Tuesday, August 25, 2015

#ILookLikeASurgeon: Getting Started on Twitter? Do This One Thing First

By Marie Ennis-O’Connor 

Getting Started on Twitter? Do This One Thing First
So you’ve decided to set up a Twitter account and you are now ready to send your first tweet to announce your arrival in the Twittersphere. Before you hit send, take a moment to consider what people will see.

Will they see you?
This may seem like I am stating the obvious, but it is surprising the number of new (and not-so new) Twitter users who start tweeting from an account with no clearly identifiable name, bio, or profile picture.  The first and most fundamental thing to understand about Twitter is that it is a conversation. Would you approach someone at an event and not introduce yourself first? Would you keep your face hidden from view while you hold a conversation? And yet this is precisely what some users do when they set up their Twitter accounts.  Your Twitter profile is the first place someone will look when they read your tweets, so make it credible and professional by following these tips.

Don’t be an egg head. Add a personal picture to your profile.
Many Twitter users will not follow accounts without a profile picture on the assumption it is a fake account. A study  published by researchers from Microsoft and Carnegie Mellon University, “Tweeting Is Believing? Understanding Microblog Credibility Perceptions,”  analyzed how users assess Twitter credibility. The study found that:

  • users are poor judges of truthfulness based on content alone, and instead are influenced by heuristics such as user name when making credibility assessments.
  • users represented by the default Twitter icon, or a cartoon avatar are perceived as significantly less credible than users with  a personal photo.
The phrase “egg head” refers to Twitter’s default  profile image. As soon as you have created your Twitter account, you should replace the default image with your own picture.  This is easily done in your Twitter account settings. Twitter is about human connections. When uploading a picture, don’t use a cartoon, or any other animate or inanimate object for your profile. A professional close-up head shot works best.  You also have an opportunity to personalize your profile by uploading a custom header image alongside your profile picture. Use this opportunity to bring more authenticity to your account, as this image shows.

Create your Twitter bio

Add your (real) name, provide a brief bio and include a link to your institution’s website, and/or your LinkedIn profile so people can learn more about you. If you are hesitant to identify yourself, then consider if Twitter is the right platform for you. You may be better with a LinkedIn account which is restricted to connections you control. Remember on Twitter your tweets are there for all to see.  

You may also wish to add a medical disclaimer to your Twitter profile, which states that you do not offer medical advice through social media, and/or the views you express are yours and not that of your employer. Finally, don’t be afraid to inject a little personality into your bio as this example illustrates.

Find People To Follow

Next you will want to find some people to follow. Use this list  of Surgeons on Twitter http://list.ly/list/lX1-surgeons to discover some surgeons who are already established tweeters. The list is updated regularly with new names so check back regularly and tweet me @JBBC if you wish to have your name added to the list.

While you will want to follow friends and colleagues, don’t restrict yourself to just this list. One of the great benefits of Twitter is its ability to be a global melting pot of ideas and people to learn from.  Including a diverse mix of health care professionals, policy makers, and patient opinion leaders in your Twitter mix will enhance your learning and professional development. You will find a wealth of knowledge and an opportunity to contribute your expertise through following health related hashtags. Some of the best conversations happen through the medium of Twitter chats.  These are pre-arranged chats which include a predefined #hashtag which links the tweets together in a virtual conversation. You will find a full list of health hashtags via Symplur's Hashtag Project.  

Send Your First Tweet
Now all that remains to do is to send your first tweet. This is an important step. A Twitter profile without any tweets may be mistaken for a spam account.  If you are not sure what you should tweet, try something simple, like introducing yourself to the Twittersphere.
Your professional reputation online is just as important as offline. Your Twitter account is one of the most visible descriptions of you on the Internet, so make sure it is projecting the best professional image.  Follow the steps I have outlined and you will be ready to create a Twitter account which will enhance your reputation both on and offline.

