What impact can social media – facebook, twitter, blogs – have on an issue? I want to consider this question in light of two “twitter days” that I participated in last week. The first is the #BellLetsTalk campaign that was held last Wednesday, January 28. This was the fifth year in a row that Bell has sponsored this event to raise funds for mental health initiatives: http://letstalk.bell.ca/en/ . The second is the twitter activity at an Ontario Medical Association Council meeting on January 31, 2015. Both of these events, it seems to me, promote participation in a public issue and strengthen our democracy.
First, what happened last Wednesday? Like many other mental health professionals, I joined colleagues, institutions, family members and patients in an effort to raise as much money for mental health as I could. We tweeted, retweeted, shared for a period of 24 hours when each interaction was worth a nickel for the campaign. In all there were 122,150,772 interactions and $6,107,538.60 was raised. I spent about four hours on twitter that day, I’m almost embarrassed to admit it. At noon and from 7 to 8 p.m., almost every tweet on my feed was about mental health and carried the #BellLetsTalk hash tag. I retweeted and wrote as many as I could. To my horror, I even retweeted Justin Bieber at one point – but only once.
Apart from the donation from Bell, and the many worthwhile projects it supports, this campaign has raised public awareness of mental illness like few other efforts. This has decreased the stigma surrounding mental health to the point where patients are tweeting openly about their struggles, something that would never have happened five years ago. More importantly, for years people with mental illness were denied participation in politics and #BellLetsTalk has made spokespeople out of those who matter most – patients.
My other big social media event for the week was at the Ontario Medical Association this past weekend. I tweeted throughout parts of the meeting as council members reported on the statements inside the room, via twitter. For the second time in a week, my twitter feed was all about a hash tag, in this case #CareNotCuts. These tweets also served to raise awareness – awareness of the concerns doctors have about the impact on health care the government cuts will have. In these tweets, there is a wealth of information about medical care, patients’ worries and models of medical practice. There is quite a significant concern about young doctors, newly graduated from their residency training, about where they will be able to practice.
In the doctor’s tweets, one can see a need to explain on twitter the economics of medical practice: that doctors don’t make a salary, that most practices are small businesses. Medical Associations are usually advised that their activism should never be about fees, but the message from many individual doctors on twitter betrays their resentment that any desire to earn a reasonable living, given their education and the risk and importance of their work, negates all the good work they do for their patients every day. There is a stigma associated with a doctor talking about fees as there was a stigma about having a mental illness. The stigma is that you’re less worthy as a doctor if you are concerned about your income.
A number of doctors on twitter are opening up a discussion that we, as citizens, need to have. How is your medical care paid for? Why is the cost of medical care not sustainable and what can we do about this? For too long, we have avoided bringing the public – patients – into the discussion. Governments who will not talk about the cost of medical care, or any public service, with the public are as patronizing today as we were with patients with mental illness years ago.
#BellLetsTalk can inform #CareNotCuts by reminding those involved in the decisions that they need to include those whom the decisions affect. They will bring new ideas to an old discussion. Democracy should be inclusive.