TikTok Influencers vs. Real Doctors

disheartening for you guys. One of the best games I've seen in a long time, >> dude. The the end I thought that comeback was legit. Oh man. >> No, there's so many for so many years, we've seen the&m team come close to victory just like in that last moment they need that one touchdown [clears throat] on fourth. >> Oh man, it was a tease. >> Every time every single time for the past 10 years, they missed it. >> Dude, it's the uh it's the Dallas Cowboys syndrome.

It's stealing defeat from the jaws of victory. >> Yeah. I mean that's been the&m story for the past 10 years or 12 years or so and finally I think this was like this defining moment. I feel like we got over that hump where we just crossed a boundary. We beat a a great team away at their house under crazy environment and you know&m won that game which was I was like man this hasn't happened in a long time. I just expected us to lose. I just expected this is not going to happen. >> It was awesome.

It was awesome. >> It was an awesome game. And see same you talk about the Cowboys, but that game was that game was >> it was a great game. I mean I for one I'm glad I have Aubrey on my fantasy team. He scored some serious points, but that overtime win was crazy. It was awesome, >> dude. Um I mean I did not think they would go down after after uh Russell Wilson just threw that deep pass to Neighbors and touchdown. I was like this is over. This is the Cowboys.

Like all I hate the Cowboys Cowboys fan. >> Yeah. But I was like, "This is it. That's that's the Cowboys, you know." But [laughter] he uh >> I know I I became a Cowboys fan in like, you know, I was a kid and but then in the mid '9s is really when I started watching football and that's like right around the time when the Cowboys stopped being good. [laughter] >> Yeah. >> It's been about 30 years since we've been good. And that's the 30 years I've been a Cowboys fan.

So >> I'm watching the documentary right now about the Cowboys. Have you seen >> the Jerry? Yeah. Jerry documentary. >> The Jerry documentary. Man, it's it's amazing and it it shows you how much of a prick Jerry Jones is. [laughter] >> Yeah, >> he changed the game, dude. He changed the game. I mean, >> he changed the game. He changed the game for sure.

You know, >> uh I mean with Jimmy Johnson, the feud that he had and you know, even though he won two Super Bowls in a row, I know >> he wanted the credit, right? >> Jerry wanted to be the guy. >> He wanted to be the guy. That's that's kind of what I see in uh a lot of doctors nowadays where you know we're seeing a lot of the people that are just wanting to be in the limelight. You know doctors have now um traded the stethoscope and the white coat for the ring light. [laughter] >> Yeah.

The the social media the medfluencers >> the med influencers are a big deal now. And you know that's it's all over my Tik Tok now. If I go on Tik Tok, if I go on uh reals or whatever, all I see is just met influencers everywhere. And the way I mean, we're doing a podcast, right? We're doing a podcast. We're talking about different things. We're giving advice uh on certain topics, but >> uh there's a lot of people out there and some are many times misinterpreting them as doctors, right?

There's a lot of people out there that are saying that they're doctors, but it turns out they're not medical doctors.

maybe they're uh PhDs or chiropractors and different types of doctorate degrees, but they're calling themselves doctors and giving medical advice which uh and a lot of times I'm sorry to say I mean the medical advice is out of with no evidence and lack is backed by no uh scientific research and it's just something >> yeah it's it's really easy to step like outside your lane right when you have your social media platform because it's not like the old days where the only platform you could get in in digital form was on TV or something or like a real news interview.

It was very difficult to do that and it was very legitimate because people had to have real credentials. But now anyone can do it. I mean it's basically the the entry point is so low. I mean like like you mentioned we're doing it like everyone's got an Instagram or a Facebook or a Tik Tok or any of these outlets. Um it's not all bad, right? Like there's a lot of good stuff too.

I mean, in general, I don't think you can paint the social media presence and stuff of physicians and regarding health care with a single brush. I I think there's good and bad both. Um, I think it's hard to tow that line and it's really hard, you know, as a patient or someone who's not in health care to really appraise the validity of what is being said. >> Yeah. I mean, you're right.

the barrier to entry to becoming u a big voice on social media has has decreased quite a bit right it's very easy to get into the the business kind of go on and give medical advice it might be easy for you like you know someone can go on Chad GBT they can look up a question and just talk about it on their social media they don't have to have any real medical credentials no one's questioning that no one's seeing if they have the license to say that there's no regulations on social media you cannot not check.

Oh, are they an MD? Are they a DO? Are they an optometrist? Or are they a dentist? Or are they a chiropractor? What are they? Are they giving me advice about teeth? Or are they giving me advice about my back? Or are they giving me advice about my heart? Right? >> So, the barrier of entry has got to there's so many. I mean, I think but the problem is I think it's very important for physicians and people who give medical advice day in day out, treat patients, do surgeries, do procedures.

is very important to uh for them to be on social media uh to be in that limelight and being able to give the give the advice because the other side uh the people that are giving advice without any credential is so much stronger and so much louder right >> yeah so that's a good point let me ask you this what what do you think is a more important thing like for a physician or doctors in general to have a voice on social media do you think it's more important for the doctors themselves like to build a brand a voice get a following you know to build your practice to keep your name out there to get referrals all that stuff because that allows you to help patients by seeing more people also builds your business it's good for your livelihood and it's an enjoyable task to do or is it really more so you think better for the average people watching that you can dispel myths potentially or fact check people I mean what what do you think is the one of the bigger or biggest benefit of doctors having a voice on social media.

