JMIR Publications

ABSTRACT

Background:

The social media site Twitter has 145 million daily active users worldwide, and has become a popular forum for users to communicate their healthcare concerns and experiences as patients. In the fall of 2018, a hashtag titled #DoctorsAreDickheads emerged, with almost 40,000 posts calling attention to healthcare experiences.

Objective:

We sought to identify common healthcare conditions and conceptual themes represented within the phenomenon of this viral Twitter hashtag.

Methods:

We analyzed a random 5% sample (N=500) of available tweets for qualitative analysis between the dates October 15 2018 – December 31st 2018, when the hashtag was most active. We dual coded 20% of the sample, and the remainder individually. We abstracted the user’s healthcare role and clinical conditions from the tweet and user profile, and utilized a phenomenological content analysis to identify prevalent conceptual themes through sequential open coding, memoing, and discussion of concepts until agreement was reached.

Results:

Our final sample comprised 491 tweets and 282 unique Twitter users. In our sample, 49.8% were from patients or patient advocates, 4.3% caregivers, 9.4% healthcare professionals, 3.5% journalists/media; 1.4% academic/researchers, and 31.6% non-healthcare individuals/other. The most commonly mentioned clinical conditions were chronic pain, mental health, and musculoskeletal conditions (mainly Ehlers-Danlos Syndrome). We identified three major themes: disbelief in patients’ experience and knowledge which contributes to medical errors and harm; the power differential between patients and providers; and metacommentary on the meaning and impact of the #DoctorsAreDickheads hashtag.

Conclusions:

People publicly disclose personal and often troubling healthcare experiences on social media. This adds new accountability for the patient-provider interaction, and shapes the public’s viewpoint of how clinicians behave. Hashtags such as this offer valuable opportunities to learn from patient experiences. Recommendations include developing best practices for providers to improve communication, supporting patients through challenging diagnoses, and promoting patient engagement.