Written by Aarini Guha

Introduction

The practice of swearing an oath to do no harm to one’s future patients is widespread across medical schools. Although these schools do not require future professionals to recite a specific oath (according to the AAMC, some schools allow medical students to create and swear by their own), one that has stood the test of time is the Hippocratic Oath. Coined in the fifth century BCE, it is attributed to Hippocrates as one of the oldest commitments still sworn by medical professionals today to act in their patients’ best interests.

In recent years, content from medical and wellness influencers has been on the rise. With their emergence, an increasing number of people now turn to social media for readily accessible medical advice. But to what extent is this beneficial for the public? Medical professionals hold significant power. They can use this influence to increase the reach of care beyond the clinic, and many have. However, social media algorithms are not without their drawbacks: conflicts of interest can emerge when popular creators are encouraged to act against the ideals of their profession in favor of sponsorships and recognition.

One of the last lines of the original Hippocratic Oath is as follows:

“Whatever, in the course of my practice, I may see or hear (even when not invited), whatever I may happen to obtain knowledge of, if it be not proper to repeat it, I will keep sacred and secret within my own breast.”

In other words, patient confidentiality is of the utmost importance when it comes to providing well-rounded healthcare. However, if conflicts of interest win out over a professional’s genuine desire to do the best they can for their charges, this ideal might be discarded. So, where is the line when it comes to the content these influencers create?

Medical Influencers— The Robin Hoods of the Digital Age?

With the cost of healthcare in the U.S. skyrocketing beyond the public’s capacity to pay for it, medical professionals have the ability to make the poor rich by spreading trustworthy and credible advice online to those who would otherwise not have access to it.

Good influencers cut out the medical jargon that makes advice inaccessible and distill important concepts into something easily understandable. Dr. Julie Smith is one such example. With over seven million followers across platforms such as TikTok, YouTube, and Instagram, Smith takes her clinical psychology training and turns it into short and long-form content to help out her viewers. For example, in one of her YouTube shorts, she uses colored and noncolored Skittles in a one-to-four ratio to represent the portion of a population with mental health issues, ending the video with the idea that even if you are not one in four, you likely know someone who is, and to always be kind. This messaging demonstrates how professionals can use their content to improve their audience’s lives in a friendly, engaging way.

Good influencers also always make sure to spread credible information to ensure that the public has access to healthcare that they can trust, instead of having to wade through a sea of misinformation. Dr. Karan Rangarajan, a surgeon known mononymously online as “Dr. Karan,” is another influencer with millions of followers across multiple platforms who is dedicated to sharing health hacks and debunking myths related to medical phenomena. In an interview with the Indian Express, Rajan gives tips on how to improve one’s media literacy in regards to health information. “I would be wary of anyone claiming [only] one thing works,” he says, “[especially if they’re] linking that to something that they’re selling.” His warning about those who have an ulterior motive behind their messaging is incredibly pertinent, considering that social media algorithms incentivize creators to post sponsored content by boosting its visibility in users’ feeds.

Dr. Smith and Dr. Karan are examples of accredited professionals who use their platforms for the good of the public in different ways while continuing to uphold the ideals of the healthcare field.

When Bad Apples Spoil The Barrel

However, not all creators are as clean about their image online or their actual medical practices. From a lack of patient confidentiality to bullying and mockery to the outright botching of surgical procedures, these “professionals” don’t quite live up to their job description.

In 2022, a video featuring OB nurses from Emory Healthcare in Atlanta, Georgia went viral on TikTok for its callous content. The nurses took turns mocking their patients, who were there to give birth, saying things like, “My ick is when you come in for your induction talking about, ‘Can I take a shower and eat?’” and “It’s the unlimited trips to the nursing station for me.” The nurses were swiftly fired after public outcry demanded consequences for their cruelty and unprofessionalism. Such mockery is an example of what happens when ideals of compassion and service are abandoned for those of fame and recognition.

Unfortunately, they are not the only example of malpractice. Ohio plastic surgeon Katharine Roxanne Grawe, known online as “Dr. Roxy,” is a more serious case. On October 9, 2018, Grawe received a letter from the State Medical Board of Ohio warning her to protect patient privacy in response to her social media content; she had performed some operations while streaming them online for her many followers to see. In addition, evidence came out that she had botched some of the surgical procedures she had performed as a consequence of filming them. Three years later, in 2021, Grawe received another letter from the Board that expressed the same concerns regarding her social media practices, informed consent, and her conduct of the operations. On July 11th, 2023, her license was revoked permanently, her negligence serving as a chilling reminder of the ramifications of powerful people choosing to abuse their power.

Conclusion

The last line of the original Hippocratic Oath is as follows:

“If I faithfully observe this oath, may I thrive and prosper in my fortune and profession, and live in the estimation of posterity; or on breach thereof, may the reverse be my fate!”

Those who swear by this oath therefore agree that good things happen to those who uphold it, and only those who uphold it. Integrity and compassion are arguably the most important traits a medical professional can have, because they encompass what healthcare is all about: service. While social media could potentially be a powerful tool for acting upon these values, there needs to be new regulations for how professionals are allowed to use it, ones that are clear-cut and outline specific consequences for breaking them. Only then can the internet truly be a safe place to search for advice, a place that is accessible to all.

Edited by Aisha Hassan