It's my great pleasure to be giving this lecture. I was supposed to be giving it live at the AANS in Boston, but as you all know, with the pandemic, we don't have a choice. So I'm going to be talking about social media and neurosurgery in general. Why social media? Promote your work nationally and internationally, or maybe promote your health system. I was first asked to have a Twitter account and at the beginning for a year I didn't use it. It's also another reason to use social media is to be trendy. Everyone is using it. And very important to be able to do community education and awareness. This is a way to reach the layman. No frontiers. It's also a kind of social media addiction. As you know, this exists. It is self-promotion, but in both aspects of the world. As you know, if you have substance and you're posting on social media, this is in a good way, promotion or self-promotion. But if someone has no substance and keeps on posting, this would be considered in a negative way, the self-promotion. So this is a little bit tricky. It's also a way to adapt and remain on the cutting edge of technology. I see sometimes older generation neurosurgeons that are using social media, which is really nice. It is also a way to be able to reach a wide audience in all continents. As I said, no frontiers. And it's a way to expand your network, your neurosurgical network, professional network. Long time ago, you needed to go to a physically to a conference to be able to meet new people and network. Now you can do it just through social media. Screening process of the postings you do. So first of all, very important for you to know the message behind what you are posting. So and know why you are posting that way, what you will be posting. Of course, no one wants to see how you do a case if there's nothing unique in it. Don't start posting every single case. It's same thing that no one wants to see another clot retrieved. As you noticed, mainly in vascular, in endovascular, some people would post every single clot that they did and every single and every single stroke. Try to post stuff that's really unique. Remember, this is not Facebook. You don't have to post all your travel pics out there. Try to be scientific and not poetic in your wording, just straight to the point. And this is important and I see it a lot. Try to avoid being hurtful to a certain specialty or group. And I take the example of vascular because I'm a vascular neurosurgeon. As you know, there are three specialties that do neuroendovascular. So I see sometimes posting that would hurt endovascular neurosurgeons or some posting that can hurt interventional neurologists or interventional radiologists. So keep this in mind. If your account is specialized, try to post every now and then something different. It will keep the interest out there. For example, in my case, I post every now and then wine. So 90% of my posting is neurosurgery. But every now and then, because I have a special interest in wine, I would sneak a wine picture or a wine event. What to post? You know, this is a really broad question and we can talk really hours about that. But in general, you need to post, as I said, a complex procedure, an unusual procedure, a new device, if you're using a new device that no one has seen before or not a lot of experience in the country with it, a paper that just was published, either you published it or somebody else, another group that published it, a lecture announcement, your lecture or another colleague's lecture. And it's very important to every now and then to acknowledge your team, the team you work with. And, you know, remember, it's not all about you. And then to acknowledge also the accomplishment of your colleagues all around the country or the world. What to avoid posting? Avoid posting bread and butter cases. Avoid posting definitely abrasive comments. Even if you get attacked or criticized, remain calm. That's very important. And give 24 hours before answering a critic or a harsh critic and take a deep breath. And I learned that the hard way. Don't answer right away. Sleep on it. Wake up the next morning with fresh ideas and decide how you're going to answer it. And sometimes the right answer is not to answer is to avoid answering. Complications. This is a subject for debate. And I would have liked to be live in Boston to a little bit discuss that and see what the audience think. Every now and then we have people say, well, guys, when you look at social media, it seems that there are no complications. Well, everyone knows that we have complications and everyone knows that complications are out there. But in my biased opinion, I don't think social media is a venue to discuss complications for different reasons. Patients are watching. People are watching. Lawyers are watching. You remember the medical legal world we live in. So I think, at least in my opinion, that discussing complications is not something that should be done on social media or at least should be done in closed chat rooms. Definitely avoid posting selfies. And every now and then I see it, avoid posting your meals. The advantages of social media, as we said, spread the knowledge. That's very important. Important. Build your own brand. Patients referral. I've had and I'll show you examples. I've had some patients referral through social media. Build academic cooperation with different groups. I'm going to show you examples of that. Access to new technology. You know, see new devices that you don't have access to in the country you live in. Access to new publications. Really, more and more I've seen that. And a lot of times I look and I see, I find out about a new paper or publication through social media. And there's nothing wrong with that. You know, you click on it and you read it and you don't have to have a physical journal in your hand. You can do it just on social media. Patients feedback. This is a double edged sword. Patients will be able to give you feedback. It's going to be be aware and be ready. It's going to be positive and negative. So those are the rules of the game. So you need to know them before you start. New friendships. Lectures, invitations. I'll