With UC Berkeley sociologist Eliza Brown and Colby Fortin, I am running a mixed-methods study of physicians on social media—pairing in-depth interviews with analysis of platform metrics. Physicians have long used media to reach the public, but social media has changed the relationship from a one-way flow of authoritative information into a two-way contest for attention, where doctors compete alongside wellness influencers, health journalists, and misinformation. (Abstract)
Our central finding challenges a foundational assumption in the sociology of trust: that trust in institutions and trust in their affiliated individual professionals reinforce each other. Across interviews with 78 physicians, we find the two are distinct and often in tension. Physicians who use social media to attract patients cultivate personal trust with individual followers; those oriented toward public education build generalized trust in the profession (Supported by IRLE and the Berkeley Economy and Society Initiative).
Potential directions emerging from this data:
The independence–capture paradox — Physicians who break free from employers and insurers don't escape the market; they just trade one master for another. The platform becomes their new boss. This adds to organizational theory on autonomy by showing that independence from one institution is dependence on another.
The expertise penalty — Platforms punish doctors for showing real expertise and reward them for seeming relatable instead—unless they frame their expertise as a stand against institutions. This adds to the theory on professions by showing that platforms upend the credentials that professions normally rank themselves by.
Platform presence as rent, not asset — A doctor's online following isn't something you build once and keep. It's more like rent: stop posting and it slips away. This extends economic sociology by treating professional visibility as an ongoing cost rather than a lasting asset.
The competitor audience — Doctors make content for patients, but the career rewards come from other doctors watching quietly. This adds to the theory on audiences by showing how platforms mix together the separate audiences that professional reputations usually depend on keeping apart.