About the Author

Marie Ennis-O’Connor is a writer, keynote speaker and social media consultant, specializing in healthcare communications.  Follow her on Twitter @JBBC

Monday, August 24, 2015

#ILookLikeASurgeon: Being Queer in Surgery

Elinore Kaufman, MD


Surgery has a rich culture, full of strengths that exceed and defy the stereotype of surgeons as privileged white men who believe they are gods. In surgery there is a shared commitment to a goal, to individual excellence but also to true teamwork, to honoring the privilege of our patients' trust, to  finding problems and fixing them, to getting quickly to the heart of the matter, whatever it is. As a surgeon-in-training, I am learning how to perform operations, but I am mostly learning how to make high-stakes decisions in imperfect circumstances, and as an imperfect individual.
This is what makes being a surgeon the best job in the world, and it has been inspiring to see surgeons celebrating one another through #ILookLikeaSurgeon. The photos from around the world show a broad understanding of the people who bring diversity to surgery, but also of how our diverse backgrounds inform our work. As a queer woman and a surgeon, this conversation feels rich, inclusive and important.
As surgeons we have a lot in common, but we also bring our own unique experiences to the work. As I learn to operate, I draw on my attendings' teaching and expertise, my patients' generosity, but also on my background as an artist. Working with paint, fiber and clay has taught me the joy of working with my hands, learning new physical skills, and balancing speed and precision. I also bring my identity as a queer person to surgery. This can mean building a special bond with my lesbian, gay, bisexual, transgender and queer (LGBTQ) patients, making sure their partners, families, and identities are not only tolerated but welcomed. It can sometimes mean giving advice about anal sex after hemorrhoid surgery. It means always, always, always using the name, pronouns, and gender that a patient prefers.

Being queer in surgery means living in a world that assumes I am straight, and coming out over and over again. Although the reactions of my surgical colleagues are rarely hostile, they can be a bit awkward. Being queer in surgery also occasionally means pulling a colleague or student aside to tell them why I didn't laugh at a particular joke, or why they shouldn't assume that a married man has a wife. It also means letting some of these moments slide, wishing that it were someone else's turn to intervene.
I've been involved in LGBTQ organizing and activism in one way or another since middle school. I've been out since high school. It's a little bit about who I'm attracted to, and a lot about how I see the world. At the beginning of medical school I was one of two openly LGBTQ people in my class of 200, and I spent a lot of time not only explaining myself to my classmates and teachers, but also working for the inclusion of LGBTQ health issues into the curriculum.
For me, being queer in surgery means giving special attention to what alienation from healthcare feels like. Many of us from have experienced real discrimination at the individual or community level, leading us to present late or not at all; or to act in ways that perplex or annoy our doctors. Depending on our healthcare providers’ responses, this can lead to worse health outcomes. It also means being aware of  health disparities that affect LGBTQ people beyond HIV: disparities in cancer, mental health and substance abuse, as well as insurance and access to care.
It means being aware of transgender-specific health care: transgender people are among the only individuals who often need surgery just to be themselves. Trans people, often with limited resources, save money for procedures that can be life-saving, but that insurance often doesn't cover. They frequently travel for services that are only available in a few places. Not every trans person wants or gets surgery, and gender confirmation surgery is not in the scope of all surgeons’ training. But still, our  profession plays a critical role in transgender people's lives.
Thinking about the experiences of my LGBTQ friends and patients also gives me a special appreciation for surgeons just being surgeons. Surgeons like to get to the point, and we can be single-minded about it. We don't usually like endless debates or complications. While at times this might make us less sensitive to certain issues that affect our patients, it can also be a good way to approach everyone equally. For LGBTQ patients this can be an advantage. The average surgical history does not include a lot of invasive, personal questions. Being brisk can sometimes make us less judgmental, not more. So I was pleasantly surprised when, as part of a surgical team caring for  a transgender woman with acute cholecystitis, the only person who cared about her genitalia was the person putting in the Foley.
I approached #ILookLikeaSurgeon with some suspicion. I am a woman and a surgery resident, and I know there are not enough of us, especially in leadership and mentorship positions. But as a white, upper middle class woman with an elite education, I come to surgery with an enormous amount of privilege already, and this disparity does not seem like the most urgent one. In addition, many discussions of women in surgery often seem to assume a uniform experience about life as a woman and a surgeon, and as a queer person, my life works differently. The assumption is often that all the women in the room date and marry men; have children at all or in the same way; and think about childcare as primarily their responsibility. I know many colleagues find solidarity in these conversations, but these are not my assumptions or my experience, and I have often felt invisible in these conversations. In its own way, invisibility is as exhausting as Q3 call.
Like many, I had a baby during my research years. Unlike my straight female colleagues, my partner got pregnant and gave birth. I did not operate pregnant or miss clinical time for prenatal visits or maternity leave. But more than that, my partner was not raised to believe that someone else would be the primary caregiver, so there's no pressure from reversing stereotypical gender roles. When I finish research in June, I know I am going to experience stress and sadness from not spending as much time with my kid as I wish I could. I know many of the fathers I work with feel this tension as much as the mothers, even if they are not expected to talk about it. On the other hand, I do need to make sure that my job offers partner benefits for health insurance that will cover us all. I'm only going to let my career take us to cities where we feel comfortable; where we have community; and where we are going to feel okay about raising our kid without her feeling like she's always the only one who has to explain her family. There are some family-friendly towns and institutions that might not be as friendly to my family.

