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Table of Contents
ORIGINAL ARTICLE
Year : 2021  |  Volume : 29  |  Issue : 4  |  Page : 218-224

Social media behavior in plastic surgery practice in Turkey


1 Department of Public Relations and Advertising, Ankara University, Ankara, Turkey
2 Department of Plastic, Reconstructive and Aesthetic Surgery, Gazi University, Ankara, Turkey

Date of Submission09-Feb-2021
Date of Acceptance02-Jul-2021
Date of Web Publication22-Oct-2021

Correspondence Address:
Prof. Deniz Sezgin Emuler
Ankara University Faculty of Communication, Cebeci, Ankara
Turkey
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/tjps.tjps_11_21

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  Abstract 


Background: It's a widely accepted fact that social media platforms have revolutionized the way human beings communicate. Nevertheless, there is little evidence describing how the plastic surgery community has adopted social media. Aims and Objectives: This study aims to identify through objective data the social media activity of the members of Turkish Society of Plastic Reconstructive and Esthetic Surgeons, their purpose and methods of use, and their opinion on the risks and violations in social media. Materials and Methods: An anonymous survey containing 26 questions on the use of social media was distributed to members of Turkish Society of Plastic Reconstructive and Esthetic Surgeons and prevalent patterns of social media implementation were elucidated. Results: 88.9% of respondents were social media users and 56.95% of the users were using social media both for personal and professional posts. Reasons for using social media included the beliefs that they can accurately inform their patients (55,89%), communicate effectively with the patients (48,48%), and that they can raise awareness among patients (47,47%). 28,96% reported that it is an effective tool in promoting and advertising their practice. Most respondents (54,70%) stated that social media had positive effects on their practice, whereas 44,95% percent reported that it had neither a positive nor a negative impact. Conclusions: This study depicts current patterns of social media use by plastic surgeons, including motivations driving its implementation and impressions on its impact. Many feel that social media are an effective marketing tool that generates increased exposure and referrals. A small number of surgeons have experienced negative repercussions from social media involvement. There is a definite oversight to ensure ethical use of social media platforms throughout the plastic surgery community. Continuing discussion regarding these matters should be ongoing as the experience with social media in plastic surgery evolves.

Keywords: Aesthetic surgeon, new media, plastic surgeon, social media


How to cite this article:
Emuler DS, Ayhan MS. Social media behavior in plastic surgery practice in Turkey. Turk J Plast Surg 2021;29:218-24

How to cite this URL:
Emuler DS, Ayhan MS. Social media behavior in plastic surgery practice in Turkey. Turk J Plast Surg [serial online] 2021 [cited 2022 Sep 27];29:218-24. Available from: http://www.turkjplastsurg.org/text.asp?2021/29/4/218/328963




  Introduction Top


Current advances in communication technologies rendered the new and social media an integral part of daily life. Social media platforms (Instagram, Facebook, Twitter, etc.,) allow instant communication with a virtual mass for a potentially infinite period.[1],[2] Social media now contains not only personal posts but also the promotional content of profit and nonprofit organizations and institutions. Such platforms are efficient due to their low costs and speed. Many industries prefer these platforms as target audiences can be filtered to further enhance efficiency.

Health industry is one of the most active industries on social media platforms. The industry and particularly the physicians share clinical studies, medical technologies and developments, and news on professional co-operation as well as an increasing amount of promotional, marketing, and advertising content. Plastic reconstructive and esthetic surgeons, like their colleagues in other disciplines, use social media to contact patients, educate patients/people, attract patients, maintain existing patient relations, enhance their visibility as part of marketing and promotional activities, and share academic content.[3],[4],[5],[6],[7],[8],[9],[10],[11],[12]

This study aims to identify through objective data the social media activity of the members of the Turkish Society of Plastic Reconstructive and Esthetic Surgeons, their purpose and methods of use, and their opinion on the risks and violations on social media.

This study is the first, as of 2019, to demonstrate and analyze the opinions of the members of the Turkish Society of Plastic Reconstructive and Esthetic Surgeons on social media use.


