If You Are Not on Social Media, Here's What You're Missing! #DoTheThing

W hat's all this buzz about social media? Why are people tweeting and ideas trending? What am I missing?If you have these thoughts, you are not alone. In this editorial, we share our personal inroads to Twitter (Twitter Inc, San Francisco, California), explain why we believe social media has staying power and enhances pathology, and offer basic tips to get you started.Let's start with some basic lingo. Social media (abbreviated SoMe) is a broad umbrella term that encompasses a variety of platforms that facilitate information exchange. Popular examples of social media include Facebook (Facebook Inc, Menlo Park, California), Instagram (Facebook Inc), and Twitter.Most are familiar with Facebook; it was introduced in 2004 and allows users to share text, videos, and images. Instagram was introduced in 2010, and it allows users to post images or short videos. Twitter was introduced in 2006, and users can post images, short videos, and up to 140 characters of text.Content on social media platforms is organized by key words or phrases, without spaces, preceded by “#”, or hashtags. Hashtags are searchable, allowing users to find related posts. Popular pathology-specific hashtags are listed in Tables 1 and 2. For example, users interested in pathology board preparation can search Twitter for #pathboards. Users interested in the United States and Canadian Academy of Pathology (USCAP) can search #InSituPathologists, #IamUSCAP, or #USCAP2016.Twitter handles (or user names) start with “@”. Messages directed toward Christina Arnold, MD, would include her Twitter handle “@CArnold_GI”, for example. Twitter handles are also clickable, bringing the viewer to the profile page for that handle. Twitter, Facebook, and Instagram also allow private messages to be sent between users or groups of users, functioning similarly to email.For the purposes of brevity, this editorial will focus on Twitter. Despite Twitter having passed its 10th birthday, medicine in general, and pathology in particular, have been late to arrive on Twitter. This hesitation may be due to conservative leanings of medical professionals to avoid unvetted communication tools, concerns to protect patient privacy, and already overburdened physician schedules.Among pathologists, Jerad M. Gardner, MD (@JMGardnerMD), was one of the first to recognize and advocate the power of social media. He joined Twitter in 2009 but did not use the service much for several years. After seeing the interest generated during his social media for pathologists lectures at the 2013 College of American Pathologists (CAP) annual meeting and the 2014 USCAP annual meeting, he decided to get more active on Twitter and began following and interacting with other pathologists, as well as physicians in other specialties. C. Eric Freitag, MD (@cefreitag), currently a resident, joined in 2010 to follow news, sports, and athletes. This soon expanded to include medical institutions, organizations, and physicians. Shortly after beginning his residency in 2015, he happened to come across Dr Gardner's Twitter account, which led to the discovery of the growing pathology Twitter community, which included pathologists, fellows, and residents from around the world. Michael Arnold, MD, PhD (@MArnold_PedPath), joined in 2011 to follow news, sports, and politics, and became active in tweeting about pathology after the USCAP 2016 meeting. Dr Christina Arnold (@CArnold_GI) joined in 2014 initially to help promote a USCAP interactive microscopy course, but she quickly recognized Twitter's importance in sharing ideas and making connections with other pathologists.It is not clear how many pathologists have joined Twitter, but it is clear that Twitter is energizing our field, as evidenced by log-linear growth during multiple years. Twitter activity related to the annual USCAP meeting has risen from 7 tweets containing #USCAP10 during the 2010 meeting dates, to 17 860 tweets containing #USCAP2016 or #USCAP16 during the 2016 USCAP meeting dates (Figure 1).1–8 The 2016 USCAP Twitter activity resulted in almost 27 million potential impressions (tweet views) and was a trending topic (a popular topic among all global Twitter traffic; Figure 2).5 To the best of our knowledge, Rasmus Kiehl, MD (@trkiehl), was the first pathologist to use a USCAP hashtag with the currently popular 4-digit year format (Figure 3).2Because social media allows instantaneous global interconnectivity, it is reshaping modern information exchange. Never before have people been able to instantaneously connect despite geographic, political, religious, cultural, age, professional, and socioeconomic differences. Users turn to social media for the latest information on anything. Social media provides the latest information on global and local news events, politics, sports, and celebrities. It facilitates international networking and is important for professional and personal engagement. Individual Twitter user mentions and interactions between users during the 2016 USCAP annual meeting (Figure 4) illustrate the broad interconnectivity that this platform provides. Of note, this analysis was performed by Greg Matthews (@chimoose) using data from MDigitalLife Online Health Ecosystem Database (MDigitalLife, Austin, Texas; @MDigitalLife), and was displayed using Google Fusion Tables (Google, Mountain View, California). On a more individual level, at the time of writing, Dr Gardner has more than 8000 Twitter followers originating from more than 100 countries. We used http://tweepsmap.com (Tweepsmap, Toronto, Ontario, Canada; @Tweepsmap; accessed February 15, 2017) for analysis of @JMGardnerMD's Twitter follower growth and global interconnectivity (Figure 5).So, what do these numbers mean for you? A lot! Below are the reasons why we believe social media has staying power, how social media is influencing pathology, and what you gain by joining the conversation.Undoubtedly, patient privacy is an understandable and constant concern. Our advice is to remember that social media engagement is no different than discussing challenging cases at conferences, in an elevator, in textbooks, on board examinations, and on unknown case-based Web sites. The strictest commitment to protect patient privacy remains absolutely essential, as in any other arena of our personal or professional lives. If the ethical principles of privacy are respected, we believe there is no significant privacy issue with sharing completely deidentified pathology images.48Now is the time to translate your social media curiosity into practice.The most high-yield benefits of Twitter come through regular engagement. Here's how to get started:Try to tweet/post at least 1 message and/or image per week. Generating and posting quality content is an important aspect of experiencing Twitter, and it will quickly increase your visibility on Twitter. The most popular messages have images of some sort: pathology gross or microscopic images, high-yield PowerPoint slides from a recent presentation or meeting, pictures from a recent trip, etc. Other popular messages include pearls from tables and graphs, links to useful papers, handy tips, or meaningful quotes. If posting material generated by others, make sure to credit them by listing their name or their Twitter handle. Until you have a large following, the best way for your message to be widely disseminated is to include Twitter users with large followings and a popular hashtag (Tables 1 and 2).In summary, social media offers tremendous advantages for pathology. It provides academic currency for career advancement via research collaborations and leadership opportunities. It is the modern route for promoting ideas, projects, textbooks, consult services, and courses. It helps us all keep current via sharing of new papers, meeting updates, and journal clubs. It facilitates a diverse network of contacts from patients to physicians to research collaborators. It provides an opportunity to share these precious resources with our global partners to improve patient care across the planet. Paraphrasing the very wise Eric Peeler, second-year medical student at the University of Arkansas for Medical Sciences (Little Rock), just #DoTheThing.49 Join Twitter today (Figure 9).

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