So yes, #ILookLikeaSurgeon, I act like a surgeon, and I also look and act like myself. Our diversity matters to us, and it matters to our patients. We can bring our whole selves to their care, and they need us to.
Elinore Kaufman, MD

Sunday, August 23, 2015

Why #IlookLikeASurgeon is Necessary for Innovation in Healthcare

Andrew M. Ibrahim MD 

Over the last two weeks the #ILookLikeASurgeon movement has gone viral on Twitter, with over 72 million impressions and 5,000 participants. Countless surgeons have joined Twitter for the first time just to post their photo and join the community.

Scrolling through the snapshots and stories, two statements are clear. First, surgeons come from all backgrounds, across gender and geography, overcoming odds and static traditions. Second, surgeons have lives outside the OR. It has been humanizing and inspiring to see notable surgeons and mentors proudly display their roles as a parent, spouse, entrepreneur, cyclist, artist, or community member. It's less of an "I can do it all" stamp, and more of a "stay true to yourself" reminder.

The images, in aggregate, celebrate diversity in surgery--revealing its strength and hope for the future.  Such diversity is a necessary foundation for innovation. The challenges facing healthcare certainly require many full time clinicians, but also need physicians who can bring something else to the table. In the past it has been limited to bench research or surgical education. But if we want to harness the energy of this movement we ought to broaden our ideas of diversity even further to embrace a breadth of surgeon innovators with a love for technology, a spirit of entrepreneurship, an intuition about policy reform, an aesthetic for the arts and so on.

Wisdom on how #ILookLikeASurgeon can move forward may be found in the prose of literature professor, Matthew Shenoda, who offered this advice to young writers:
Aside from all of the standards of reading and writing and honing in your craft, is to live; to find the spirit within you; to find the fire and understand why you do this.
Don't isolate yourself from the rest of society like many writers tend to do, but really engage in society; understand the tempo and rhythm of humanity and bring that to your work.
Study your own history, understand knowledge of self and bring that to your work.
Engage in the human experience on every level you can and bring that to your work.
And understand that this a healing art.
Understand that this art has more power than any of us truly realize and come to it with that humility, come to it with that understanding and help shape the lives of other people through this art.
But my biggest advice is to feel an urgency in your work, and to bring that to table.
Know that this art can transform lives, it can change people...
If young people do that, and bring that with the fire of youth, they're unstoppable.

AM Ibrahim 2012
Being true to yourself as a surgeon can be met with resistance. While my small attempts to humanize patient interactions -- asking ED patients about their favorite sports teams, giving pediatric patients a cartoon dressing, sneaking floor patient’s real coffee from Starbucks or playing a patient’s favorite music while pushing them back to OR -- were sometimes recognized as valuable, more often they were discouraged as “inefficient” or a “waste of time.” My choices in research elicited similar responses. In addition to peer reviewed scientific publications, I chose to also publish a painting with an essay about caring for a patient with a terminally ill spouse. While sometimes discredited by my surgical peers (one suggesting to not even list it on my CV), it was an important expression about what we experience caring for surgical patients. And if the data on quality of life for surgeons is any indication on what ails our profession -- 40% report being burned out, 30% depressed -- it may be exactly those kinds of humanizing interactions that we should be encouraging, rather than silencing.   

Most recently, I decided to forego the traditional two years of bench time “in the lab” to pursue research in health policy and innovation. Some of you may be reading this thinking, “Great! Of course we need surgeons to train in policy and pursue research that helps guide healthcare reform.” Still, many surgeons were quite comfortable to enumerate aloud all the better ways to spend my time. Fortunately for every detractor, there have also been advocates. Not surprisingly, many of them are also the same leaders who were the first to tweet and support the #ILookLikeASurgeon movement.

