Twitter-verified public health professionals are mostly men

On Twitter, many users covet the “blue check”, the official stamp of verification given by the company that “lets people know that a public interest account is genuine”. This way, users can tell the difference between a real politician’s account and a parody account (probably sometimes hard to tell these days).

Doctors are one group asking for this verification, in part because during the pandemic they have amassed a large following and influenced online conversations around covid-19. And they often get their blue check – at least male doctors do. This does not hold true, however, for a large proportion of female doctors, according to a new study in the Journal of the American Medical Association (JAMA).

As for verified Twitter accounts held by doctors, of the 779 identified study authors, 70.7% were male and only 29.3% female.

The findings raise questions about Twitter’s verification process and, of course, the extra cachet given to health messages reaching wider audiences on social media.

“I wanted to know who was getting, for lack of a better term, respect or that extra kind of gold star,” said study co-author Fumiko Chino, a radiation oncologist at Memorial Sloan Kettering Cancer. Center in New York. City and a clinician researcher interested in health outcomes, health equity and health care disparities. Chino is verified on Twitter.

“Unlike, say, a celebrity, a verified doctor really does potentially have a wider voice and would be a bit more trustworthy than someone who hasn’t been verified.”

Getting Your Blue Check and the Fast Track to Healthcare Professionals

Twitter representatives did not respond to a request asking them to explain their verification process. But on the company’s website, it sets out a number of categories and requirements that various people and businesses need to meet to be verified – including things like the account needs to be active, notable, and not recently created.

For “activists and organizers,” where Twitter categorizes medical professionals, the requirements state that “the account reflects an individual, not an organization” and that “the account’s follower count is in the top 0.05% in their area”. However, Twitter says it will verify accounts that do not meet all of its requirements in matters of high public interest, due to their expertise or public role. This includes healthcare professionals during outbreaks.

“Social media has become part of a physician’s professional and public profile,” the study authors wrote. “The verification validates and reinforces this status and may have important implications for patient engagement and academic advancement based on digital scholarship.”

Why it’s important to know who has the social media floor

Chino said she thinks the verification lends weight to messages put out by doctors. It can be both good and bad. While people think science is black and white, it’s actually very, very gray, Chino said.

And since vetted doctors compete online over things like wearing masks (some say you don’t need them) because they’re making decisions based on various data they’ve reviewed, it can leaving others, such as immunocompromised or “at-risk” people, vulnerable.

“We failed to control the flow of information about different levels of risk and how we should behave,” Chino said.

Anjana Susarla, a lead AI professor at Michigan State University who has researched how people search for health care information on social media, said information seekers are looking for usually from reliable sources that look like them. While doctors and healthcare professionals may turn to the CDC for example, an average internet user may not be well versed with reliable government resources.

“If Twitter provides a different verification status for men and women, it could affect the perception of what is trustworthy information on Twitter,” Susarla said.

Susarla gave the example of someone seeking advice on whether to send their children back to school. Information from a pediatrician who posts advice on Twitter who is a mother may differ from that of a male pediatrician. But if the woman isn’t verified and the man is, it could impact how people choose to use the information they provide. Susarla also said the verification process is notoriously opaque.

Chino has helped co-author additional studies that explore how sex and gender inequalities lead to some information being amplified over others. Looking at Twitter influencers in his field of radiation oncology, Chino and his co-authors found that “male academic radiation oncologists based in North America hold particularly influential positions in virtual communities.

That men are more likely than women to get the blue check is nothing new – older studies have found the same patterns – but the recent study shows that this is a persistent problem. Previous research has shown that in general, men are much more likely to be verified than women.

“We’re in a liminal space right now where voices trying to promote a public health message are actually being attacked,” Chino said. “I think we have to be very careful about the voices we raise because unfortunately I feel like there’s been a real erosion of trust.”

Thanks to Dave Tepps for writing this article.

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