Hello, my name is Joshua Bederson. I'm professor and chair of the Department of Neurosurgery at Mount Sinai in New York. Thank you for allowing me to present some of our experience around social media in neurosurgery today. These are my disclosures. The objectives of this course are to identify some strengths of social media among the various platforms, to be able to improve the effort around your social media presence, to build your brand, and to demonstrate an understanding of what we think engages an audience. Social culture is changing. Almost everyone now has a computer and or cell phone and is on some sort of social media. Social media by definition requires images, videos, and provides easily accessible information. It builds awareness and boosts visibility. It enables businesses and brands to reach audiences that traditional marketing strategies may fail, such as medical professionals. It can communicate authority. You can demonstrate the experts in your field showcasing cases, events, awards, et cetera. Social media allows you to answer questions directly from patients, practitioners, and other interested parties. It can be free. Of course, paid campaigns can help, but in general this is a relatively cheap media to use. It is clear that U.S. News and World Report scores are heavily influenced by reputation and social media, and that social media independently influences reputation. 41% of users of the Internet say that social media influences their choice of a doctor, facility, or practice. In my own practice, it is clear that virtually every patient has looked me up online. It's also known that the higher the U.S. News and World Report rank, the more active physicians are on media like Twitter, and physicians of all ages are currently engaged in social media. At this point, it would have to be believed that online engagement between hospitals and physicians would be a missed opportunity if we're not taking advantage of it. Our own rankings are seen here. In 2019, our departments of neurology and neurosurgery were ranked number 14, and the top social media platforms of our department are Twitter, Facebook, Instagram, and YouTube, surprisingly. The stats that we have available demonstrate that upwards of 80% of physicians of all ages are currently active on social media. 60% say that social media improves the quality of care they can provide, and 30% or more use social media for professional networking. Some of the benefits of participating actively in social media for physicians are improving brand awareness, finding a niche within a brand, amplifying that brand, and increasing your thought leadership among peers. It is very useful to clarify misinformation that may be posted elsewhere, and I think it actually advances overall knowledge in the community. It provides an additional way to communicate with colleagues, in addition to direct communication, and likewise for collaborations, as well as to promote, communicate, and demonstrate what's going on in your own institution. I mentioned that many patients use it. It is really interesting to know that most patients who see me for the first time in real life feel like they recognize me because they have looked at me online or members of my department. It also allows us to engage in promoting peer-reviewed research and to refer to peer-reviewed research, although social media should not be mistaken for or substituted for peer review or the peer review process. Here you can see some statistics demonstrating the massive growth in billions of social network users over the past decade. And here you can see the most popular forms of social media platforms, with these other platforms rapidly catching up to Facebook. Here you can see YouTube, Instagram, and Twitter, which are the ones we use the most frequently. When you look out into the available and well-done sites, here are three that come to mind. UCSF and Mayo have very strong presences. I particularly like Mike Lawton's and Barrow's. I think Michael has hit a sweet spot between outstanding content, great visuals. He is a very engaging personality, and he is serious and yet approachable. And as you can see, even from this year, the quality and content of the visuals and the seriousness of the content all mean a great presence that he has and deserves. Our own presence began only a couple of years ago. It's now four years ago. We started a Twitter account, and some of the faculty began to participate. Our first Instagram account was in 2018. If you look at our Twitter platform, I think most of you know that it allows individuals to follow current trends, to post news and comments in real time, and it is most important to share articles, links to other media, photos, videos, et cetera. Our current Twitter account has 4,500 followers. We have a fair amount of engagement from all over the world. Our cerebrovascular program alone has 2,500 followers, and the deep brain stimulation program, which is not managed by a marketing team, it's just done internally, also has a fairly robust program. For me, Instagram is the best personally, although it may not have the biggest impact. It's a highly visual platform. It allows users to follow, post, engage with photos, tag users and trends, and we're still ramping up with it. We started in 2018, late in the year. The department now has about 2,100 followers and seems to be growing fairly rapidly. It may be a little more difficult to generate content than Twitter because you have to put it together beforehand and may require a little more work before you post. Looking across my department, here are the faculty, residents, and fellows who are actively engaged with social media, and as you can see, a fairly robust number of the attendings and residents and some fellows, and many of the APPs have their own accounts. If we look at the heavy users, and you can rank people by followers, Leslie Schlachter, otherwise known as Brainy Leslie, stands out. She has to be one of the busiest, most successful influencers in neurosurgery these days with more than 18,000 followers. The department, I mentioned, more than 2,000, and you can see some of the attendings whose activity is beginning to rise significantly here. Same with Twitter, although in Twitter, really, it's Mount Sinai Neuro that is the biggest, and Jay Malko has a very strong following. There's so much evolving rapidly in cerebrovascular that I think Twitter is a particularly good venue for someone like Jay, who himself influences the evolution of the diseases in cerebrovascular and has got his finger on the pulse of cerebrovascular changes. Looking at our Twitter users, we have a total of 25,000 right now, and that is almost exactly the same as our numbers of Instagram users. I forgot to mention that earlier, but we have about 25,000 Instagram followers right now and 25,000 Twitter followers, and here you can see the breakdown by user in the department. Here are just a couple of examples. Brainy Leslie, her following is more than 18,000. She does now divide her story into different categories, focusing on some of the work we do. Her large team, Leslie's responsible for 105 advanced practice providers in the department of neurosurgery, and she focuses on their own stories. She highlights activities of the entire department, not just me. She also posts personal posts from her own life, as well as other PAs in the health system. Kurt is senior resident and cerebrovascular fellow, has a strong Twitter