June 29, 2021 -- When epidemiologist Katrine Wallace first downloaded TikTok last summer, she thought it would be a fun escape from work. But as she scrolled through the app’s comedic bits and dance trends, she also discovered COVID-19 misinformation. To counter it, she started making her own videos.
The second video she ever posted, which explained how doctors recorded deaths from COVID-19, received over 87,000 views. “There was a real thirst for information -- real information that was evidence-based about the pandemic,” she says. Nearly one year later, she has amassed over 124,500 followers and over 2.5 million likes on the app.
Wallace is one of many scientists and doctors who use TikTok to teach people about health and medicine. In videos up to 60 seconds long, they debunk COVID-19 myths and answer questions, from how to prevent smelly armpits to what medications can make birth control less effective. In some videos, a doctor simply speaks directly to a phone camera, but in others, they perform short skits or dances while text with medical facts appears on screen.
TikTok, a short-form video app, has skyrocketed to fame in the past few years. The app has been downloaded 2.9 billion times globally, according to SensorTower, and its average monthly users grew 61% in 2020, compared to the previous year. The platform tends to attract a younger audience; in a 2021 survey in the U.S. by the Pew Research Center, 48% of 18- to 29-year-olds said they used the app, while 22% of adults ages 30 to 49 reported using the platform.
TikTok provides a different way to teach than traditional public health outreach, these doctor-creators say. Reaching people in a 15- to 60-second video can be just as, if not more, effective than dense reports or long social media posts, “especially for a generation that's used to consuming content very quickly,” says Jennifer Lincoln, MD, an OB/GYN in Portland, OR. Lincoln, who has 2 million followers and over 32 million likes on TikTok, talks all things women’s health on the app. It’s “the health class you wish you had in HS [high school],” her bio reads.
Wallace, PhD, who teaches and does research at the University of Illinois at Chicago School of Public Health, feels she has more impact on social media than she would in on-the-ground public health campaigns. When she does a video, “I’ll press ‘submit,’ and 20,000 people will see it,” she says. “I wouldn’t have that reach any other way.” TikTok’s algorithm also pushes content to people who don’t follow her, which makes it easier to build an audience, she says.
But a larger audience also brings more scrutiny, and medical professionals can come under fire for their videos’ content. In one universally panned video from late 2019, a nurse imitated a hyperventilating patient, with the caption, “We know when y’all are faking.” In another video that was later deleted, an emergency medicine doctor criticized patients for seeking primary care in the ER.
To avoid such missteps, Lincoln imagines her next patient watching every video she makes. “Is that something I would be OK with her seeing, or would I feel like it has somehow damaged our potential doctor-patient relationship?” she asks herself.
Maintaining boundaries doesn’t exclude the doctors from taking part in viral trends or dance challenges. Those who do them hope that the app’s informal vibe will help patients view doctors in a different light. For Austin Chiang, MD, a gastroenterologist and chief medical social media officer at Jefferson Health in Philadelphia, a main goal of his platform is “being a relatable figure,” he says, “so that people aren't so distrustful of doctors or feel we are unapproachable.” Chiang, whose videos have received nearly 15 million likes, makes TikTok videos on topics ranging from debunking weight loss myths to daily life as a doctor.
Other doctors may have questioned doctors on their social media presences in past, but now, “a lot of that judgment has subsided,” Chiang says. For these creators, their institutions and colleagues are generally supportive of their online fame.
“I always joke, ‘When is this going to start negatively affecting me professionally?’” says Anna Blakney, PhD, a vaccine scientist at the University of British Columbia. Her content mostly has to do with COVID-19 vaccines, but she also gives tours of her lab and films her experiments. While many of her colleagues may not understand or use TikTok, “they understand the need for it, especially right now, and understand what I’m trying to do,” she says.
Online popularity has also made these TikTok docs vulnerable to harassment. When Heather Irobunda, MD, an OB/GYN in New York City, posted about getting her COVID-19 vaccine, “the anti-vaxxers came hardcore for me,” she says. “It can be really scary -- getting a series of death threats or physical threats and being called all kinds of vile, nasty names.”
For Irobunda, this harassment has stayed on the app, but for others, it can migrate elsewhere. In January 2020, Cincinnati pediatrician Nicole Baldwin, MD, made headlines after she posted a TikTok supporting vaccinations, and strangers made threatening calls to her office and spammed her Yelp and Google Review pages with negative reviews. Wallace has also been targeted by the anti-vaccine movement, she says.
But even in the face of intimidation, these creators say they aren’t going anywhere. Irobunda, like many other doctors on the app, started talking about health on social media as a way to combat misinformation, and “if we let the people who harass us because we’re telling you scientific, truthful information drown us out or kick us off, we’re not doing anybody any good,” she says.
Ultimately, this type of criticism pales in comparison to the positive impact of their content, Lincoln says.
“I have had hundreds and hundreds of messages sent to me from people who said that my content, whether it's on TikTok or Instagram, is the reason they felt educated and empowered. It's the reason they went to a doctor for the first time in 10 years, or it's the reason they felt that they could speak up and ask about something,” she says. “As a physician, you love helping people face-to-face, and to be able to do that in a different way makes it completely worth it.”