More than just celebrate diversity (a tremendous feat on its own), the #ILookLikeASurgeon movement has paved the way for a new era of surgeon-innovators. Our leadership and mentors now have a duty to embrace the diversity of surgeons -- their backgrounds, their skill sets, their passions, their visions, their career goals -- and create environments where our true selves can be developed as a strength rather than discouraged as a weakness.  Celebrating diversity is the first step to innovating our profession.

Andrew M. Ibrahim MD | @andrewmibrahim
Robert Wood Johnson Clinical Scholar
Institute for Healthcare Policy & Innovation
University of Michigan

Saturday, August 22, 2015

Why I had to invent #iLookLikeAnEngineer to challenge tech stereotypes

By Isis Wenger
Who knew one simple Medium post could ignite such a profound movement?
#iLookLikeAnEngineer is now being spread globally in over 50 countries. It has received over 75,000 tweets and has been covered in countless international news outlets.
The fact that this campaign has been adopted and continued by such a vastly ranging demographic illustrates the dramatic need for it to be addressed. This is not just about my voice; your voice is equally important. This is about the voices of thousands of people all over the world, unified together under a mutual message.
Together, we have the power to create a sustaining positive impact.
Gender diversity challenges seem to be what mainstream media has picked up on the most. While I think that it is absolutely wonderful that this has sparked so many positive discussions about the way that women are treated in STEM, I want to clarify that #iLookLikeAnEngineer is intentionally radically inclusive.
It’s not just about me and it’s not just about women.
#iLookLikeAnEngineer is about anyone and everyone who wants to pursue STEM, regardless of their external appearances.
Labeling this as a “campaign for women” is very limiting, and will only further separate us from everyone else in the community.
We see ourselves as equals, so we must also recognize others as equals, starting with our own actions and words.
Fighting exclusion with exclusion will not help us get closer to forming a solution. It is important to realize that we are all on the same team; this movement is for everyone regardless of skin color or X-chromosome count.
Do you have any ideas that would help create a positive change? There are many alternative paths that can be taken towards creating the solution; increasing awareness and discussions is only one route.
Isis Wenger getting an award from
the City of San Francisco for challenging stereotypes
in the tech industry  (Photo by Kenny Hoff)
As individuals we have the the power to influence our own environments so that we can be more mindful and empathetic towards others. When we know better, we can do better.
Starting with ourselves we can work together towards co-creating a more respectful and inclusive community.
I will continue advocating for this cause and I encourage you to share your voice because yours matters too.

This appeared originally in the Washington Post.

Friday, August 21, 2015

#ILookLikeASurgeon 101: How to Be an Advocate for Surgical Workforce Diversity

Photo Credit

Marissa Boeck MD, MPH

Like many before and others who persist, I held out on speaking up about workforce gender inequalities. Despite repeated examples in my job as a female general surgery resident, I only paid vague attention to the equity campaigns that appeared in my Twitter feed, had minimal interactions with surgical society outreach programs for female surgical residents, and sporadically read news commentary on continued gender disparities in promotion and pay across industries. Through silence it would appear I was accepting circumstances as they were. I viewed Lean In, its rebuttal, and the #ThisIsWhatWeLookLike campaign from afar. It wasn’t that these issues didn’t resonate with me, but I simply didn’t have the time to participate. Surgical residency, make that a surgical career in general, remains incredibly demanding. This is despite 80-hour workweeks, still the equivalent of two full-time jobs in most fields, and an alleged recognition of the importance of work-life integration. Yet as a general surgery resident, adhering to a regular self-care regimen of sleep and food was challenging enough, without the added task of advocacy.

That is, until now. With research years affording a semblance of normalcy, combined with a Twitter-engaged female surgeon research mentor, I stumbled upon a movement at its inception. But it wasn’t only circumstance that pushed me to join; this somehow seemed different. A simple phrase, #ILookLikeASurgeon, captured a well acknowledged yet all-to-often marginalized inequality, culminating in a voice that was at last loud enough to be heard. Initially built on gender biases in surgery, the hashtag has evolved to represent the lofty aim of dispelling all stereotypes, arguing that physical traits do not equate with intellect, skill, or capability.

