In this extended segment with Marc Iskowitz, allergist turned digital health influencer Dr. Tania Elliott talks more about the ethical conundrums that can arise when medical influencers work with industry, including the provider conduct standards she’s working to promote. Listen to part 1 here

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Hey, it’s Marc. It’s time for part two of my conversation with allergist turned digital Health influencer, Dr. Tonya Elliott and the first part of our discussion Dr. Elliot shared a breakdown in the eye line allergy Community telling us. What information is trending on social media as allergy season heats up and what Waukee Trends she and fellow allergist are working hard to combat. She also talked about a recent decision to start dedicating her energy to social media influencing full time in this segment. She talks more about the Dr. Patient relationship in the social media realm as well as to Dr. Pharma and Dr. Advertising relationships specifically some of the ethical conundrums that may come up and working with industry Health Focus PR agencies as well as more generalist firms. They want to give a listen to Dr. Elliott’s advice for working with Physicians. There’s certainly not your average influencer.

She also addresses the lack of standards in this area and how she’s working with her professional association with the mission of helping doctors understand best practices for social media and Healthcare. Enjoy. What are some of the ethical conundrums that may come up when working with Pharma and you know sort of when you’re asked to review or end or endorse a specific product

one thing that’s really hard about the doctor Pharma is often times. You’ll someone will come to you to talk. You know your spokesperson for a brand right and they want some social posts and then they want some degree of exclusivity.

And as a physician, like, you know, it’s okay that you don’t want to you. You’re not gonna like represent another brand and also, I mean how many media pitches can you do about allergies? Like you can’t really represent two Brands, which I get that. However,

to have exclusivity

is an me pose an ethical challenge because now I am not informing my patients about other options for their care. So if you’re censoring what I say because I’m representing this one brand then how is that not considered?

Skewing somebody because they if they’re only coming to me for health information and I’m only talking about this one brand they may not realize that there’s other things that exist. Right? So I think Pharma companies just need to be really careful with, you know, putting asks on providers around what they can and cannot say that doesn’t mean you’re going to endorse another product that’s in the exact same category. But you know in terms of acknowledging and making sure that providers

Have the responsibility of making patients aware of a number of different options that are available to them is really important, right if they’re coming to me to learn all about all things allergy and I’m only talking about this one thing they might think oh, that’s the only option that I have

absolutely right.

So I think that that’s a really interesting ethical question that we need to ask ourselves and sort out.

and I just think in terms of the

You know what is allowed and what is not allowed in terms of content creation. I think we’re great about it with commercials. Right? It’s like this medication may cause blah and that but you’re not really seeing that as much when a health Creator or digital Creator is is endorsing a product right? It’ll say Ad partner. But like is that enough? Whereas we have so many other regulations when it comes to like broadcasting and commercials and other types of ads. So I think there will be more to come as it relates to Pharma and what we can and cannot do and say in the in the space of social media when you’re being asked to promote or endorse a product or create use your generated content for medication OTC or not.

So a lot of the onus kind of falls on on the clinician to to make all this clear, you know, there’s like you said, there’s no real like third party standard setting body coming in and telling you you have to do this. It really is up to you to to make all these things clear into adhere to the Hippocratic Oath.

And you and and that’s the thing. That’s why I’m like so passionate about this because where’s a provider getting their information from so like through the American College of allergy Immunology. I’m going to be pushing for us to create standards for social media like conduct standards right best practices for social media because the you know, the more we get out there more we’re going to get asked to endorse Brands. I mean to have a doctor say yes, I like this supplement or I you know, like this inhaler would have you right? It’s it’s inevitable what’s appropriating what’s not appropriate and that doesn’t exist and I so I think all of our specialty organizations need to do more of this I’m part of a committee with the World Health Organization called fides. They are focused on getting Health influencers across the world to promote accurate health information and anything that’s really important right there combating misinformation, but I think there’s a whole other area here, which is the codes of conduct and the level of appropriateness. So that providers

Getting taken advantage of and then, you know even in the worst case having some sort of malpractice fall on them the individual and then everybody else sort of washes their hands of it. And you know, we saw a lot of this in the Telehealth space and the virtual care space. We’re still seeing it in that space. And then again, this is this other wild west Uncharted Territory. So I want to call more attention to it and I want more specialty organizations to be paying more attention to it to protect clinicians.

