Verified public health professionals on Twitter are overwhelmingly male

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

Doctors are one group applying for this vetting, in part because during the pandemic they have built a large following and are influencing the online conversation around covid-19. And they often get their blue check – at least male doctors do. However, this is not true, for a large proportion of female doctors, according to a new study in the Journal of the American Medical Association (JAMA).

As for physician-verified Twitter accounts, of the 779 identified by the study authors, 70.7% belonged to men and only 29.3% to women.

The results raise questions about Twitter’s vetting process and, of course, who is given additional information when it comes to health messages reaching a wider audience on social media.

“I was interested in who gets, 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 clinical researcher interested in health outcomes, health equity, and health disparities. Chino is confirmed on Twitter.

“Unlike, say, a celebrity, a vetted doctor really potentially has a stronger voice and will be trusted a bit more than someone who isn’t vetted.”

Getting your blue check and quick access to healthcare professionals

Twitter representatives did not respond to a request to explain the verification process. But on the company’s website it defines a number of categories and requirements which various individuals and companies must meet in order to be verified – including things like the account must be active, notable, and not recently created.

For “activists and organizers,” where Twitter categorizes medical professionals, the requirements are that “the account reflects an individual, not an organization” and “the account’s follower count is in the top 0.05% in their region.” However, Twitter says it will vet accounts that don’t meet all of its requirements on matters of high public interest because of their experience or public role. This includes medical professionals during epidemics.

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

Why it matters who has the floor on social media

Chino said he thinks the vetting adds weight to the messages doctors are sending. This can be both good and bad. Although people think of science as black and white, it’s actually very, very gray, Chino said.

And as proven doctors argue online about things like wearing masks (some say you don’t need them) because they make decisions based on different data they’ve reviewed, it can leave others, such as the immunocompromised or “at risk “vulnerable persons.

“We haven’t done a good job of controlling the flow of information about what the different levels of risk are and how we should behave,” Chino said.

Anjana Susarla, a professor of responsible artificial intelligence at Michigan State University who has done research on how people search for health information on social media, said people who seek information tend to look for trusted sources who look like them. Although doctors and health professionals may turn to the CDC, for example, the average Internet user may not be well versed in reliable government resources.

“If Twitter provides verification status to men and women differently, it could affect the perception of what is reliable 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 posting tips 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 can affect how people choose to use the information they provide. Susarla also said the vetting process is notorious for being opaque.

Chino has helped co-author additional studies that examine how gender and gender inequality cause one piece of information to be amplified over another. Examining Twitter influencers in her field of radiation oncology, Chino and her coauthors 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 isn’t new — older studies have found the same patterns — but the recent study shows it’s an ongoing problem. Previous research has shown that, in general, men are much more likely to be checked than women.

“We’re in a liminal space right now where voices trying to promote a public health message are actually under attack,” Chino said. “I think we have to be careful whose voices we elevate, because unfortunately I feel like there’s a real erosion of trust.”

Thanks to Dave Tepps for editing this article.

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