following, and this is an example of one of his. Likewise, Neha Dengaj, chief of our division of neurocritical care, who you can see here, has a very strong following and a robust presence, particularly at the national meetings on neurocritical care. So one of the things I think is important is to get started, is to sit down and think about what are your goals for entering social media in the first place? What's the message you want to get across? Do you want to educate? Do you want to increase awareness of your department, institution, practice, yourself? Are you aiming for new referrals? Are you aiming to support people around you? So it is important to identify those goals and to try to tailor your content towards those goals. Instagram is image-heavy, and so strong imagery and videos are very, very helpful and useful there. I find in my own posts that videos tend to get the most interest. Twitter is more about a rapid response, but also supports images and videos. So in addition to identifying goals, you want to specify who's the target. Is it other professionals like yourself, physician, PA, nurse, administration, science, researchers, patients, students, referral sources, companies, etc., and try to tailor each post to each one of these. I think branding is all part of this. One of the goals here is to build a brand, and so you need to think about your username. You need to think about what you want to include about yourself. What do you want to convey? What do you want to be known for? Are your interests in neurosurgery the same as your interests outside? Do you want to include personal information, etc.? One of the recommendations is that you will follow others once you've established yourself somewhat, and here you will follow others. So you will follow others, but you will not and here you will choose very carefully who you follow, usually those with like interests. Marketing can be useful here in terms of retweets, reposting, and so on. I think it's important to create a plan to develop your account and executing and overseeing it. Are you going to do this yourself? Do you have a team? If you have a team, what is the role of each team member? I think using a content calendar is not a bad idea to organize and plan posts. I do think it's important to plan ahead of time, at least a week in advance if possible, except for comments that you might make spontaneously on Twitter, and then of course make sure you have enough content to keep yourself going once you decide to get started. In terms of scheduling, I'm not sure yet what is the most effective frequency to post, whether it should be every day, every week. Twitter can be more frequent. There is data to show that most Twitter users look during lunch and commuting times. Instagram requires a little bit of time for each post to mature, and so more than once a day was certainly not recommended, and maybe less is more in an Instagram account. You can certainly spend some time drafting your posts. That way you don't have to take it down if you see something you don't like after it's up, and you certainly want to link accounts, both yours if you have more than one medium that you're using, and to other people that you would like to link to. I think staying relevant and posting regularly is key, and that really also contributes to when you would start, so once you get started you want to stay engaged. What's the anatomy of a good post? I do think there needs to be some personal engagement there. Just random pictures and data is not going to be very attractive to most people. Visual content quality is key, as we've discussed. You want to focus on your syntax and what you're saying. You definitely want to edit it. If people are helping you, make sure that you believe in what is being said, and to vary the post somewhat. If it's the same thing every week, that will rapidly lose interest, and you will see that people will unfollow you. As I said, I found that videos are some of the most popular of my posts, and here you can see one that we posted that had a pretty decent reach. I think it's interesting to join platforms that are not all the same. We sometimes develop campaigns around certain events or issues, and at major conferences live tweeting is thought to be helpful. It's good to be concise. We've spoken about visuals. It is important to think about hashtags since these are used throughout. One of the ways to engage your audience is to post questions and to retweet postings and replies. Some of the challenges, it's important to have high-quality imagery, and you need to have some input on the quality of these pictures and to oversee what is being posted. I do think it's worthwhile to keep track of your audience, to note the responses, and to be responsive to those. It's critically important to maintain PHI, and this needs to be monitored. Clearly, if you have more than one person doing this, it's helpful, and not everyone has the resources or team. There are ways to make sure you maintain confidentiality, and some of these are useful. We do get consent when it is relevant to include a date or a face, but it is important to know you should get consent when you have a date of a surgery, for example. It's always better to get consent because you can get more creative with your... In my own journey on social media, we started in May with a Twitter account and Instagram just in November. Knowing that I will never be as good-looking or popular as Mike Lawton, I'm perfectly happy to have my department members popular and active on social media, and with 25,000 followers right now, I think that's probably going to be more effective than developing a super-strong presence on my own. But I did start on Instagram a few months ago, and here you can see a gradual growth. I think I'm up to about 700 followers right now. You can look at some of the demographics. About a fifth are New York, but there is representation outside of New York. Obviously, this is the age range that you see here. It looks like most people are engaged in the afternoon. Some of the successful examples are the more visually pleasing ones. This particular video got several thousand visits. Those that are colorful and descriptive, people seem to be interested in technology and how the team works together. Since COVID, we at Mount Sinai have been quite engaged in this response, as have all of you, and we've certainly seen growth of our social media following during this time that I'm sure also is related to the increased presence and activity on social media generally during this crisis. So I'm going to finish there, except to add this one slide that goes a little bit outside of social media. The combination of stay-at-home and social distancing with social media has led to our developing a global tele-rounds program that seems to be gaining some traction. Normally, our Grand Rounds might have 70 to 100 people, and here you can see a Grand Rounds that we had a week ago with almost 500 people, allowing us to solicit participation from experts like Anil Nanda, Chirag Gandhi, Mike Scholder in the region and also internationally. So with that, I'll finish, and thank you very much for the opportunity of presenting our experience. I welcome any questions that you might want to send my way, and be happy to speak with you or introduce you to any of our local people. Thanks again.

neurosurgery

social media

information accessibility

medical professionals

online engagement

strategic planning