  Methods Top


The questionnaire containing 26 questions, designed to anonymize the names and personal information of members, and the informed consent form were approved by the decision dated December 16, 2019, and numbered 85434274-050.04.04/95388 of the Ethical Committee of Ankara University. The questionnaire was then delivered on a digital platform (www.surveymonkey.com) to the 980 members of the Turkish Society of Plastic Reconstructive and Esthetic Surgeons. Nonmember plastic surgeons were excluded from the research. The online digital questionnaire was sent out on December 16, 2019. Participation was based on volunteering, and a reminder was sent on the 2nd, 4th, 6th and 8th weeks since the first issue. The questionnaire was removed from the platform on February 16, 2020. Logistic regression analysis was conducted on the gathered data on SPSS Statistics Software (IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY, USA), with a statistical significance of P < 0.05. Analysis was run on SPSS 20.0 software at 95% confidence level.

The questionnaire consists of three parts, namely the demographics, preferred social media platforms, purposes and reasons; personal and professional use of social media; and the positive and negative aspects of it.

Findings

Of the 980 members of the Turkish Society of Plastic Reconstructive and Esthetic Surgeons, 37.3% (365) responded to the questionnaire.

The age distribution of participants is striking. Participation is high among the 36–45 age group while it is limited in the group below 30, though conceived as the most active in the new media. Such a low level of participation is believed to be the result of specialty training often lasting until around the age of 30, thus delaying the subsequent membership process. Surgeons with 1–10 years of work experience demonstrated high participation levels. Many of the participants work in larger population cities. However, there are also several surgeons (11.7%) working in locations of 500–750 thousand population [Table 1].
Table 1: Demographics

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Almost half the participating surgeons have their private clinics. Surgeons who have private clinics, but also work at university, public or private hospitals have at most 1–3 other plastic surgeon colleagues. Most of the operations are esthetic surgeries while reconstructive surgery operations are limited [Table 2].
Table 2: Working conditions

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Surgeons were asked about their social media habits in their private life and 88.9% replied that they used social media and 11.1% replied they did not.

There is a significant correlation between professional work duration as a plastic surgeon and social media use in daily life (odds ratio 4.58, P < 0.05). 92.3% of surgeons in professional life for 1–10 years, 94.4% of those working for 11–20 years, and 75% of those professionals for over 20 years use social media platforms.

The most common reason among surgeons for not using social media is that it violates patient confidentiality [Table 3]. Violating patient confidentiality is followed by difficulty in protecting objectivity, immense exposure to negative comments, harming personal relations, and other reasons. There is a significant correlation between these reasons and the professional work duration as a plastic surgeon (P < 0.05). 1.9% of surgeons working for 1–10 years, 0.9% of surgeons working for 11–20 years, and 8.8% of surgeons working for over 20 years expressed that they do not use social media because it is hard to maintain objectivity (odds ratio 1.584). 2.5% of surgeons working for 1–10 years, 8.8% of surgeons working for over 20 years replied that they do not use social media because it is overly exposed to negative comments (odds ratio 2.025). 4.9% of surgeons working for 1–10 years, 1.8% of those working for 11–20 years, and 10% of surgeons working for over 20 years do not use social media because it harms personal relations (odds ratio 1.258). 5.6% of surgeons working for 1–10 years, 2.7% of surgeons working for 11–20 years, and 18.8% of surgeons working for over 20 years do not use social media because it violates patient confidentiality (odds ratio 4.478). Surgeons in professional life for over 20 years have higher ratios in reasons for not using social media.
Table 3: Reasons not to use social media

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Most of the surgeons who use social media (40.98%) hold only one personal account [Table 4] and a majority prefer Instagram (88.78%) [Table 5]. There is a significant correlation between the professional work duration as a Plastic Reconstructive and Esthetic Surgeon and the preference to use Instagram (odds ratio 0.259, P < 0.05). 80.9% of surgeons working for 1–10 years, 83.8% of surgeons working for 11–20 years, 56.3% of surgeons working for over 20 years use Instagram. There is not any significant correlation between the use of other social media accounts and the working duration as a plastic reconstructive and esthetic surgeon.
Table 4: Social media accounts

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Table 5: Preferred social media platform

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Both personal and professional use of social media is prevalent (56.95%) [Table 6].
Table 6: Purpose of social media use

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Among the reasons to use social media, personal/private posts (60.94%), communication with friends/family (57.58%), and providing accurate information to patients (55.89%) are the most common [Table 7]. The majority run their own social media accounts (79.8%). 50.5% is active for less than an hour in a day, 44.1% is active for 1–3 h, and none exceed 3 h a day. 75.1% have a website for their workplace/institution/name, and 60.1% have a social media account connected to that website. The social media platforms connected to professional websites include Instagram (34.8%), Facebook (28.8%), Twitter (7.4%), YouTube (9%), LinkedIn (3.8%), and the others (0.5%).
Table 7: Reasons to use social media

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There is a significant correlation between holding a professional website for workplace/institution/name and term of practice/length of practice as a Plastic Reconstructive and Esthetic Surgeon (odds ratio 0.078, P < 0.05). 59.9% of surgeons working for 1–10 years, 90% of surgeons working for 11–20 years, and 85% of those working for over 20 years have a professional website.

