Twenty Twitter Rules

Herewith, stolen musings betwixt wordsmith and troglodyte. We present one side (the coherent one) of a tête-à-tête between Gregory Miller, MD and Matt/Mike Dawson, recorded sometime between sudoku-smackdown and coffee-time…

…I applaud you for taking on the huge field of Social Media. Blogs are easy to figure out. Most people don’t want to start a blog or write an ebook. What I think is lacking (or at least *I* haven’t seen it) is “How to use Twitter to improve your medical practice.

I agree that Twitter is extremely useful in medicine as the speed-dating version of blogs. It has the advantage of being easily digested because of the limitation on text, but it is also extremely ephemeral.

I hope my experience as a recent-adopter ‘presenting the novice perspective’ might be of use to you. These are the Twenty Twitter suggestions I make to new users, or at least what I would do if I had to start over, or wish I had known at the time:

1. You can be an information consumer, broadcaster, or both.

2. It is ok to vary between the two at various roles.

3. Start as a consumer.

4. Don’t worry about followers. Some people will ‘follow, unfollow’ and may ‘refollow’…but don’t get upset if they don’t.

5. Followers ultimately *stay* for quality, which is the percentage interesting content. Don’t rush it with too much crap.

6. Consider setting up a separate Twitter account just for medical tweets. (Excess ratio of ‘sup/nuthin’ tweets => mute or unfollow)

7. You will find feeds that interest you, and your list of interesting ‘broadcasters’ to follow will grow from the posts themselves or Twitter’s recommendations.

8. Observe what works and doesn’t work. Self-contained original posts are solid gold. Conversations can be good, but are more difficult to follow.

9. After starting as a consumer, progress to proto-broadcaster by favoriting and retweeting. (I still haven’t figured out what is favorite-worthy vs retweet-worthy.)

10. When broadcasting, content rules. Don’t screw things up too early. Reward the people who are giving you a chance by following you.

11. Consider your audience. Hello! Your tweets are for your followers. For example, I am 70% about ultrasound, 15% anesthesia, 15% ICU, 5% remedial math, and 10% other. That fortunately reflects my followers, so I try limit my tweets to those first 3 subjects, even if I have a hilarious line that Louis CK would shave his beard to see. Or unless I want to ask my homies ‘sup.

12. View retweets as borrowed content, but your content. Does it pass the test of what would interest your followers? Good stuff deserves to be acknowledged. Great stuff deserves to be spread around.

13. While some tweets are 140 characters of medical brilliance, a more common useful contribution directs people to blogs, articles, tweets, or other examples of other people’s brilliance.

14. Not everything has to be original, but it should add value for followers. For example, if you are mentioning an article, it’s nice to a) include the bitly link and b) add the gist. Too many articles are “Inter-user variability in ultrasound assessment of gastric volume“. Well? Better is a bitly link with “U/S assess of gastric vol highly reproducible & reliable” with Twitter handles of authors included. Especially if you have read the article.

15. Work on brevity. It’s hard. (Proudly, this email is evidence of the great strides I’ve made.) Don’t make each tweet an hours-long process, but when starting out, reread it to see if the abbreviations or structure will make sense to the person seeing it cold.

16. Own your expertise, but play nice. View Twitter as a chance to share your experience with others who might find it valuable, while remembering that there is often several valid viewpoints and/or you may be wrong.

17. Pay it back. Give new contacts a chance by following back.

18. Respect your rules for mute or unfollow. If someone is really good, and they start off wrong, they’ll eventually show back up in conversations. People learn, but if they’ve been doing it a loooong time, it’s probably what they’ll always do (because it must be working on some level.)

19. Don’t follow the above suggestions too literally. I may have problems with that as evidenced by the compulsion to draft a 20-point list.

20. Don’t write 20-point emails to a famous internet personality on how to use a medium in social media known first and foremost for brevity.

…Oh yeah, almost forgot #21 – thank those who helped you along the way

BA MA (Oxon) MBChB (Edin) FACEM FFSEM. Emergency physician, Sir Charles Gairdner Hospital.  Passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | Twitter |

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