Are you an academic surgeon on Twitter? Are you leveraging hashtags effectively?
Few people gave much thought to the hashtag or pound sign (#) until the advent of Twitter. If you are not comfortable utilizing hashtags that are popular in your specialty, you aren’t using Twitter to your full professional advantage.
A Twitter hashtag is created by adding “#” in front of any word or string of words. Twitter hyperlinks all hashtags, so clicking on a hashtag allows quick access to all tweets containing that hashtag. While this concept sounds simple enough, real world hashtag usage is a bit more complicated. One of the bumps in the learning curve of hashtag use is the plethora of hashtag applications. This article will focus on hashtag usage in academic surgery. (For more on the nuances of hashtags, see the New York Times Magazine article, “#InPraiseOfTheHashtag”.)
The very first Twitter hashtag was prompted by a conference, so it should come as no surprise that hashtags are useful for disseminating knowledge presented at academic surgical conferences. Nearly all surgical conferences have a designated hashtag used for both social and educational tweets related to the conference.
Twitter Journal Clubs
From their inception, hashtags have been used to conduct Twitter journal clubs.1 The first surgical Twitter journal club was #urojc.2 Since that time, surgical societies and even individual departments have begun hosting Twitter journal clubs. Notable examples are #EASTjc and #UMichSurgJC.
Tweetchats are semiformal Twitter conversations that generally occur over a set time period. During the designated time, a moderating account reveals topics or questions for participants to respond to. Tweetchats such as #bcsm (breast cancer social media), #lcsm (lung cancer social media), and #obsm (obesity social media) provide a unique opportunity for surgeons to interact with patients and advocates. Other notable tweetchats include #hcldr (healthcare leader) and #AWSchat (Association of Women Surgeons).
One of the first specialty-specific hashtags to evolve into common usage was #PlasticSurgery.3 #ColorectalSurgery is also becoming increasingly popular.4 Other notable examples are #BariatricSurgery and #ENTsurgery. Others are likely to become more popular with time.
Disease specific hashtags are not extremely popular, yet they hold potential as a powerful tool for researchers to share findings with one another as well as the general public via Twitter. A hashtag such as #appendicitis allows readers to easily find tweets discussing the disease. In addition to connecting researchers, such hashtags are likely to be noticed by journalists and patients.
Some of the earliest hashtags used by physicians were those in medical education. #MedEd has been used for all things related to medical education. #FOAMed, referring to “free open access medical education,” has been used largely by emergency medicine and critical care physicians to disseminate freely available resources. Modifying these hashtags to #SurgEd and #FOAMsurg allows users to find surgery-specific content.
Dissemination of Research
A visual abstract is a visual summary of the information contained within an abstract. Such images have been shown to increase retweets and broaden readership.5 Adding the hashtag #VisualAbstract to the tweeted images makes the visual abstracts easily searchable by others passionate about dissemination of research results.
#SurgTweeting (and all things #Surg…)
#SurgTweeting has been used for topics of general interest to surgeons on Twitter, particularly areas of interest to surgeons passionate about using social media. As a tongue-in-cheek extension of this practice, some have added #Surg- to everything from sandwiches and desserts to mentorship, leadership, and parenting. These hashtags not only identify specific topics, but also foster a sense of community and camaraderie. Similarly, the #ILookLikeASurgeon hashtag started out as a means for female surgeons to declare their place at the table, and quickly evolved into a widespread community of surgeons highlighting positive tweets about their colleagues and their profession.6
Show me the data
You may have noticed statistics and graphics regarding hashtag usage. This data is calculated by Symplur as part of the Healthcare Hashtag Project. While no one “owns” a hashtag, Symplur provides a useful clearinghouse for healthcare related hashtags. There are currently over 14,000 hashtags registered. Categories include conferences, tweetchats, diseases, and other hashtags. Anyone with a Twitter account can submit hashtags for inclusion in the Healthcare Hashtag Project. Once a hashtag has been registered, tweets are prospectively entered into the Symplur database for analysis. Users can search the database and output transcripts and analytics for any 180 day period after the hashtag is accepted. A subscription to Symplur Signals facilitates advanced analytics over any time period following hashtag submission, and includes sentiment analysis, useful for academic research, marketing, and user interaction.
What is an influencer?
Symplur calculates the top ten influencers over a period of time based on mentions, tweets, and impressions. A mention occurs anytime a username is included in a tweet. Symplur calculates impressions for a given user by multiplying their tweets by the number of accounts following them. In this way, an account with 100,000 followers having tweeted a single tweet generates one hundred times more impressions (100,000) than an account with 100 followers tweeting ten tweets (1,000 impressions).
Why use hashtags?
Hashtags enable you to reach a larger audience than simply your followers. Using hashtags allows those who search that hashtag to see your tweet, regardless of whether that user is following you. Thus using hashtags increases your followership by allowing those with shared interests to see your tweets.
Hashtag strategies and etiquette
If you are hosting a conference, Twitter journal club, or tweetchat, it behooves you to submit the hashtag to the Healthcare Hashtag Project. This allows the description of the hashtag to be searched by others and ensures that tweets are prospectively stored in the Symplur database, enabling analysis and making follow-up research possible. It can also be useful to confirm that hashtags related to your speciality and research interests are included in the database, and that hashtags for your new project aren’t already being used by another.
In general, it is strategic to use any hashtags that are of relevance to the content of a tweet and within the character limit. As conference tweeting becomes increasingly popular, it can be challenging to sort through the tweets to find those in one’s area of interest, and the hashtag can even be misappropriated. For example, there were adult-themed tweets using the #ACSCC16 hashtag during the 2016 Clinical Congress of the American College of Surgeons. There are likely to be more this year. A strategy to make tweets more searchable (and more specific) is to add specialty specific hashtags to the conference hashtag, such as #ACSCC17 #plasticsurgery.
The use of hashtags in academic surgery will continue to evolve. Just as with medicine and surgical techniques, one learns by doing, possessing a passion for lifelong learning, observing colleagues, maintaining humility, and keeping an open mind. #KeepTweeting
By Heather Logghe, MD; Natalie Tully, Sarah Bryczkowski, MD; and Christian Jones MD, MS
1. Topf JM, Sparks MA, Phelan PJ, et al. The Evolution of the Journal Club: From Osler to Twitter. Am J Kidney Dis. 2017;69(6):827-836.
2. Stork B. Around the World in 48 Hrs: International Urology Journal Club Twitter. Dr. Brian Stork, MD. http://www.drbrianstork.com/blog/urology-journal-club-twitter/. Published November 28, 2012. Accessed August 1, 2017.
3. Branford OA, Kamali P, Rohrich RJ, et al. #PlasticSurgery. Plast Reconstr Surg. 2016;138(6):1354-1365.
4. Logghe HJ, Pellino G, Brady R, McCoubrey AS, Atallah S. How Twitter has connected the colorectal community. Tech Coloproctol. 2016;20(12):805-809.
5. Ibrahim AM, Lillemoe KD, Klingensmith ME, Dimick JB. Visual Abstracts to Disseminate Research on Social Media: A Prospective, Case-control Crossover Study. Ann Surg. April 2017. doi:10.1097/SLA.0000000000002277.
6. Hughes KA. #ILookLikeASurgeon goes viral: How it happened. Bull Am Coll Surg. 2015;100(11):10-16.
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