Intended for healthcare professionals


Twitter going global

BMJ 2011; 342 doi: (Published 05 January 2011) Cite this as: BMJ 2011;342:c7390
  1. Fiona Pathiraja, clinical adviser to the NHS medical director1,
  2. Annabel Bentley, medical director2
  1. 1Department of Health, London, UK
  2. 2BUPA Health and Wellbeing, London, UK
  1. f_pathiraja{at}


Fiona Pathiraja (@dr_fiona) and Annabel Bentley (@doctorblogs) explain why Twitter is increasingly relevant to doctors and discuss how to use it as a professional networking tool

When the BMJ first covered Twitter in June 2009, it was seen as Facebook’s lesser sibling, a niche micro-blogging service.1 Since then, its popularity has skyrocketed, and now many doctors, researchers, and healthcare leaders are regular users. In this article we discuss how to use Twitter as a powerful professional networking tool.

Twitter provides doctors with access to a vast global professional network of commissioners, providers, journals, patients, clinicians, and many others. Twitter’s open network crosses geographical and interprofessional boundaries. Importantly, it flattens hierarchies—where else can a junior doctor strike up a conversation with the editor of the BMJ (@fgodlee)?

By choosing whom they follow, users set their own filters for information. Twitter’s real time nature means it could be the first place where stories break. Indeed, news about rosiglitazone, the supposed i-stethoscope, and the government’s health white paper was spreading virally long before it reached print media. Journals are no longer weekly or monthly publications; their regular tweets reach thousands on a continuous basis, making evidence based medicine more accessible than ever.

As well as being a source of information and ideas, Twitter helps doctors to raise their profiles and build powerful networks. Virtual networking can result in collaborative research, publishing, and job offers. By recognising that connecting to others can enhance your career, you will soon be engaging in the global healthcare conversation.

Tips for Twitter

For Twitter to be useful, you need to find a range of people to follow who tweet information that you are interested in. If your specialist interest is public health, you can follow your local primary care trust, global bodies such as the World Health Organization, individual doctors, and health policy makers worldwide. Following journals or organisations is a good way to keep up to date, but do remember that Twitter is about connecting with other people.

If you are authentic, professional, and open, networking comes naturally. Do not be afraid to follow people whom you do not know personally; a key benefit of Twitter is connecting to people with whom you wouldn’t usually be able to communicate directly.

Ten to follow

Thought leaders
  • @david_colquhoun—David Colquhoun, professor of pharmacology at University College London

  • @Richard56—Richard Smith, former editor of the BMJ, and blogger

  • @SamListerTimes—Sam Lister, health editor of the Times

Healthcare professionals
  • @mrpublichealth—David Conrad, specialty registrar in public health, Liverpool

  • @silv24—Natalie Silvey, foundation year 1 doctor, West Midlands

  • @amcunningham—Anne Marie Cunningham, general practitioner, Cardiff

  • @cochranecollab—The Cochrane Collaboration, Oxford

  • @TheIHI—The Institute for Healthcare Improvement, USA

  • @TheKingsFund—The King’s Fund, health policy think tank, London

  • @cebmblog—Centre for Evidence-Based Medicine, Oxford University

Case studies

Please note that all the people in the case studies featured in this article tweet in a personal capacity. Their tweets do not necessarily represent their employers’ views.


Colin Weir; consultant general and vascular surgeon, Northern Ireland

I joined Twitter a year ago but have only recently become an active member of its health community. Aside from meeting doctors outside my own field of practice, Twitter allows me to make intellectual discoveries and indirectly get opinion on clinical queries. Connecting with individuals within my profession creates a sense of community, which is not achieved by other media.

A word of caution: do not divulge information that could identify a patient-doctor encounter. This may seem obvious but is easy to forget—I have come very close. Like a carpenter who measures twice and cuts once, I always read twice before sending. Humour is a powerful tool, and I have struck a balance between following people who are fun, clever, and great communicators. Twitter’s openness has given me a strange but wonderful experience of making new friends—most of whom I have never met.