Borrowing a phrase from a well-known female surgeon role model Dr. Julie Freischlag, we now need “active transport” to disseminate and implement the #ILookLikeASurgeon principles, which will ideally become the new normal. As indirectly proven by the campaign’s popularity, the historic method of passive recognition is not enough, inadvertently propagating and perhaps even reinforcing the issues. Yet as others have pointed out, self-photographs of surgeons alone are also unlikely to lead to increased surgical leadership diversity, a more accepting work environment, or equality of pay. However, the five words of #ILookLikeASurgeon have hit a nerve, spawning an awe-inspiring global community of passionate individuals who together want to challenge the status quo, and truly alter the culture of surgery for the better.

Here are some ways to become a part of this extraordinary effort:

1. Join your Social Media (SoMe) platform of choice – or why not all of them? -  and post a picture!
Although born on Twitter, #ILookLikeASurgeon has expanded to include Facebook, Instagram, LinkedIn, and undoubtedly other platforms flying beneath the radar. Getting on SoMe is fairly simple:
1.     Sign up for an account (Twitter 101)
2.     Post a picture of yourself doing an activity of your choosing, showcasing that surgeons can and do look like anyone, making sure to use the #ILookLikeASurgeon hashtag. Other complimentary ones include: #ChallengeStereotypes, #DiversityMatters, #CelebrateDiversity, #BeTheChange, #HumanizeTheProfession…or make one yourself!
3.     Consider the judicious use of emoticons for further emphasis and effective use of limited space
4.     Like, retweet, and/or comment on posts from other community and organization members, showing camaraderie, engagement, and interest, which will hopefully encourage future posts
5.    For Twitter specifically, become savvy by following @Support and @TweetSmarter
6.     Start building a virtual community of engaged, passionate individuals, who you’ll likely cross paths with one day #IRL (in real life).
7.     Think about with whom the #ILookLikeASurgeon message will resonate most, and reach out! That’s the great thing about SoMe, former and current U.S. presidents to large organizations and celebrities are just a click, like, comment, or 140 characters away.

2. Encourage others to join the conversation – or as I like to refer to it: #PositivePeerPressure.
There are many within our surgical community who continue to resist the true power of SoMe. If breaking geographical and hierarchal barriers isn’t convincing enough, here are a couple of recent articles to persuade them to hop aboard the #SurgTweeting train:
1.     A recent blog post on KevinMD highlighting the need for SoMe in academic medicine
2.     Twitter 101

3. Share your perspective, experiences, and suggestions for change via a blog, editorial, op-ed, or letter to the editor.
Numerous inspiring, impassioned, genuine pieces have already been written, as many felt compelled to speak out as #ILookLikeASurgeon gained momentum. Yet there are undoubtedly more stories to be told, with words capable of powerfully capturing past and current struggles to inform the most needed future interventions. More importantly, these words have a truly global reach, serving as a missing message of encouragement or hope for those lacking local surgical mentors.

4. Website creation and development
Currently in the development phase, visit ILookLikeASurgeon.org to sign up for site launch notifications. And if you are a tech guru, or even just a little tech savvy, we’d love your help!

5. Participate in events at the various meetings – or organize one yourself!
Planning for #ILookLikeASurgeon activities at the American College of Surgeons Clinical Congress 2015 is currently underway. Given the global response and interest, there’s no reason why #ILookLikeASurgeon events shouldn’t pop up around the world. Post on SoMe to gather local interest, reach out to societies and organizations in your country, and make the virtual tangible with real-life meet-ups. Not only does this create an environment for mentorship and solidarity, but also will generate discussions of local surgical workforce challenges and issues, laying the foundation for relevant, actionable targets for change.

6. Join the growing team behind #ILookLikeASurgeon, which welcomes your input and ideas for development and implementation of next steps
Everyone who posts on a SoMe platform is truly a part of #ILookLikeASurgeon. As the community grows from one to thousands, there is an emerging need for increased member involvement in order to transition from a virtual groundswell to concrete interventions. Please reach out if interested, including with ideas, partnerships or funding suggestions. Individuals from all levels of training are welcome!

“If we could change ourselves, the tendencies in the world would also change. As a man changes his own nature, so does the attitude of the world change towards him...We need not wait to see what others do.” –Mahatma Gandhi

Marissa Boeck MD, MPH @KickAsana

Post-Graduate Fellow in Global Health, 
Northwestern University Feinberg School of Medicine
Arthur Tracy Cabot Fellow, 
Harvard Center for Surgery and Public Health, 
Brigham and Women’s Hospital
General Surgery Resident, 
New York Presbyterian Hospital – Columbia