>> Yeah. I mean I think now more than ever is very important for doctors to be on social media and on you know on video formats especially you know the for like I remember when I was in medical school or even residency even fellowship I mean it was looked down upon to for doctors to be on social media it was called unprofessional.

I mean we as doctors we lived in this um you know ivory tower where we being a doctor was considered to be this sacred thing and you know we're better than that and we're uh we we have a different place and we need to be self-respecting and not be on social media. We cannot be on TikTok. I mean that's not for us. That's that's that's for people who who are not serious unserious people need are on social media. But I think that's changed quite a bit, right?

Cuz we've seen over the past like 3 4 years the amount of misinformation that's pre like pervaded uh is is prevalent sorry uh in social media and um you know and there's so much misinformation being spread around everywhere. People are coming in and just talking about mitochondrial health or news or >> like what is that? [laughter] >> Mitochondrial health. How do you measure your freaking mitochondria? I mean, it's inside the cell. >> I guess they they can see the electron transport chain.

I mean, who knows? >> I mean, there's [laughter] people we know or hear about that can just walk through the airports and recognize people with mitochondrial dysfunction by looking at their faces. Like, what kind of BS is that? >> Who knows, man? It's it's modern day psychics. You never know, >> right? So, I mean, in [laughter] in the age of misinformation, the age of disinformation, I think it's much more important for physicians to be on social media.

Now Frank quite honestly I think there should be uh you know um um different courses in medical school in residency uh where uh medical students can take electives about how to you know grow their social media presence not only it's important to be on social media to counteract the misinformation disinformation but you're building a brand right I mean if you truly believe in yourself and you truly believe that you're doing the right thing for patients you have that knowledge you have the skills um you want to stand out.

I think being on social media is very important for you to build the brand. Uh make sure that your message is getting out there and in the end if your message is getting out there and patients see that and they think okay this guy is legitimate. I want to go and see him because what I think what he's telling me is the right thing to do and it's consistent with everything I've researched online and looked online. They would come to you for the right kind of treatment right now.

Yes, they might fall prey to some some some uh uh person who's trying to prey on them and trying to sell them a bunch of stuff, but eventually, you know, you want you want to drown out those voices. And that's why I think physicians who have the right credentials need to be on social media. >> Yeah, for sure. You know, it's interesting if you think like well before social media existed.

I mean, there were doctors out there who advertised on billboards and you know, all those magazines like I remember in Dallas, every city has its own version, but I grew up in Dallas and in like D magazine it would have always a segment like top doctors or best doctors and it was a very big honor and you know we would look everyone would look and know like oh look there's that guy. Oh wow, my doctor's in the top doctors. That was awesome. Uh like Castle Connelly, all of these things, right?

These are just methods to advertise and get some recognition. Um long before social media, now it's just become easier and you don't have to rely on these outside sources to rate you, right? It's kind of like US News and World listing of best colleges in the country. I mean, what the hell is that really based off of, right? But it doesn't matter whether it's legit or not. The fact that it is a rating system, everyone wants to be on it.

I think social media in a way has made it easier to put your voice out there for sure. Um, but for the patients or just average people listening, I think it's really challenging for them to know if something is a legitimate source or someone is using their social media presence, their brand, the reputation, following they've gathered um to to maybe like to sell something. >> Yeah.

You know, uh it's funny you talk about those top doc list and since I started my own practice, I found out that a lot of those top doc lists is something you reach out to them, pay them a certain >> you got to pay for it. Yeah. >> Yeah. [laughter] It's it's not something that they just look out for the top in in in the city and they're like, "Oh, that guy is really good." And he I think I'm going to rank them as a top doctor now.

All the top doctors on the list have been paid for uh for the >> totally you you pay to play, baby.

I mean it's like uh I don't know I mean it's like just like journals right like if you do a lot of research like real scientific research you try to you do a study you write a manuscript and you publish it in a journal I mean so many journals will charge you money for the publication fees and they're not cheap there sometimes like 1 1500 2,000 bucks just to publish a freaking paper that's like four and a half five pages long um but that's like the currency medicine or at least it used to be was like the thing is are you well published Do you have book chapters?

Do you have textbooks under your name? Do you give lectures on the national circuit? Are are you somebody? You know what I mean? But now it's kind of the script has flipped. Are you somebody is like how many Instagram followers do you have? How many Tik Tok views do you have? And one isn't I'm not claiming one is better than the other. I mean, I think it's just changed. >> Yeah.

I mean, you know, we all know about those open access journals where people would just go pay and create that prominence about them. you know, this is the most published doctors out there and you know, you find out that they have 200 different published studies. Uh, but they're all published in these open access journals where they paid like, you know, $2,000 to get their research published.