There is a significant correlation between the term of practice as plastic reconstructive and esthetic surgeon and connecting Instagram to a professional website. 33.3% of surgeons working for 1–10 years, 45% of those working for 11–20 years, and 28.8% of surgeons working for over 20 years have Instagram connected to their professional websites (odds ratio 0.758, P > 0.05).

Concerning the correlation between seniority in plastic surgery and the patients choosing surgeons on social media, around 30% of patients choose surgeons on social media. This correlation is 64.7% among surgeons working for 1–10 years, 73.7% among surgeons working for 11–20 years, and 83.3% among those working for over 20 years (odds ratio 4.458, P < 0.05).

There is a significant correlation between the term of practice and opting for social media advertisements on professional websites or social media platforms (odds ratio 0.241; P < 0.05). 15.4% of surgeons working for 1–10 years, 16.2% of surgeons working for 11–20 years, and 1.3% of surgeons working for over 20 years use social media advertisements. Surgeons in professional life for over 20 years hold both higher professional experience and recognition. Combined with their lower social media habits compared to the younger generation, it might be deduced that they rarely resort to social media advertisement.

Concerning the impacts of sharing on social media, two prevalent opinions are that it has a positive impact and that it has neither positive nor negative impact [Table 8].
Table 8: Impacts of sharing on social media

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There is a significant correlation between the term of practice as a plastic surgeon and the several positive impacts of social media, including increased local and regional popularity, enhanced patient communication, new referrals from acquaintances, and low-cost advertisements (P < 0.05) [Table 9]. 43.8% of surgeons who are in practice for < 10 years, 32.4% of surgeons in practice for 11–20 years, and 21.3% of surgeons in practice for over 20 years affirmed that social media enhances local and regional popularity (odds ratio 0.328). 32.7% of surgeons working for 1–10 years, 20.7% of those working for 11–20 years, and 21.3% of surgeons working for over 20 years noted that social media increases communication with patients (odds ratio 0.440). 24.1% of surgeons working for 1–10 years, 13.5% of those working for 11–20 years, and 8.8% of surgeons working for over 20 years affirmed new referrals from acquaintances. Twenty-one percent of surgeons working for 1–10 years, 13.5% of surgeons working for 11–20 years, and 2.5% of those working for over 20 years emphasized low-cost advertisement.
Table 9: Positive impacts of social media

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Concerning the negative comments on social media platforms, 73.43% noted that they did not suffer any such comments while 26.57% affirmed that they were targeted for negative comments. When asked about their responses to negative comments, surgeons responded that they did not react (11.8%), directly replied to commenters to disprove their allegations (8.2%), sued the commenters (2.5%), encouraged patients to comment positively (0.8%), and issued a public statement (0.5%). 66.7% of participants affirmed that their reaction helped decrease the negativity, while 9.1% affirmed their efforts were of no use and 24.2% were not aware of any conclusions.

Perception of social media concerning patient confidentiality [Table 10] included that social media is a secure platform to contact patients without violating patient confidentiality (38.39%), that existing concerns on patient confidentiality does not affect their social media use (8.05%), that concerns on patient confidentiality result in their limited social media use (17.9%), that plastic surgeons' social media use should be supervised based on appropriate ethical guidelines by the Turkish Society of Plastic Reconstructive and Esthetic Surgeons, Turkish Medical Association, the Ministry of Health or other such institution (56.7%), and no particular opinions on the subject (1.1%).
Table 10: Perception of social media concerning patient confidentiality

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About the perception of social media concerning patient confidentiality, there is a significant correlation between the term of practice as a plastic surgeon and the opinion that the social media use of plastic surgeons should be supervised based on appropriate ethical guidelines by the Turkish Society of Plastic Reconstructive and Aesthetic Surgeons, Turkish Medical Association, the Ministry of Health or other such institution (odds ratio 1.259, P < 0.05). 53.1% of surgeons working for 1–10 years, 55% of surgeons working for 11–20 years, and 75% of those working for over 20 years believe that the social media use of plastic surgeons should be supervised based on appropriate ethical guidelines by the Turkish Society of Plastic Reconstructive and Aesthetic Surgeons, Turkish Medical Association, the Ministry of Health or other such institution.