Right as you were the former medical director at Dr. On Demand and so, you know, you interesting interesting parallel there with with the wild West’s analogy and you know, you mentioned you’re working with specialist organization, you’re special to organization to set those standards for providers and and so that you can cut down on misinformation but do it safely and I want to kind of ask you a little bit more about you’re involvement with your Professional Organization the American College of Allergy Asthma and Immunology or chair of the pr committee as you said and you know are already coming up with some of these, you know, real-time issues as some of as you and some of your college kind of wade into this area that you know, they’re looking for guidance on and so, you know, people naturally look to their professional association for that guidance. You also created the first ever medical specialty social media subcommittee with the mission of helping doctors understand best practices for social media and Healthcare and you know, you’re you’re just struck me as you’re providing some really invaluable Services here, but the decision to

to be that involved it comes with a trade-off of your time. You just talk about the thinking behind your decision to be involved there.

You know, I think all this is a no regrets move. There’s no.

Question that we are ingesting all of our health information online and then so I feel like this is the widest web to cast in terms of providing useful health information, right and then the next layer of that and I’m thinking about a care delivery model, right the next layer of that is a utilization of generative AI like okay, I’m gathering my information then the next layer of that. I’m thinking from a patient perspective is I’m going to use generative Ai and you know clinical decision support just sort of like serve up. Okay. This is the most likely diagnosis for me. And then I think the next layer of that is probably a Telehealth visit or specialty, you know, tell a visit with a provider or multiple providers because I think in the best scenario, it’s one patient and doctors for multiple Specialties kind of surrounding the patient and that could all be virtual and then the next step in that is that making a diagnosis or someone can go to a lab and get a diagnosis and then care gets delivered into your home you get your prescription sent to your door. So like

I just feel like that’s sort of the future of care delivery not this ridiculous. I’ve got to go take off time from work. Go sit in a doctor’s office get this very limited myopic recommendation from a single individual, you know, whatever their you know, knowledge bases or background is that sort of the information that I’m gonna get with regard to my diagnosis as a patient. I mean, I think that’s ridiculous in the in the age that we are in in health care. So anyway, so like considering that that’s sort of my worldview of where Healthcare is going. I didn’t want to dedicate my time to like opening up allergy practice, you know, it would limit my ability to reach people.

So anyway, I this is a no regrets move to sort of be in this space really understand this space understand the power of this be able to get real-time data and analytics to understand. What’s what messages are resonating with people and what isn’t and then from there that’s going to inform, you know, the next product offering that I either create or I endorse but this is the way more powerful approach to reaching people and getting them the information that they need to empower and improve their health. So whatever company thing, you know, it is that I do next like social media has to be an integral part of that.

Otherwise you limit yourself and you don’t feel like that’s a good model in today’s day and age that we should limit ourselves to one provider at a time.

Right and I should limit

Also one patient at a time,


You know, if I’ve got information that I can that I know is applicable.

To so many people. Why should I limit that to the number of people who can access an appointment with me? Why should I limit that to my geographic location? Right? Why should I limit that based on how much somebody can pay

right? Okay.

So I want to make sure that everybody anywhere has access to what I have to say so that their health can be be improved and I want to under and I want to hear their voices

talking about some of the pitfalls of doing what you’re doing. Now in terms of unintentional algorithms censorship, you know, what’s someone uses a certain words they become blocked by the algorithm and this can often prevent doctors from speaking on important topics, like sex education say or vaccination. Do you encounter that and your space?

Yeah, so it’s well-intended right to to make sure that inappropriate information is not

Getting you know that not being shown to people to viewers. I think I think the approach would really be elevating authoritative voices, which I think YouTube is doing a really good job of elevating authoritative voices versus going after and censoring, you know, and going after misinformation because you’re just going to be chasing everything everywhere versus saying hey, these are authoritative voices that we want to make sure that the algorithm elevates but I’ll give an example in the allergy space seam and Allergy it affects one. It affects 40,000 women a year and it’s actually an allergic reaction to a protein that’s found on the semen and it could be a leading cause of infertility. So people don’t realize that I, you know want to post and provide information around that but I actually can’t type right the word semen. I have to put a little Asterix and you worry that that information is not going to get to people that really need to hear it and women can be really suffering you can be allergic but also be allergic to latex condoms. You can develop swell.

Burning so people will have a complete blind spot to this and not know anything about it because it is being censored because the word semen is being used.

So that’s an example that impacts the allergy space.

Well, okay, that’s another Pitfall to have to keep in mind. I probably should have asked you this early. But what are the social media platforms doing about addressing health information and myths and how does misinformation impact clinical practice?

