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Why We Tweet

Neurologists Tell All

Avitzur, Orly, MD, MBA, FAAN

doi: 10.1097/01.NT.0000514057.87080.80
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ARTICLE IN BRIEF

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The inaugural feature, Why We Tweet, launches this issue with brief vignettes of neurologists who are active users of social media — why and how they use it.

Social media has become so inculcated into most of our lives that it's no longer appropriate to refer to it as a trend. I only look at Facebook now and then, but as a lurker, I am in the minority: More than 1.86 billion people worldwide actively use their Facebook accounts each month. That said, I am one of more than 1.2 billion monthly active WhatApp users, and continue to marvel at the clarity of international phone reception and ease of data transmission. LinkedIn, the world's largest professional network, has 467 million members, and it's my go-to app for work-related contacts.

Indeed, just before I wrote this, I pinged the chief executive officer of United Healthcare on LinkedIn when I discovered that this year's electrodiagnostic testing claims were being denied for “lack of correct diagnoses.” Apparently, the company's coverage policy had replaced as covered services neurologic ICD 10 codes with vascular and cardiologic ICD 10 codes in the new 2017 coverage policy. In other words, if I had coded my EMG studies as related to a cardiac arrest (I46.2), V tach (I47.2), or embolism and thrombosis of renal vein (I82.3), they would have been covered, but cervical and lumbar radiculopathy (M54.12 and M54.16) — as well as most other commonly used diagnostic codes — were not covered. I am pleased to report that he responded within five minutes and then notified me two days later that the problem had been solved. If you haven't gotten on the social media train yet, this should drive home why so many of us are frequent travelers.

It appears that Twitter, in particular, is being used in novel ways by our neurologic colleagues. I just read a post about a vascular neurologist who needed an elderly man to tell him when his wife's stroke symptoms began. All the man could remember is that his wife “fell off the sofa in the seventh inning of the Yankees game.” The neurologist and his emergency department colleagues decided the fastest way to get that timestamp was to look up #Yankees on Twitter; it allowed them to ultimately administer tissue plasminogen activator (tPA) and get an excellent recovery.

It's been seven years since I first wrote about social media for Neurology Today (“Neurologists Friend and Tweet Too! Some Rules to Keep Posts Safe for Practice,” http://bit.ly/NT-Twitter). Since then, Twitter has ballooned to around 313 million monthly active users including the 45th president of the United States, @RealDonaldTrump, who has tweeted 34.4k times as of today. I don't follow politicians, but I do like to follow fellow neurologists, and find time to learn new things about the world of neurology fast — in 140 characters or less — during the course of a busy day.

Neurology Today thinks you, too, may want to see what your colleagues are tweeting, and why. In this new series, Why We Tweet, we will be profiling neurologists who are active users to learn what they like about Twitter and how they use it.

Want to share about how you use your Twitter accounts? Check out our daily Twitter feed at https://twitter.com/NeurologyToday, and tweet us at @Neurology Today. If you want to comment on our articles in more than 140 characters, post to our Facebook page at www.facebook.com/NeurologyToday.

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Sean Orr, MD (Twitter handle @AxionNeuro and @RestoredMD)

Place of work: Axion NeuroTherapy, Inc., St. Marys, GA

Subspecialty: Neurology; Vascular Neurology

Years on Twitter: Nine

WHY DID YOU JOIN TWITTER? I joined because it seemed like an interesting way of connecting with colleagues at conferences. Since then, Twitter has helped me to expand my interests and discover where the principles of neurology can be applied to solve problems in other fields. Twitter has also become a platform that has allowed me to develop a broader perspective, and making these “outside” connections has enabled rich conversations that stimulate new business and operational ideas.

For example, I've developed connections with entrepreneurs and consultants who are involved with improving the delivery of health care. Daniel Burrus (@DanielBurrus), Evan Kirstel (@evankirstel) and Dave Chase (@chasedave) are actively engaged in creating solutions using the Internet of Things (IoT), wearable devices, and venture capitalization. Professor Pedro Domingos (@pmddomingos) incorporates neurolearning principles throughout his work, applying them to machine learning techniques such as Artificial Intelligence. And Maria Konovalenko (@mkonovalenko) has spearheaded a movement to extend healthy human life. Twitter has made it easy to have conversations with them and inform them of the scientific and business aspects of neurology, extending the utility of our specialty beyond the bench and exam room.

HOW DO YOU HELP SPREAD THE WORD ABOUT NEUROLOGY? I believe that it has been important to carefully curate a high-quality network of colleagues working within different areas of the neurosciences. But I've found it just as helpful to make connections in other industries, such as data science and medical informatics. To be of value, I often post content in a cross-pollinating fashion, allowing ideas to flow freely across disciplines in ways that spark new ideas.

For example, I've developed an interesting following of neuromarketers in Spain, and I enjoy sharing elements of behavioral neurology that they can apply to their work. I also share clinical insights with leaders who are leveraging neural networks and cybernetics, such as Scott Zoldi (@scottzoldi), the chief analytics officer of FICO. I don't know of another medium where it's easier to access leaders such as Doug Weber (@dougweberlab) from DARPA, Vala Afshar (@ValaAfshar) from Salesforce, or Andrew Ng (@AndrewYNg) of Baidu. These organizations are giant, but Twitter allows me to cut through to individuals and share ideas that would never connect otherwise.

Physicians are educators, and I've always thought that it's important to teach others about the practical benefits of neurology. So, I'll often generate new content based on my own thoughts of how I think medicine should be reformed. In fact, Twitter is one of the best platforms to advocate around the issues of physician disruption and burnout, as well the integrity of the patient-physician relationship. I also frequently summarize new findings from the literature to demonstrate how neurology benefits our communities and how patients can get access to help for their neurological problems.

WHO DO YOU FOLLOW?

  • Walter J. Koroshetz: @NINDSdirector
  • Neurologist David Spencer, MD: @PDXDCS
  • Science journalist Steven Pinker: @sapinker
  • Stroke neurologist Amie Hsia, MD @DCStrokeDoc
  • William P. Cheshire @DoctorCheshire

PROUDEST MOMENT ON TWITTER? I was excited to tweet about the story of Colombian neurologist Dr. Francisco Lopera, who was featured on “60 Minutes.” He identified and has cared for the world's largest cohort of patients with young-onset Alzheimer's disease, an issue that is near and dear to my heart as my wife is Colombian. It delighted me to showcase the story and spread the word about his willingness to think deeply about the issue and advocate strongly for the welfare of his patients.

ANY TWEETS YOU REGRETTED? I accidentally re-posted some political tweets while I was learning to automate my news feed and hadn't set up the appropriate filters. I'm not a fan of political trolls and deleted the posts right away. I think it's better to keep things positive and creative!

WHAT HAS BEEN YOUR MOST UNEXPECTED MOMENT IN 140 CHARACTERS OR LESS? I was excited to be recognized as one of the “Top 50 Human Behavior Experts to Follow” in 2017 by a biometric research company called iMotions.

WHAT IS YOUR FAVORITE NEUROLOGY TWEET? https://twitter.com/AxionNeuro/status/804884259404206082

© 2017 American Academy of Neurology