"My doctor self and my human self": A qualitative study of physicians' presentation of self on social media

Abstract

Introduction. When using social media, physicians are encouraged and trained to maintain separate professional and personal identities. However, this separation is difficult and even undesirable, as the blurring of personal and professional online presence can influence patient trust. Thus, to develop policies and educational resources that are more responsive to the blurring of personal and professional boundaries on social media, this study aims to provide an understanding of how physicians present themselves holistically online. Methods. 28 physicians based in the United States that use social media were interviewed. Participants were asked to describe how and why they use social media, specifically Twitter (rebranded as “X” in July 2023), which is especially popular among physicians. Interviews were complimented by data from participants’ Twitter profiles. Data were analyzed using reflexive thematic analysis guided by Goffman’s theory of presentation of self. This theory uses the metaphor of a stage to characterize how individuals attempt to control the aspects of the identities—or faces—they display during social interactions. Results. We identified seven faces presented by the participants. Participants crafted and maintained these faces through discursive choices in their tweets and profiles, which were motivated by their perceived audience. We identified overlaps and tensions that arise at the intersections of faces, which posed professional and personal challenges for participants. Conclusions. Physicians strategically emphasize their more professional or personal faces according to their objectives and motivations in different communicative situations, and tailor their language and content to better reach their target audiences. While tensions arise in between these faces, physicians still prefer to project a rounded, integral image of themselves on social media. This suggests a need to reconsider social media policies and related educational initiatives to better align with the realities of these digital environments.