I think YouTube is doing a really good job of working to elevate authoritative voices and they’re working with government organizations. They’re working with specialty like, you know, like the American Heart Association American College of allergy Immunology. We’ve been speaking with them and individuals

And you have to sort of mean a certain number of following and Views and all this sort of stuff, but they’re really working to elevate those voices and kind of give them the Seal of hey, this is actually an authoritative voice that we trust that information is going to be surface to you. I’m not sure about what Instagram and tiktok are doing in that space. I would think they’re looking to do similar and so but I can’t speak to those those others, but I really do think that that’s the way to go and also think that you know, the the algorithm may want to consider treating health information.

From clinicians or authoritative sources differently than other types of information and again, you know acknowledging local lay person can provide very useful health information. But like we have to figure out a way to say like well, this is based or backed off of clinical data and research and then this this isn’t this this is coming out of thin air. So I hope with time we continue to get better at that but I think you know as a general rule finding those influencers or those organizations that really are putting out great content, you know, Mayo Clinic for example Stanford, you know Finding ways to elevate that information. So that’s the first thing people sees makes the most sense.

And that’s why it’s important again for you to align yourself with the recognized whether it’s special to organizations or you know, you’re academic affiliation just to bring this fascinating interview to a close. You know, I wanted to give you the last word here, you know, you mentioned that doctors are not your traditional Health influencers, which I thought was a really interesting statement.

Maybe one last piece of advice for Pharma companies or Brands. They’re looking to partner with doctors on social media. What should be their approach? What would you recommend some kind of rules of thumb there?

Well one is like I actually think there are some providers that really would be interested in doing this stuff and don’t know how so maybe it’s as simple as partnering with a specialty organization to say like, hey, we want to sponsor a course on you know best practices for social media or leveraging social media to build your practice or something like that. So that doctors could get more educate or how to become a digital Creator. Just something really interesting and fun right because doctors like I mean, we’re so old school you self to call the office for god sakes to make an appointment people don’t even have online scheduling come on so like but and then they don’t have websites and they’re not online, but they realize that that’s where it’s going and they realize that there’s an opportunity for new patient acquisition, right? So if you can show providers that there’s an opportunity for them to learn a new skill.

Said to get new patients in the door, they’ll be open to it. So wouldn’t that be great if you farm a company’s like hosted some sort of lecture Sears or something fun around how to become a digital Creator and then actually got to meet some of these folks right and then taught them the skill and then partnered with them on co-creating content one caution is like, you know, you you may be working with agencies, right PR agencies or what have you these brand agencies to help you find doctors. You just want to make sure that these agencies know how to find doctors and and look maybe this is this is the role of not necessarily the farmer companies, but of the agencies right to host open houses or casting call types of things, you know to sort of get an understand the clinician Community or work with the specialty organizations or what have you. This could be a really fun time for doctors to show their creativity. Everyone’s so super burned out. So this could be great teach them how to become a digital Creator and now you have a whole new dossier of providers that are

Student engage I can’t tell you the number of doctors that come to me to say. Oh, I got to really learn how to do that. Oh, I know. I really need to step up my marketing game great like Leverage this as an opportunity to teach them as skill about your world and then you have a whole roster of doctors to work from to match to Pharma companies.

It’s great idea and it’s probably no different from you know Industries, you know relationship with with leading Physicians and kols over the years in terms of offering them, you know, whether it was course content that would be helpful to them, you know, and also was perhaps was an overlap with the with the companies therapeutic area that they had products in so there was a a nice marriage there.

That’s exactly right the digital. Kol right? I’ve done that for you know for Pharma companies really speaking about the medication but how about around content creation? That would be really even if it’s a webinar or a course or dinner or a lecture and you’ve got these dots like myself right that are doing this type of work and then we’re teaching and educating other providers or even non-physicians on how to do this stuff and how it’s gonna be a channel for new patient acquisition and how to build the practice. I think that could be super interesting and really Elevate the types of digital content that ends up getting created for Farm.

Absolutely. Yeah. Well, that’s a great note to end on and

This has been certainly a fascinating conversation. It’s great to reconnect with you, Dr. Elliot. And thanks so much for your time again today. Really appreciate it.

Thanks for having.

Great, that’s it for this week. The mmm podcast is produced by Bill Fitzpatrick Gordon faylor, lesabusak and Jack O’Brien. Our theme music is by scissy and Son rate review and follow every episode wherever you listen to podcasts new episodes out every week and be sure to check out our website. Mmm for the top news stories and farmer marketing.