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LMS President’s Message: May 2023

LMS President’s Message: May 2023, My Experience with Going Viral on Twitter
By Lee Dossett, MD

Around this time last year, I got a very unexpected e-mail from the US Department of Education.  For a couple years I had tried to get my student loans to qualify for the Public Student Loan Forgiveness (PSLF).  For those who aren’t aware of it, this program will pay the balance for federal student loans for anyone working for a non-profit employer and had made 10 years’ worth of payments.  It can be complicated to navigate the process and I had given up qualifying for forgiveness.  But thanks to an executive order from President Biden, which loosened some of the requirements, I got a surprise letter saying my loan balance was now zero.  The first thing I did after telling my wife was pull out my phone and tweet about it.  At the time, I had less than a couple hundred twitter followers that were mostly friends, acquaintances, and spam-bots, so I did not expect it to get any attention outside of my immediate sphere.  That is probably why the first 2 words were “Holy sh*t!” due to my excitement.  Well based on whatever algorithms at work at the time, it slowly started to gain traction.   First dozen of “likes”, then hundreds, then thousands.  Ultimately over the next week it was liked by over 100,000 people and viewed by millions.

As exciting as it was to see my message reach such a large audience, it also brought with it some unexpected upsides and downsides.  Let’s start with the upsides. First and foremost, the increased visibility brought attention to an important issue facing medical professionals across the country.  I had multiple news agencies reach out to interview me and I was featured in a story on NBC News.  Many individuals reached out to me with questions about the public service loan forgiveness program and how to navigate the process. I was able to connect with these individuals and offer support and guidance and have been pleased to be informed that at least 4 people I know from med school, residency, and work have subsequently gotten loan relief.  The program is still active, and I encourage anyone who meets the qualifications to apply.

Now, on to the downsides. Going viral on Twitter can be overwhelming. The influx of notifications, messages, and mentions can be difficult to manage. One of my first calls was to my employer’s public relations department.  While my employer was not listed on my profile, a quick google search makes it easy to find.  I did not want my profanity to reflect poorly on my hospital.  Ultimately, I deleted the tweet a few months later when I took a more high-profile position in my organization.  I think it is important for any user of social media to be aware of the risks of public comments and future implications.  Twitter can be very important for physicians to have a presence on for advocacy, patient information, your own education, and sense of community.  

There’s also the issue of potential backlash. While most of the response to my tweet was positive, there were some negative comments and pushback from individuals who disagreed with the federal policy of loan forgiveness.  Soon I was getting tagged in arguments between strangers that devolved into base politics and insults.  I witnessed the downsides of being able to argue anonymously on the internet.  I stayed clear of those arguments as I certainly wasn’t going to influence anyone’s opinion on anything at that point.   It’s important to be prepared for this and to respond in a respectful and professional manner if you do decide to wade into those waters. 

Overall, my experience of going viral on Twitter was a mixed bag. While it brought attention to an important issue and helped to elevate my profile, it also came with some unexpected challenges. As medical professionals, it’s important to stay engaged on social media and to use our platforms to advocate for ourselves and our patients. However, we also need to be mindful of the potential downsides and take steps to manage them.