John Appleby; chief economist of the King’s Fund

I joined Twitter in July 2009 because I found that journalists were breaking stories about aspects of the NHS and health that were useful to me in my work. The immediacy of Twitter for news and information, along with the potential to connect with a variety of people, is particularly valuable. As the chief economist of the King’s Fund, I’ve recently been using the hashtag #tahitloace (tweet an hour in the life of a chief economist) to tell people about what I do on a daily basis. This has come into its own in the run up to the recent comprehensive spending review.

How do you define Twitter success? Lots of followers? I wonder how Stephen Fry copes with 1.9 million followers. I would advise those new to Twitter to focus on selecting key people and organisations to follow in the beginning, and to not confuse personal and professional life; and don’t tweet anything you wouldn’t want to broadcast through a megaphone. As for defining Twitter success, this is an individual matter, depending on what you want to gain from the Twitter experience.


Emma Stanton; Harkness fellow in healthcare policy and practice

My relationship with Twitter began 17 months and 201 tweets ago. After establishing my online self on Facebook and Linkedin, I progressed to the Twitter community out of curiosity and a self confessed slightly geeky early adopter approach to new technology and networks. I’ve experimented with using it as email; to share my blog; for inspiring quotes; and for an eclectic range of articles and conference discussions.

Last week I stumbled upon my first tweet-up (Twitter discussion) on healthcare communications and social media. This is geographically dispersed, but the Twitter literate group has been hosting Sunday night discussions with the hashtag #hcsm since 2009. This is the “value add” of Twitter—the ability to be part of a lively online debate traversing geographical boundaries, without the carbon footprint. The biggest statement about my profile is my Twitter name @doctorpreneur—a hybrid of doctor and entrepreneur.


Mike Cadogan; emergency medicine consultant, Perth, western Australia

I became part of the Twitter health and medical conversation in September 2008 and originally joined to engage with fellow medical bloggers and to “learn without being taught.” It is difficult to encapsulate succinctly a person in 140 characters, but my profile defines me as a physician with interests in music, education, and semantics.

Twitter allows healthcare professionals to observe, interact, and engage with the general public, with e-patients, and with fellow professionals, through borderless communication. This enhanced interaction creates a heightened awareness of global medical, ethical, and social issues. Importantly, it provides a platform to initiate change through a “wisdom of the crowd” model. There are negative sides too: information overload and the deluge of pharmaceutical spammers. I would encourage others to participate, not pontificate, with your tweets and to remember that Twitter is powerful—it can help you to interact with a wide variety of forward thinking, likeminded professionals on a global stage.

Challenges of Twitter for doctors

Twitter is a public communication platform that is not secure and must not be used for any patient identifiable data. This means doctors must not use Twitter to discuss patients’ cases or to communicate directly with their patients. The 2009 confidentiality guidance from the General Medical Council states that patients’ information must be “effectively protected at all times against improper disclosure.”2 The guidance reminds doctors that many improper disclosures are unintentional. Tweets containing patient identifiable data are likely to be a breach of the Data Protection Act.

If you work for an organisation or a person with a public profile, your tweets could be misinterpreted as representing your employer. So, consider stating in your profile that your messages are personal views. Everything you post on Twitter must be legal and should not contain defamatory statements.34 Doctors concerned about receiving messages that could be considered to be harassment or that could be defamatory should contact their medical defence body or employer for advice.

A further consideration is how to manage your online identity. The delineation between personal and professional is becoming increasingly difficult to maintain in an online environment. There is only one internet, so where previously it was possible to ensure messages for colleagues were kept separate from those for friends and family, this is no longer the case. One of the duties of a doctor is to maintain the public trust in the profession, and this extends to activities in online fora such as Twitter.


Twitter is far more than just social networking. If used well, it can be part of continuing professional development and can help you to develop your own global network.

If you have read to the end of this article, join the global healthcare conversation and tweet about it to your followers.


  • Competing interests: None declared.


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