show you. I've had some lectures, invitations just through social media. Disadvantages. Well, it is addicting and we know that. And you start being addicted to that. It is time consuming. People can steal your ideas. Again, be careful. You cannot go and, you know, come up with new ideas that you are starting to develop. You cannot post them on social media because those people out there, they did not sign a non-disclosure agreement. So, you know, people will steal your ideas. Be ready for harsh criticism and practice self-control. That's also important. Along the same meaning, grow a thick skin. Some would perceive it as self-promotion in a negative way. Again, yes, we talked about this. And remember, once it's out there, that's it. Once you post something, even if you can remove it or delete it later on, it's been out there. Everyone saw it. People took snapshots of it. So keep this in mind. Patients' privacy. It's very important. You have here two group of patients, a group that signed a full consent. Just make sure, check with your hospital consents that the consents cover all type of social media postings. If your patient signed that, it means you don't have to worry. You can post the patient, the name, the face and everything. But the majority of the social media postings that we see, those are patients that did not sign any consent. So make sure that you don't have any patient's identifier. If you can't cut them or crop them, make sure you can blur them. Even regular medical record, even date of birth. It doesn't have to be just name, anything related to the patient. You cannot show the face of the patient, for sure. And avoid using gender pronouns. You can use just a patient or the patient. Technical advice. People tend to look more at a picture than a movie. And I noticed that from all my postings, I always have more hits and likes on pictures than movies, because movies is more complicated. They need to click on it and it needs to upload. If they don't have good Wi-Fi or internet, it's going to take some time. So that's why try to use a collage. There are a lot of apps there where you can put multiple pictures and then post a still pic. But sometimes if you want to show a technique, surgical technique, you don't have a choice or an angiogram or an endovascular technique. You have to make a movie. In case you're making a movie, keep it short, less than one minute. We know that more than one minute, you're going to lose interest. People are going to lose interest. That's why a lot of social media, they won't even let you to post more than one minute. It's limited at one minute. Don't put any sound or music on that. Really, that's very important because people are not doing social media sessions. They don't come home and spend an hour just looking at social media. They are looking at stuff between cases, maybe during a conference call or maybe while walking in the hallway, and they don't want to click on something and suddenly the music or a weird song is going to come out. Learn to edit your movies. Don't rely on other people. It's really easy. Trust me. I use iMovie, for example, but there are so many out there. Speed up some parts. Because you have one minute, you need to put really the important parts. So there are some parts that you need to speed up sometimes times 8, times 10 or 20. Zoom to highlight a certain spot for people to see. And make sure, that's also very important, make sure that the first frame of the movie is an interesting one. Because this is what the reader will see before they click on the movie. And I've noticed that, I'll give you an example. For example, those are two posts. There's here on the left, this post, where it doesn't look interesting, but when you click on it, this is a one-minute movie about transradial difficult arches, and how to manage difficult arches, and what catheters to use to manage that. So very educational movie. As opposed to this movie here on the right side, that I'm pointing to, this movie is, I was doing a bypass, and this is a STA, just a beating, pulsating STA. This is like a 15-second movie, nothing else in it. Well, I have much more hits on that movie than this educational movie. Why? Because the first frame on this is not interesting, but the first frame on that is. So this is why what I started doing is, if I have a movie where, as you know, you go, you know, by step, by sequence. You start with imaging, then patients, then surgery. Well, imaging sometimes is not interesting. So I start putting the first frame as a surgical picture, and then I go back. Once they click, I go back to the usual steps. No multiple postings per day. Well, it will steal the highlight from both postings. That's why I would recommend an average two or three postings a week. Some advice. Don't be harsh in your answers. Stay open-minded. Don't take it personal. That's very important. You can't please everyone. Don't let it consume your time. And keep in mind the family time. Sometimes it's taking from your family time. Acknowledge the achievement of your social media colleagues. That's very important. You don't have to answer every comment, but keep it balanced. It means if you have a posting, you have 20 comments, 20 nice comments, and you answer 18 of them. Well, don't leave those two left out. Or don't answer anyone. Direct message people to answer certain comments. Some people will put some comments and questions, and sometimes it's very particular to this person. That's why direct message him and answer. Do not fall in the trap of giving medical advice, even if someone direct message you. And this is very important. You're going to have a lot of patients giving you their stories, their histories, and ask you, what should I do, and things like that. Some examples. Invitations to give lectures. I was invited by the Royal London Hospital to go give a lecture on endovascular for medical students. This is all by people that I met on social media. Unfortunately, it was supposed to be on 6th of April. I couldn't go because of the pandemic. On the right is the Pairs. It's the biggest radiology conference in the Middle East. I was invited also through social