But, um, then then there was a trend in the, you know, maybe mid in the 2015 2014 era where a lot of doctors were getting on Tik Tok on uh, Twitter. At that time it was called Twitter. Now it's called X. Uh, and then >> it'll always be Twitter, bro. >> It's always gonna be Twitter for me. >> I mean, what is X? >> Yeah. What is [laughter] It's Twitter, dude. I want that blue bird back. >> I mean, do you do do you tweet or do you exceed? >> Yeah.

[laughter] >> I don't understand what it means when you write on X now. >> Yeah, I just X, bro. >> X. >> Yeah. No, but there was a study done. was interesting where they looked at uh a physician's uh actual publications and their online uh their research publications that they had uh versus their Twitter presence and the more they posted on Twitter, the lower amount of publications they had.

So the more prominent and more voicers they were on Twitter and social media, the less amount of publications they had. It's very interesting that inverse relationship between how much you're publishing >> versus how much you're prominent on social media, right? But who's to say that a a very highly published physician who has a legitimate research is very knowledgeable should not be on social media.

I think if a lot of the guys that we know personally know like you and me both know in our fields that are experts in their field. They're they're out there saying the right things. They're attending conferences. They're making speeches and conferences. I mean what if they were on social media?

What if they were saying the right things and drowning out all these fake meduencers out there that are saying all kinds of BS uh to uh misguide patients or >> and I think I think a lot of them a lot of them are like I I really don't think there's a stigma anymore and I don't think there has been for a handful of years of doctors having a social media presence that's really about their practice and them as physicians.

I I think it's very common like [snorts] you know especially Atlas like LinkedIn and stuff um it's very common to have like a very a real professional brand um talking about real issues people post about their publications and there's like real discourse back and forth like this study I just did showed blank and people comment on oh wow that's interesting or oh I mean there's even some disagreements and I think in a very uh balanced way and I think that's great to put that out there because not everything is correct not everything is good science Um, and even more so, um, this is something I see a lot in a lot of my connections on LinkedIn.

They'll post about like if they get an insurance denial that they think is just ridiculous. Basically, just making the conversation more normal and more regular about the fact that so much of healthcare is controlled not by the doctor or the patient, but by this third party presence, this entity, this insurance company. You know what I mean? Like that's just an example that I think doctors can use their social media presence in a positive way to bring light to issues.

Um >> the other side is what you were mentioning like medfluencers who are hawking their craft. >> Yeah. I mean LinkedIn is a different example right LinkedIn mostly is uh has historically been a more professional thing where people go on looking for opportunities looking for jobs looking for connections and networking and that's kind of the uh always been the purpose of LinkedIn. Uh but are the masses on LinkedIn? Are they following the right people on LinkedIn?

And and and and I feel like there's a stigma on patient on on physicians being on LinkedIn or Twitter and discussing amongst peer what's going on versus being on reals and Tik Tok and other social media outlets where there >> Yeah, you're right. There there is a difference for sure.

there's a difference and that stigma is still not gone where a physician that goes on Instagram uh goes on Twitter or sorry goes on Instagram or goes on Tik Tok there's still stigma on that and a lot of people are hesitant a lot of physicians do not know even where to start I mean I don't know where to start how to create my um Tik Tok page or how to create my reals page I'm maybe not as as uh social media savvy I mean we started this podcast and this is one way that we're able to give some of our thoughts thoughts out there to drown out some of the the the noises that we're hearing, right?

But but not everyone is starting a podcast or is social media savvy to be able to go in front of a camera and just talk about a topic uh openly uh or even think about a topic. A lot of times physicians who are actually seeing real patients don't even have the mental capacity.

I mean, we're really pushing ourselves being late night at these place, you know, in the office to to record this, but a lot of physicians don't have the mental capacity at the end of the day to really get on the social media and and and talk about the topics that they have on their mind or maybe dispel some kind of misinformation or disinformation out there.

So it gets very hard for physicians who are seeing 30 40 patients a day to then get on social media because they're busy running that hamster wheel uh of daily dealing with insuranceances and dealing with denials and making sure their patients are taken care of where >> yeah it's a it's a hard balance. It's a hard balance for sure. >> But you know what I was saying is with there are patients people out there that don't have that kind of patient base.

They're not really seeing patients in clinic or dealing with real life issues, but they're the most active on social media because they have the time and they're making money, right? >> Yeah. I I would just say like I I think I wouldn't paint it in such a negative light. Like I I think there's definitely people that are less clinically productive that have more time and more desire, right?

Maybe they don't want to be as clinically productive or they work in a different type like if they work shiftbased and they don't have a regular like you have a real clinic that you it's just you and they're your patients and even though you see your last patient at 5:00 p.m. you go home, if something happens, you get contacted. I mean, it's your patient. You got to take care of them, right? Like, you still have their responsibility. You're their doctor.

But if you work shift based like anesthesiology or in the ER where once your shift is done, you clock out, you're done. Someone else takes over, you're not following up that patient. I'm not saying it in the sense of abandonment or anything negative. That that's the nature of that type of practice. Those types of practices may afford you a lot more time to do these kind of things. And I I think a lot of the doctors that are very active on social media, a lot of them are ER doctors.

