a level of personal trust and privilege and power imbalance in the relationships that doctors have with their patients that is consistently there like no other profession.  Doctors CAN engage on social media anonymously – this right is NOT being taken away.  It is however, stated that doctors who want to say that they are doctors SHOULD (not MUST) identify themselves.  Doctors can therefore continue to tweet and blog anonymously but should not make representation to themselves being a doctor.   In my earlier blog piece on this matter, there may be exceptions as to why a doctor needs to be anonymous and these could be stated in the bio or a link to explain why a nom de plume is being used - I think that this would be the fair and transparent thing to do.  I think that the public have a right to know why a doctor feels the need to be anonymous given the special status that the profession holds within the community.

Doctors will feel unable to comment on medicine and medical politics

Anybody is free to comment on medicine and medical politics.  If they do not include that they are a doctor in their bio or links on the bio, there is no reason why they cannot continue.  It is not essential to be a doctor to comment on medicine or medical politics. Other professionals such as biochemists, scientists, those in the pharmaceutical or medical device industry often know a great deal about medicine without having to be doctors.  If one feels a need to state that they are doctor because they want the credibility that comes with that, then they 'should' use their real name.

There are valid reasons to be anonymous

This is something I do agree with.  Particularly with whistle blowing and for doctors working in small communities.  Additionally, if you want to actively debate controversial emotive topics that can truly put ones safety in danger such as abortion issues, this is also a valid reason.  These doctors have good reason to not comply with 'should' and could make good argument to the case.  To quote the GMC guidance:-

'You should’ is used when we are providing an explanation of how you will meet the overriding duty. ‘You should’ is also used where the duty or principle will not apply in all situations or circumstances, or where there are factors outside your control that affect whether or how you can follow the guidance.

CONCLUSIONS

In conclusion, I think that for most this will end up being just a storm in a teacup.  Several commentators are propagating the argument that 1+1=3.  The suggestion that doctors who say that they are doctors 'should' (not MUST) use their real name is my opinion perfectly reasonable. As per point 17, "Any material written by authors who represent themselves as doctors is likely to be taken on trust and may reasonable be taken to represent the views of the profession more widely."


Update
The following piece has been published on Croakey on crikey.com.au - strong recommend that you have a look at this as well
http://blogs.crikey.com.au/croakey/2013/04/05/its-all-just-a-social-media-and-medicine-storm-in-a-teacup-says-one-surgical-tweeter/

Addendum for Blog Post September 2012

Addendum 31 March 2013 to September 2012 Blog Piece


The main reason I have decided to put this up on my blog is that the issue of anonymous tweeting is running riot in doctor circles over recent GMC-UK recommendations. Rather considering this a new piece in isolation, I regard it more as an addendum to my blog post from September 2012.  If you read the earlier blog, this will make a lot more sense.


A doctor on twitter who had read this blog piece recently, sent me the following cropped mobile phone screenshot by email (easy to track down via either one of my publications or through the University of Sydney website - you see, I don't try to hide) that was taken of a tweet made about 10 days ago - comment was made that it was seen from a re-tweet as this person like myself, does not follow @otorhinolarydoc.  It wasn't sent to me anonymously but there is nothing to be gained by mentioning who that person was.  Interestingly, it is noted that he has since changed his user name and from this I gather that he is perhaps no longer a trainee and now a qualified ENT surgeon.  Whilst we can say it is a bit of harmless banter, it is essential that readers understand that M & M are an essential form of quality control and good clinical unit governance that must be taken seriously.  The purpose is not to chastise this tweeter but raise the question as to whether anonymous tweeting for entertainment purposes potentially undermines public confidence in the medical profession.  Whilst it might seem minor, you can give an inch and before you know it, you have a mile.  Once we lose public opinion, it is something unlikely to be regained.  Another issue is that of mentorship - registrars often copy the behaviour of their mentors - perhaps there is some shared responsibility between himself and his former mentors if these are the attitudes with which he has been raised as an ENT surgeon.  Let you be the judge on this.