A How-To Guide For New Tweeters

Scott Krugman MD, MS, FAAP

Chairman, Department of Pediatrics

MedStar Franklin Square Medical Center

I joined Twitter almost 2 years ago. I wouldn’t say I’m a “pro,” but I’ve learned a few things about what to do, and what not to do. As many of our mentors told us as residents – it’s OK to make mistakes, just not twice. It’s easy to make mistakes on Twitter, but not so easy to correct them, since Twitter doesn’t have an edit function. 

Most physicians join to learn, to advocate, and to engage in thoughtful conversation. But unfortunately, that’s not all you get. Occasionally there are trolls, bullies and inane memes. So what can a new Twitter doctor do (and not do) to be part of the productive discourse?

•    Re-read your tweet before sending it. Would you be comfortable with it on the front page of your local newspaper? If not, don’t send it.

•    Avoid any tweet that can be linked to a patient. HIPAA laws apply and most institutions do not want descriptions of the care that goes on their hospital broadcast to the whole world. If you must talk about that awesome case you just saw, make sure you have approval from the patient, your hospital, and it is completely de-identified.

              Do you want to amplify a message or story? Don’t just re-tweet – add a comment and quote tweet it. This allows you to provide context or your opinion, and is a good use of quote tweeting. But don’t just read the headline, read the story! You don’t want to tweet out something you either haven’t read or actually don’t agree with.

•    Do you want to have a conversation with someone? Use the reply function. Two (or more) people can engage in effective banter by replying to each other. Quote tweeting and commenting on a post does not foster conversation.

•    Do you agree with a tweet? Easy, just like it and re-tweet it.

•    Do you disagree with an opinion? You have two options: ignore or engage. There are definitely times to ignore. The most obvious is when the person tweeting has fixed beliefs that may or may not be based in reality (just search “vaccines”). If you choose to respond, be prepared for an onslaught of vile personal attacks (especially if you tweet about political issues or guns). The same goes for bots or trolls. If you are brave, you can engage, but sometimes it’s better not to feed the trolls. If you do choose to engage, don’t forget the first rule, and be professional. State your opinion and stick with facts. Don’t just make vague contradictory statements. And remember, you can always leave the conversation.

•    When you get annoyed or frustrated with someone or a topic, you have options: block and mute. You can block anyone on Twitter. If you do, you cannot see their tweets, they cannot see your page, and they can’t tweet at you. If you feel someone is being abusive or hateful, you can report a tweet to @support and they will investigate and potentially take action on the user. The mute function can be used for users, or even words. If you are tired of a thread that keeps coming up in your conversation, you can mute a word, and no tweets with that word will appear.

•    Finally, don’t forget to take a break from Twitter. It can be a time suck, it can be addicting, and you can feel like you’re missing something when you aren’t on. Don’t feel obligated to see every tweet that comes your way. One tool that can help manage your time is lists. You can group users together in a personal list, like “doctors,” “politicians,” or “news”, and then see topical tweets quickly. Even easier, there are public lists, and lists you can subscribe to, like the American Academy of Pediatrics “tweetiatricians”, so you don’t have to create your own.

Good luck new user. Be careful out there in the Twitter universe, and make sure you clear with your organization what you may (and may not) tweet (Pro-tip: don’t call out a specific organization). Otherwise you might get that dreaded call from your hospital’s public relations department or your boss calling you to task.