Um, a lot of them are hospitalists because they have that one week on, one week off and in their time off, they have the luxury of that. They have time. Um, I think it just depends on what you can focus your energies on and it's hard when you have a busy clinic, you know. >> Yeah, there's a there's a fine line, right?

I mean, there's and I I welcome and I encourage I think anyone with uh good medical advice to give, evidence-based medical advice to give or even uh experience space advice to give to go out there on social media and give the advice. But there's also a lot of people that uh are taking advantage of people who don't have anywhere to kind of look into and these people have a lot of social media following and they're going on there and they're giving certain advices.

uh maybe have an online clinic or a small clinic where they check labs or tell you that you have mitochondrial dysfunction or you know chronic Lyme disease and then sell you a bunch of supplements. Now where is that fine line where you're using um social media to build a brand uh provide patients with the right care versus uh building your brand to prey on patients by selling some useless supplements and making a huge profit out of it.

That's where it gets blurry and it's hard for a lot of patients to kind of differentiate between what's real, what's legitimate and what's what's what's uh you know not real and who is taking advantage of them. It's it's very hard to tell. I mean I sometimes fall into those things fall into a lot of these trends and uh you know ideas about supplements and cold plunges and whatnot that I I look into. I'm like oh wonder what what's that about? And I try to look into that and read into that.

>> Right. So what about physi people who are not as uh uh you know in this medical universe or educated about the healthcare um you know what about them they easily fall prey to these things. Yeah, it's a good question. I mean, you know, is it like it's kind of an ethical question, right?

Is it wrong for, let's say, a doctor is using, you know, their credentials, their expertise, whatever you want to call it, and they gain a social media following and stuff and now they make a partnership, let's say, with some supplement or vitamin company, and they start selling pills that, hey, these will help your longevity. These help you sleep better. Go ahead and take them. Here's a uh a promo code. Right? We see this all the time.

First 20 people to comment, I'll DM you privately and give you my special newsletter. You know that that stuff is very common. I is that wrong? You know, like they are using their expertise, their knowledge and their successful social media tactics to generate income. Um, in a way that's what every single job in the world is that you use whatever skills you have to make money. And is it wrong? I mean, I don't think it has a right or wrong answer. I mean, what do you think?

>> Yeah, I don't think there's a right or wrong answers, right? Some people might truly believe that uh you know, certain supplements that they're partnering up with, they truly believe in them. They think that they really work for patients. But what I understand is if I'm prescribing a medication or a supplement that for me to prescribe it, I will make money by prescribing it. Am I a little bit more motivated to prescribe that to someone who might not need it as well? >> For sure.

I think I it's human nature, right? You probably >> human nature. I mean, money drives a lot of our habits and a lot of our actions. Now, if I'm every time I sell bourberine supplement or uh you know, vitamin D supplement that I tell patient, hey, you would benefit from this. Yeah, there are some studies, some small studies that have shown that, you know, your um your A1C may get better and your lipids may get better.

What if I tell them that, hey, I sell this creatine supplement, which is if you're working out, this may be much better for you. Am I causing harm? No, not really. I'm not causing harm. Um, am I choosing sometimes that expensive bourberine over actual metformin that would possibly work for them much better and is much cheaper, but I would not make money from it. Am I prioritizing bourberine over metformin?

That would that would question that that would be the question that I would put forth to a lot of people where where does that ethical line come into play where I'm preferring a supplement over a medication that might have solved their issue much faster. Right. >> Yeah.

You know, I think in a setting where there's like actual legitimate evidence that this treatment, this medication, whatever it is, works and is beneficial with low risk versus you have another one that's maybe a little new, cutting edge, whatever, but is a little less evidence-based, but that one you have a financial incentive with and you favor that one. I think that's a very slippery slope.

And in fact, I would take a step further and say that is that is wrong because you're financially incentivized to do something that has far less evidence, less robust, and more expensive. Um whereas like another example that maybe is a little more gray area, like for example um in my clinic in orthopedics, people come in with wrist pain all the time, whether it's a sprain, tendonitis, whatever, right?

One of the many treatment paths that I give them, you know, when you're talking about non-surgical stuff, which is what a lot of these things are, these overuse injuries, weekend warrior injuries, you know, um, is a wrist brace in addition to all the other stuff like anti-inflammatories or steroid injection, right? Someone's get wearing a wrist brace. And so that patient has the option, they can go to CVS or Walgreens and buy a wrist brace for like, I don't know, 15 bucks.

They can go to Amazon and probably get it for cheaper than that. or they can get it from me in the clinic right there um with a hefty markup. Um because the institution I work at, the academic center or any employed practice, they're going to mark it up just like every place on the planet marks things up if you get it from them. You get something wholesale, you mark up the price and you make a profit on that margin. And so, is it wrong for me and my group to charge the patient more money?

truly selfishly, right? We make money from that, but the patient also gets it right then. So, it's at time zero. The patient is happy knowing they got it from their doctor and they can trust it and they're a little weary like an off-the-shelf thing from CVS, Walgreens or something. So, there's that element of trust. Um, is that right or wrong? I mean, I think the patient is happy with it and obviously we are happy with it because we are making a bit of money on the DME side.