media. It was my last trip before the lockdown of the pandemic. And it's a huge conference, more than 3,000 people. Academic cooperation. This is a physician from Australia that saw my posting on COVID and stroke. He got in touch with me. He said, let's do something together. We wrote a paper. It's going to get published. That's the paper here, where we talked about what cases to choose to do to do them during the COVID pandemic, how to manage and be safe. This is in the paper showing this is in the paper showing the paper we use, a case that I did, etc. Another scientific cooperation. This is a paper that was published, a review article, use of social media networks in neurosurgery. And they used one of my postings. It was an aneurysm clipping here. Sometimes you use social media to raise the morale of your team, especially in those pandemics. So this is our TikTok. What she meant in the hood is in the paper. Here I am. So and again, one of the comments was, as I said, you're going to have some negative comments. You can't please everyone. Somebody said, well, it seems that you guys are not busy. If you have time to do those dances. Well, you know, I ignored that comment. Another one here that it's not a bad comment, but he said that, you know, this is great, but you need to be careful. Look what happened to this doctor who danced during surgery. She was suspended from medical board. I think we've all seen that she was doing surgery. And during surgery, she started dancing. But again, you guys are smarter than that. So I answered him. I was like, this is this is a staged thing. He thought that the guy that had the sign was the patient. Like, absolutely not. This is all my team. It's not something like that. So, you know, patients, families will identify themselves on social media. This is at the beginning. It's a little bit tricky because you put everything anonymous, but some people would realize that like here I clipped six aneurysms in one patient in one setting on one side, and then I posted it anonymous with no identifier. And then the patient's daughter here, you know, put a comment on social media. Then the patient's husband said, thank you again. I mean, they identified themselves. That's not your fault. You didn't identify the patient. And it's very important to be transparent to the patient. Your patients will follow you and you don't know which patients is following you. For example, I posted this. One of my patients that I've done a bypass on said any chance this is a brain I might know. I said, no, that's not you. And what I meant by you need to be transparent, it means, for example, if you're doing the first in the country of a certain case or a device and you post it and then the patient you intervened on was going to look at the post, say, oh, my doctor posted that this is the first case I do. And he realized or the patient realized that that was him from your posting. That's not good. You need to have disclosed this to the patient before. Patients referral. I've had some referrals through social media. This is someone who referred me a patient that I ended up seeing in clinic. Another doctor who referred me a patient I ended up seeing in clinic. Grateful patients, those are the best. You see those patients, for example, here, this is a patient who presented with a locked in syndrome. I did a basilar thrombosis intervention on her. Another case of inter arterial chemo for retinoblastoma. The patient sent me a text like you treated my kid that was two years old. Same thing. This is the mom of retinoblastoma. And then this is a funny story. This is one of the early patients I've done retinoblastoma. We were on the Philadelphia Inquirer front page on a Sunday. The patient was four months old when I treated him. Now he is nine years old and he has a social media account. He has an Instagram and we are friends. And every now and then he messaged me. That's him. The nine years old is like, hi, how are you? Hey, Ty. He's like, I had a basketball game. I scored two points. I said, wow, awesome. So that's really nice. Well, you even get wine sometimes. Definitely I didn't get a Petrus, but this is when I posted that I became a level three certified sommelier. Some winemakers told me, well, I want to send you some wine, give me your opinion. And I got free wine for that. Sometimes it's better not to read the comments. Again, as I told you earlier, some things get politicized. It's when I appeared on CNN talking about COVID and stroke. As you see here, some people started posting things about that, which I stopped reading. CNN is fake news. And I'm sure everyone knows how to read that. I'm not going to read it. Or I was also on MSNBC and people said lies. And anyway, abrasive comments. Sometimes your followers defend you. This is when I first put out there my web cases. Someone said, well, this is another experiment and your patients are guinea pigs. This is an abrasive comment. I didn't go through back and forth with him, but I had one of my followers who took the initiative and started answering him. And he beat him up. Actually, at the end, this guy said, wow, you are really going for the juggler. I retreat from this hostile conversation. Anyway, it was my follower, not me. Don't justify yourself. One time I showed a case of a carotid, which I think I managed it in an acceptable way. But the peripheral vascular guys all went crazy on me. They were very abrasive. So I went through back and forth with them. And here it is. I post dinosaurs disappeared because they couldn't evolve fast enough to cope with the changing world. Then I started showing them the concept of flow diversion, even at the neck, because they don't know that. But then later on, I said, you know what? I don't need to justify myself at the end. You know, my last advice. Remember, social media gave a voice to the village fool. So two things. First, you don't want to be this village fool, that person. And second, be ready, because to this village fool will be someone who is going to comment on your posting. Thank you very much.

social media

neurosurgery

work promotion

professional networks

posting tips

patient privacy