Portal de Periódicos da CAPES

Social Media: Diamonds or Coal (or Worse)?

2017; Elsevier BV; Volume: 18; Issue: 12 Linguagem: Inglês

10.1016/j.carage.2017.11.003

2377-066X

Karl Steinberg,

Social Media in Health Education

I freely admit that I spend more time than I probably should on social media and the internet in general. I post pretty frequently on Facebook, and I’m a member of several groups, including the PA/LTC Physician and NP/PA group (readers, please join!) and the Slow Medicine group. I tweet on Twitter, and I participate in tweet chats that are relevant to me. I am on LinkedIn and have more than 1,000 contacts. My dogs even have an Instagram account (although I don’t know how to use it yet). I think there’s a fine line between reasonable, healthy, and gratifying social media time and activities spent (defined as “the level at which I participate”) and overkill, obsessive, and unhealthy levels of social media (perhaps “the level at which you millennials/Gen Zs participate”). I try to stay on the sane side of that line, and I do use these platforms for professional purposes, especially to find out about newly published research on interesting topics and to stay abreast of lay press coverage of palliative medicine, physician aid in dying, and other bioethics-related matters, geriatrics, and post-acute and long-term care (sadly, usually horror stories of neglect or abuse). The Society’s “We Are PA/LTC” website (https://paltc.org/we-are-paltc) is attempting to bring some positive, balanced coverage to nursing homes and those of us who live and work there, thankfully. I post sometimes about my travels and the meetings I am attending, and share legislative updates, invitations to professional events, and links to articles in JAMDA or stories in Caring. I also post pictures and videos of my dogs, clips from concerts I am attending, jokes, cartoons, science and astronomy videos, great photos taken by others, links to specific sites like BoredPanda, YouTube videos of cute animals, happy birthday messages, family-related content, photos, videos, or screenshots when we’ve had some very unusual weather, references from Snopes when someone has posted something that is actually fake, and occasionally political news (sometimes with a pithy comment) when I absolutely can’t help myself. And I like taking pictures of misspelled words or bad grammar on TV and publicly shaming them for doing things like spelling “Reagan” wrong. I am not much of one for posting about the meal I just consumed (unless it was exceptional) or sharing that I am in a grumpy mood (which is rare anyway), but I have Facebook friends who do. I do not sit in judgment of that. I figure, like attendance at a 12-step meeting, participation on social media probably has a therapeutic value for each person. Many of our readers will no doubt disagree — I often hear laments of how social media are destroying genuine social activity (sometimes invoking images of groups sitting at restaurant tables, each looking at their respective smartphone to the apparent disregard of the actual other humans). Stories of young people committing suicide because of cyberbullying or not having enough followers or “likes,” are disturbing. Social media can help keep people connected and engaged, but we have to find a sweet spot that does not completely undermine direct human contact. In October, a dear family friend, dating back to high school, died after 2 years of living with glioblastoma multiforme. Thomas Eberlein, PhD, was a chemistry professor at Penn State University who was brilliant, funny, and a great dad and husband. He and his family visited our home earlier this decade, and I would see him at reunions and, yes, on Facebook. After his diagnosis, Tom and I had a few opportunities to talk about important, meaningful things — life, death, priorities — and to reminisce about our adventures together decades ago. I am not sure, absent social media, we would have stayed in touch, at least not to the extent we did. I attended Tom’s memorial service, which occurred just a few days after his death, via a Zoom video conference. (This is the platform the Society uses for our committee and board meetings; video is optional, but sometimes people forget their video is on, to the surprise of others on the call.) This and other conference call platforms allow people from across the country or world to participate in the same meeting in real time. Along with many of Tom’s loved ones from a wide array of locations, I was able to attend his memorial — my first virtual attendance at such a service, but I suspect not my last. That is a real gift of technology. Social media can help keep people connected and engaged, but we have to find a sweet spot that does not completely undermine direct human contact. For our nursing home residents and their families, applications like Skype or FaceTime can be a godsend. Helping our residents see their grandchildren or great-grandchildren playing, singing a song, or dancing in real time is definitely worth advocating for. We should do everything we can to facilitate frequent and meaningful interactions of this nature. The hardware is not expensive, and it can enhance quality of life and a sense of connectedness. Even those with visual or hearing impairment can benefit from these interactions, although they may require more active assistance setting them up. I also notice that I get advertisements or promotions for things I like — such as cinnamon-flavored candy, pet stain removing solutions, or classic rock concerts. Also, even though I don’t tell my computer what time my flights are, I now get pop-ups telling me it’s time to leave for the airport based on current traffic. Do advertisers know too much about me? I am ambivalent about this, but probably on the whole I see it as a positive thing. I like seeing things I like! If I didn’t know the Doobie Brothers were coming to town, now I do thanks to Facebook, Google, or Twitter. I don’t always click on these things, but sometimes I do — I am OK with targeted advertising. Of course, people worry about their privacy, and I suppose I do too, to some extent. I am generally law-abiding and not that secretive, so it doesn’t alarm me unduly that my cell phone and computer know what kind of music I like or the four locations I drove to yesterday. I have nothing to hide (e.g., I am not laundering Russian mob money), so if people want to use my information to sell me stuff, let them. Am I a mindless pawn in a Big Brother-esque conspiracy? Perhaps. But I still like hearing about stuff I like hearing about. This brings up a bigger discussion, one that is too big to fit in this column. When it comes to political discourse, there is a theory that social media have played a big role in driving us apart. That is, if I only see posts that agree with my beliefs and politics, it’s going to reinforce those beliefs, and the same applies for the people who have beliefs very different from mine. This, along with the anonymity afforded by Twitter bots and fake Facebook accounts, has resulted in real polarization and incivility. That is scary, and getting scarier every day. I guess time will tell whether social media and the immediate supply of information (and misinformation or disinformation) through technology are a blessing or a curse. In the meantime, we should certainly take the good parts — like live video apps for our patients to interact with their families, or the opportunity to attend a memorial service remotely — and use them to our advantage. In this strange new world we inhabit, social media have the potential to bring people together who otherwise would not be able to be together, and that is a good thing. Dr. Steinberg is chief medical officer for Mariner Health Central in California, and a longtime nursing home and hospice medical director. He is editor in chief of Caring and chairs the Public Policy Committee for the Society. The views he expresses are his own and not necessarily those of the Society or any other entity. He may be reached at [email protected] and he can be followed on Twitter @karlsteinberg.