So, I think truly, again, maybe I'm rationalizing, right? Human beings are awesome at rationalizing all their behaviors to themselves. But I think that's kind of a win-win scenario. But I mean that that's my perspective. >> I mean I see that in that case patient is paying for the convenience and uh the the trust they have in their doctor to provide them with the right fitting the right brace that will truly help them. They might be hesitant in going to another place and getting the same brace.

Now if you were providing a much lower quality brace that uh you're cutting cost on and a brace from Amazon or CVS would be much better for them that I think that's where it becomes unethical just like I >> you know uh people prescribing or selling something like bourberine versus actually prescribing metformin because they would make a little bit more money on it.

uh or um you know prescribing um a compounded um GLP1 uh versus the FDA approved one because the compounded ones yes somearmacies are great and if you have a trusted pharmacy uh it might be working really well for the patients but it's inconsistent and somearmacies try to cut cost versus the actual FDA approved uh GLP-1 medication that might help patient lose weight more consistently and might be more beneficial for them. Uh where is that line?

and where is that ethical line of um are you doing harm at that point if you're providing a lower quality medication uh to make that little bit of profit for the patient and that's where uh you know uh I have a problem where people can use their social media um you know platform to sell a subpar supplements or medications and maybe cause harm to patients right um I have been um I have received emails from multiple different companies to sell and sign on to their uh supplement uh program where I would get supplements for a very low wholesale cost and then I can sell that to the patients for a little markup and make money off of it and all I would be saying hey there's something natural you can take and it would be easy for me to go ahead and and do that and patients would buy it from me because if their doctor is selling them supplements and it's right easily available and they can still go to CVS, Walgreens or wherever and buy those supplements from there but they are getting it from their doctor's office.

>> Yeah, they would trust it more. >> They trust it more, right? But the problem would come in if I choose the supplement over a life-saving medication. >> Yeah. No, I hear you. I agree with that. >> So, I think that's where the the slippery slope is. I mean, you know, the other slippery slope is the patient privacy, right? A lot of um a lot of metfluencers or uh influencer doctors uh that go on social media and tell patient stories, right?

Oh, I had a patient today that came in with uh a broken arm and uh you know, I had to do an X-ray and blah blah blah and I told them about this story. You know, whatever whatever story they had, it was interesting, but where does patient privacy come in? Or how how does a patient feel when they they recall a story about them? Yeah. They don't say any names, they don't say any any identifying information, but the patient knows that they're talking about them.

you know, uh, is that a breach of that patient doctor trust and relationship that they have when they talk about a patient on social media to get views? Um, is that where is the where where is the ethical dilemma in that where you're using someone's health struggle or health story to get followers and gain that social media influence? >> Yeah, it's a good question. I mean, I I would kind of like analogize it to like in politics.

I mean, think about how often we've all heard any politician, whether presidential level or local politics, they're on an interview and they get asked a question and they answer that question with a story, some anecdote, and they start talking, "Oh, I met this lovely lady. She lost her son. He was serving our country in the armed forces." Um, and it's a great loss, but they're they're a true American family, you know, and I met them. I went in their home. I had a meal with them. I sat with them.

I cried with them. we really made a connection and these are the people that I am fighting for. You know what I mean? Like these kind of stories are there all the time. Whether they're true or completely fabricated, who the hell knows? Uh but it's common place, accepted and people even like hearing it in the realm of politics. You know what I mean?

And so I I don't think necessarily medicine has to be any different because, you know, if we start talking about something or I bring up a patient's story, I'm going to very purposefully not disclose when it happened, not disclose anything identifying about the patient and maybe even on make up a little bit of stuff for one, maybe to add flare to the story, but two to make sure it's completely deidentified.

Um, and the only person that could potentially know anything about that patient and that patient's story is the patient themsself if they happen to be listening. And would they be upset or perturbed about it? I think some people might be. I think some people might think exactly what you're saying like he's using our interaction to further whatever agenda to to now put it out there and get views or likes. But I think other patients may not. They may even think, "Oh, wow. That's awesome.

he remembered this or like we really made a connection and he's sharing with his other patients. You know what I like I don't think it's necessarily a bad thing if you truly keep it deidentified. >> Yeah. Yeah. Yeah, I mean you know um a lot of times uh big pharmaceutical companies or corporations have for many years used physicians to uh come on their advertisements or uh TV ads, radio ads, flyers, social media ads, go on and talk about a medication and tell a patient's story, right?

Um but but now with the rise of social media, physicians themselves can just go on and give their own unbiased views now. And I think that's a win right there. Now physicians don't have to depend on uh big corporations to give them that TV space or that online space to go on there and they can give unfiltered views on social media which I think is a is a is a good thing. you know, it's it's lowered that barrier of entry.

But but on the other hand, I mean, you know, if you're um like like you said in in the terms of um using that platform to tell a story and that gain that influence and um use the patient story and personal stories to gain your influence, uh I think there should be some kind of patient consent involved in that and uh I don't know how anyone would go about doing that, right?