  Discussion Top


Social media posts on esthetic and beauty trends over the recent years altered individuals' perceptions of themselves and their means of popularity. While social media posts changed individual expectations, selfies increased individuals' expectations of themselves and their appearance.[13],[14],[15],[16],[17] The social media posts of Plastic Reconstructive and Aesthetic Surgeons differ substantially from those of other physicians due to the current change in society's body and beauty perception.[4],[6],[18],[19],[20]

The fact that plastic surgeons hold the highest share of posts on social media compared to their colleagues in other medical disciplines is barely surprising, and in fact, natural.[21],[22],[23] The reason is the esthetic and visual components of surgical and nonsurgical esthetic and reconstructive procedures.[24],[25] Target audiences consider social media a reference for the surgeries and interventions they are interested in and decide on their surgeons based on social media as well. As some surgeons combine their personal and professional accounts in one, patients learn more about their surgeons' travels, hobbies, family gatherings, and other components of life. Often, patients seek to know their surgeons and what they can achieve based on social media posts and from another perspective.[5],[26]

Some surgeons underline that social media enhance their marketing skills and can be used to increase patient volume. On the other hand, the pressure from rapid growth in volume forces other colleagues, or competitors, to “retread,” bringing up discussions on how to maintain professionalism in the digital era as well as ethical arguments.[12],[22],[27],[28],[29],[30] Despite all its positive impacts, social media surfaces professional, legal, and ethical difficulties.[1] The most common concerns about the use of social media include professionalism, professional ethics, blurred professional and personal boundaries, and patient confidentiality.

This study analyzed the social media activity of the members of the Turkish Society of Plastic Reconstructive and Esthetic Surgeons, their purpose and methods of social media use. Within this scope, participants admitted to social media use; that they share personal and professional posts mostly on their personal accounts; and that they prefer Instagram the most, followed by Facebook. Besides their personal activities on social media, they also use their accounts professionally to accurately inform/communicate with/raise awareness among patients and to cooperate and compete with colleagues. Surgeons who defend that their social media posts impact their business positively believe that around 30% of their patients choose them due to their social media posts. They noted that social media positively increased their popularity, that they receive positive feedback from patients and that social media contributes to patient communication and information. Surgeons believe that concerning patient confidentiality, the social media use of plastic surgeons should be supervised based on appropriate ethical guidelines by the Turkish Society of Plastic Reconstructive and Esthetic Surgeons, Turkish Medical Association, the Ministry of Health, or other such institutions.

Current legal regulations in Turkey limit physicians' promotional activities on traditional media platforms, while it is yet to reach social media platforms. Although the Ethical Statement by the Turkish Society of Plastic Reconstructive and Esthetic Surgeons include several items on professional behaviors in a wide perspective, such as social media use, patient privacy, promotions, advertising, and relations with the industry; there is not any official guideline drafted or implemented yet in Turkey on the social media activity of doctors nationwide. This study hopes to contribute with its findings to the development of a better-structured supervision and guideline on the social media use of Plastic Reconstructive and Esthetic Surgeons in Turkey. It must be noted that the sporadic visuals and content on social media might negatively impact the careers and reputation of plastic surgeons in Turkey, and therefore, posts should be shared selectively. It is critical that plastic surgeons should share increasing amounts of quality posts to protect their professional reputation. These quality posts will also ensure accurate information and strengthening of society, thus encouraging patients to refer to specialists to receive appropriate treatment.


  Conclusion Top


Social media is an ideal platform for interaction, communication, participation, and marketing. Communicating with patients and colleagues outside of usual environments will clearly contribute immensely in this digital era. On the other hand, medical ethics, health risks, and legal responsibilities should not be ignored as digital platforms expand their reach. Both patients and physicians should be protected through professional guidelines and supervision.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8], [Table 9], [Table 10]


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[Pubmed] | [DOI]



 

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