Um, a lot of times I think most people would end up making up stories or taking inspiration from multiple stories and I think I see that uh a lot of people doing that quite often where they take two or three stories uh refine that story to create a patient story to tell that on their social media to gain that kind of influence and I think that's okay because you're using that story to provide a lesson or provide some kind of anecdote where other people might interest find interesting and when they see that story they might see oh that happens to me as well and they might relate to that and then that they might something might click.

Okay, they might have to go see a doctor or they should go um you know seek help for that condition they're having. So I don't think it's wrong, right? But um we have to kind of talk about where is that slippery slope of uh using stories all the time versus certain stories to just uh >> uh teach a lesson.

Now, if you're on there going on social media and complaining about patients and bashing patients and talking about, "Oh, this patient was so disrespectful or uh this patient came in asking for this and can you believe they asked for this?" You know, I've seen quite a bit of that and a lot of physicians going on there complaining about patients or saying negative stories about patients.

that I think is something a lot of professional physicians should uh avoid uh and mostly try to focus on using patient stories to teach a lesson or say give some kind of health care anecdote which could possibly benefit patients and I think that's where I think is a good line to draw for me personally that's where I would draw the line. >> Yeah, I hear you man. I mean, you know, it's like in one sense, it's kind of nice to believe that you can be unfiltered.

U but that's just not really how the world works, right? You take one little snippet out of context like like the example you're giving.

I mean, there's doctors out there that, you know, whether they're on a podcast or an interview, they're just chatting with their friends, they put a little reel or something or a Tik Tok video that they think in the moment is funny and they're just like letting themselves relax, blow off some steam, um, talking about some encounter that wasn't good or some patient they thought was annoying and they dulge it. I mean, now that can be viewed thousands and thousands of times.

And if a patient sees that, they're going to think, I mean, is this a doctor that I want to go to? Like, he's making fun of other patients. is he going to do the same thing to me? You know what I mean? So even if that the intention was just I'm just going to blow off some steam. I'm just this is funny. You know, it's the intention is not to harm anyone. It may be received in some other way. I mean you can't control how someone will receive something.

So I think more so to protect yourself and your professional brand and your integrity um and your like practice. I don't think that kind of stuff is really a smart idea. Um >> is it is it you think is it risky for physicians who are very established to have uh very highly sought-after reputation like you know they're assistant professors or professors at certain institutions or they have a big busy private practice in the community and well respected.

Is it risky for them to go on social media and give their views because u the way things are it's easy to get cancelled now right they might go on there and maybe in a moment of u freely speaking or fre speaking unfiltered they might say something that may be taken out of context or maybe uh may appear uh to other people as rude or demeaning and they might get cancelled or might get multiple messages on the social media or the reviews page about bashing them or might lose lose their position at the university.

Um that is something uh real practicing physicians who have businesses who have a legitimate position have to worry about. Um and maybe that's what's also keeping that entry into the main u mainstream social media limited for a lot of these physicians as well. Right. You work at a bigger institution. So what do you think? >> Yeah, it's a good point.

I mean, you know, if you're already like very established, let's say you've been practicing for like 20 years and I mean, you've got busy clinics stacked till forever and you're basically set. I mean, you're at your capacity and you're doing great and you're happy. You don't really have the same incentive of someone who's young and fresh and hungry to develop a social media brand to garner more patience.

you would more so do it maybe because it's something new, it's something fun, um you have a message to say, you have years of experience and you just want to get a voice out there. I think those would probably be more common reasons to once you're established to make a social media presence or for education because there are a lot of physicians that do a lot of really legitimate good education um on these platforms.

But you know like for me being employed in an academic practice um we have a lot of social media I guess safeguards I don't know if you would call it that but like um the university itself the college I guess they restrict in a way I mean we aren't supposed to post anything that could be misrepresented or say anything that could be misrepresented as like the opinion of the university right which makes sense I mean if I'm talking as an individual, no matter what industry I'm in.

Like if I'm an engineer at some construction company or an oil and gas company, I would as an employee refrain from saying, "Hey, this is the opinion of Hallebertton." You know what I mean? So I don't think that's unreasonable. That's kind of any employer employee relationship. But you're a little more guarded, right?

or especially if I enter a relationship like I'll give you an example like I started doing um some work with an outside company and I joined a scientific advisory board which I think is interesting it's cool it's a company working at the intersection of healthcare and AI like I they posted about me because they want to use all of their physicians who are part of their scientific advisory board to advertise their brand so they posted that hey Dr. Adah joined this company this and that.

Uh, welcome. We welcome his expertise and all that stuff. They put my picture on there. And I got a message from someone at uh at Baylor saying, "Hey, we saw this. Congrats. This is really cool. This is great." Um, but you got to fill out a conflict of interest disclosure form. Um, which okay, that's fine. I mean, I didn't even like cross my mind. I didn't like purposely omit it. I just didn't even think about it when I joined this company um that I would need to fill that disclosure form out.

But that just shows that like something on social media even that I didn't post it but it has now repercussions for me. It adds an extra thing I got to do with my life. It adds an extra line that if I'm being fully forthcoming with everything anytime I give a lecture and I give a ton of lectures to the residents to the fellows and stuff every lecture I give I got to put that line on there. You know what I mean? So, is it a real conflict?

Like, if I'm talking to residents about like elbow trauma and fractures in the elbow, is that AI intersection is really relevant? Probably not. But like, for all of the lectures to be vetted and everything and the CME credits, the continuing medical education credits to be divulged to everybody for that meeting and for that 1-hour talk, I got to have all the disclosures on there. So, you know what I mean?

Like to your question of being in a big academic center, what could the potential repercussions be or things you got to watch out for? Stuff like that. You got to be more vigilant. I would say I mean can you uh imagine a world where there are regulations where a lot of the social media influencers have to uh disclose all their sponsorships and where they're getting money from.

Yeah, >> a lot of times >> a lot of times they go on there and they recommend certain supplements or certain drinks and they for them they don't have to say that I'm getting paid by them. They just say this is my personal view and I've used it and I've been using this for so long and it's helped me improve my gut health and my leaky gut syndrome and my uh uh mitochondria health has improved since I've been drinking this drink.

Do they have to really disclose the money that they're getting from some of these brands or the the profits they're making? I mean, maybe there should be their Twitter page. >> I I honestly think that like I mean, anyone who's watched TV and advertising in their life, if you see someone on TV advertising a product, I think it's pretty safe to assume they're getting paid for it. You know what I mean? It's like athletes.

If you see some football player on a Gatorade ad, you know, he's getting money from Gatorade. And good for him. I mean, why not? You know what I mean? So, I kind of think the same thing with this stuff.

If I see some doctor wearing figs in a Instagram ad and the ad is showing a bunch of photos of someone who looks really good wearing the figs and then it's like a link to buy figs, I'm going to assume and I have no problem if it's true that that person in the ad is getting paid by figs and they're using their brand and their image to market figs. Whether it's a direct payment, an affiliate marketing thing, whatever it is, I think it's totally fine.

Figs, by the way, are a a type a brand of scrubs. >> Yeah. >> Uh for the viewers, if you're not aware, >> wear on the daily. >> Yeah. >> Yeah. No, but at what point is it what point is uh going on social media and talking about a certain service or certain uh supplement line that you're selling, a certain uh uh procedure that you're providing? At what point is the exploitation versus modern outreach? Right?

For example, uh I do uh I do participate in a lot of pharmaceutical industry sponsored clinical trials, right? Uh with a lot of my patients, I'm up front. These are clinical trials where this is the benefit. This is how you're providing benefit and this is how you're being provided the benefit. You know, we that I that's the frank conversation I have.

Now, I I have done social media videos for certain clinical trials out there and to go and talk about obesity or talk about uh lipoprotein a uh where is that line between exploitation going on there talking about a condition try to recruit patients for clinical trials versus uh you know it being a tool of modern outreach where I'm trying to reach as many patients as I can to inform them and educate them about a clinical trial right uh that is and these are my intentions I know what my intentions are I my intentions are for the benefit of the patient and benefit of the science but uh other people might take it at certain way where they're thinking that I'm um you know spreading some kind of um uh message from a pharmaceutical company and trying to enroll patients in clinical trials.

Same with a lot of patient people that are going on and um talking about hey um you know I'm I've been drinking this drink and this this yellow green drink that I drink every day has improved my gut health. They don't have to say that I'm getting paid by this drink, but this is something that they're saying that, you know, or or a physician that that goes on and tells you make sure you get this lab checked, this lab checked, this lab, get checked. But in the end, talk to your doctor.

They just have to say that line before taking anything, talk to your doctor. Right. >> Yeah. Which is crazy. Like you know this, if you watch a video and some random guy recommends XYZ and Yeah. uses that canned line in his mind of to avoid a lawsuit like but talk to your doctor before doing anything. You know what I mean? And then the patient shows up like I have patients so often come to my clinic. We're talking about like muscle arthritis, bone health, whatever.

And they randomly ask like what do you think about? And they'll like spec like this random supplement or this random like amino acid or this just like dude I've never heard of that. And they're like okay but what do you think? I was like did you not hear what I said? Like I have no idea what that is. You know, there's no evidence. There's no science behind it.

You just saw some random thing on TikTok because some jacked guy who's a fitness dude recommended it and promised that's why he's got huge biceps and now you want to take it and you're asking me because I'm your doctor. Like, I have no idea. I have no opinion on that. I have no advice on that supplement. All I know is I've never heard of it. It doesn't have any evidence behind it. It may work. It may not.

But like I think that's hilarious what you were saying when when people online will say that like they'll recommend so much stuff in favor and then but talk to your doctor before doing anything >> as if that absolving uh and the liver king was on social media. He had no credential whatsoever.

All he had was he was this jacked guy with huge muscles and he was ex exploiting patients selling his supplements saying that I eat liver and these are the liver supplements that I'm selling and buy those and you'll be jacked like me. And then later you find out this guy was using steroids >> just right he was just juicing and that's why he and he made a lot of money on the on these supplements.

Uh there's tons of people that are selling supplements or there's a bunch of people that you know um I personally know of and seen patients that are seeing functional doctors or or chiropractors or you know who are able to check patients labs.

So what patients do is they go to these functional doctors and these functional doctors check tons of labs, Lyme disease and um you know um particle size and LDL particle number and you know all >> all kinds of stuff >> and then when they get the results and they go to them they don't get the right answers and they're told oh go talk to your cardiologist or go talk to your [laughter] neurologist and then they show up and they said that okay I've I I did these functional results and it told me that I have long uh chronic Lyme disease and long COVID syndrome and I was told to take these supplements and my cholesterol is just do you think this will interact with your medication that you put me on or is this okay to take?

It's it's very hard to tell them that there's no science or evidence behind it. No studies have been done. There's no way I can answer your question if this medication interacts with this supplement. I honestly don't even know what's in your supplement. I mean, do we even know if vitamin D when it's being marketed as vitamin E, vitamin D, is there any vitamin D truly in there?

We don't know because these supplements do not undergo any kind of clinical trials to even truly be assessed for what's really in them and what med what uh side effects or effects they're causing, right? Um same with with that idea of oh yeah, go talk to your doctor with peptides.

I mean, a lot of these patients now are coming in because a social media influencer told them, "Go talk to your doctor about getting on peptides, >> uh, or NAD, uh, you know, and patients come to me now and they're saying, okay, what do you think of peptides?" I'm like, I think what everyone thinks. No one knows anything right now. >> Yeah. >> Theoretically, some may work, some may not. Uh, there's anecdotal evidence.

I mean I if if I start telling you and make a syringe of water and tell you this is my peptide A16C and this improves your energy levels and muscle health and you start injecting it weekly, you'll start having some kind of energy and you'll feel better, right? Uh >> the placebo effect is real. >> Placebo effect is very real, right?

I mean, we see that in clinical trials all the time where patients start feeling a certain way because even though if they're on placebo, but I truly cannot tell you what the benefit is without a large randomized placebo control trial, >> you you just can't know. You know one one thing I I'll I'll add um as we close the end here.

One thing I think you know in this vein all this stuff like peptides and NAD and all of this stuff so much of it is initially propagated and supported not by doctors on social media by random people by uh self-appointed fitness gurus by random podcasters and stuff. And these people will actively call into question the years of expertise, experience, and knowledge that real physicians, real scientists have. Almost as if it's like a cool thing to fly in the face of so-called real experts.

It's like, "Hey, look at these people. They've spent so much of their life doing this, blah blah blah, but we got this new thing. All right? They don't want you to know about it, but we we know it works." You know, that's such a common thing. And I remember distinctly watching one Joe Rogan episode u where he was interviewing Mark Zuckerberg when Zuckerberg was on uh his podcast. They're talking about Zuckerberg's knee injury and he had ACL surgery and then went through rehab.

And they're talking so much about the surgery, how everything went well, blah blah blah. And then out of nowhere, Rogan asks him about some random I thing I'd never heard of, some peptide or something like that. And Zuckerberg was like, "Oh, no. I never took that." And my doctor didn't recommend it. My surgeon didn't recommend it. the guy he trusted to do his surgery. And Rogan was like, "Oh yeah, don't listen to doctors, dude.

They don't know." And I was like, and I was like, "So, you would trust someone to do a surgery on you, put you to sleep or you might die, cut you open, put random stuff into your body, close you up, and tell you how to rehab it, but you wouldn't trust them." Like, it's just like the buffoonery. I mean, it's so stupid. Like, it doesn't even make sense.

There's a total lack of logic behind it that Joe Rogan thinks some random dude, his friend, some fitness guy knows more about peptides and the the real effects of them long term which haven't been studied in any extensive detail in real science. You know what I mean? Like it just but that's why I think it's important for physicians in general to have a real voice to combat stuff like that and to have a real element of truth behind it rather than just charlatanism. >> Yeah.

I mean, just because I know a friend who had some uh PRP injected into their knees and all of a sudden magically they had uh a functioning knee doesn't mean that will work on everyone, right? >> Yeah, totally. >> There are anecdotal evidence the placebo effect is real. We don't do science on anecdotal evidences. We don't do science based on just something that in your mind is improving and you know a couple of people that improved on this. We do things based on evidence.

We do things based on large scale studies. Uh and that's the only way to know if something is generalizable, right? Um a common line I hear is oh yeah you doctors don't get uh educated about these things. You guys don't know. I mean I watch as much Joe Rogan and as much these uh you know Huber man, Peter Tia and these all these influencers and met influencers and uh experts that go on there and talk about all these things. Yes, I keep myself educated but can I advise these things to my patients?

No, it's not time yet. I mean maybe in the future they'll do some large scale studies. Maybe a pharmaceutical will recognize some of these peptides or some kind of vitamins that do truly work. And you know what they're going to do with that? They're going to try to make money from that. They're going to turn that into a medication by doing large scale studies and say that yeah, this truly works. And then they're going to sell it to you for millions and millions of dollars. Yeah.

You think there's some magical potion out there, some magical supplement out there that's that no one else knows about and it's working magically for you and no one else has tried to make enough money from it. No, >> if it sounds too good to be true, it probably is. >> It probably is. So, that's uh you know, I hope more people uh look into that, real. Until then, we'll keep watching the Aggies and the Cowboys, and hopefully the Texans, who are 02 right now, pick up the slot. >> Yeah.

All right, man.